The deluge of hypersensitive structures spread around the human head make drilling into the skull a risky undertaking. Be it fear of striking nerves, major veins or arteries, doctors performing cranial surgery must take great care over many hours. A new drilling robot built at the Eindhoven University of Technology (TU/e) could help lighten the load, cutting down operation and recovery times while making the process safer and potentially cheaper.

In essence, the new robot is a CNC milling machine that has been equipped with a surgical drill and seven axes of motion, allowing it to attack the problem from different angles. But the developers say the robot's flexibility doesn't compromise its precision, which is maintained at a sub-millimeter level by its stiffness, low weight and low amount of reverberation.

Dubbed the RoBoSculpt, the machine is guided by a set of programmed instructions from the surgeon and CT scans of the patient's skull, which have been precisely marked with the sections of bone destined for removal. The head is then held in position and the robot automatically mills a cavity of the desired shape and dimensions.

Although the robot's designer, TU/e PhD candidate Jordan Bos, has only carried out technical tests so far, he and the team say the machine has the capacity to work faster and more accurately than humans, which means shorter recovery times and a lower chance of complications.

But rather than taking the reins entirely, the team says RoBoSculpt will start out by lending surgeons a helping hand. At first it could handle the preparatory work for a cranial operation, with humans still handling the critical part as they get used to working safely with the robot. The researchers are planning the first pre-clinical tests for later in the year, and then expect the robot to finally perform its first surgery within five years.

"This is an important step towards the operating room of the future," says skull base surgeon at Radboud University Medical Center Dirk Kunst, who acted as co-supervisor for Bos. "RoBoSculpt is an optimal collaboration between the surgeon and the machine; they really complement each other to achieve the best results for the patient."

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