Robot-assisted neurosurgery Delivering precision to stereotactic neurosurgical procedures www.renishaw.com/neuro

apply innovation Precision, versatility and productivity 5 Precise and repeatable surgical localisation 6 Allowing you to focus on patient care 7 Physiological and image-guided procedures 8 Compatible with a range of imaging technologies 9 Procedure: implantation of depth electrodes for epilepsy monitoring 10 Procedure: deep brain stimulation 11 Responsive service & support - wherever you are 13

Robot-assisted neurosurgery Precision in everything The neuro | mate® surgical robot provides a platform solution for a broad range of stereotactic neurosurgical procedures. neuro | mate® has been used in thousands of electrode implantation procedures for deep brain stimulation (DBS), stereo electroencephalography (SEEG) and biopsy. neuro | mate® provides consistent, rapid, precise targeting and reduces clinical complication rates in stereotactic procedures3/5. neuro | mate® can be used with a stereotactic frame, or in frameless mode for reduced patient trauma. It is also compatible with procedures...

Precision, versatility and productivity A new platform for functional neurosurgery Renishaw is applying cutting-edge precision engineering technology to the challenges of functional neurosurgery. We are helping leading clinicians to enhance the safety and costeffectiveness of their procedures, improving patient outcomes through consistently accurate delivery of implantable devices3/4/5. The neuro | mate® surgical robot is a central element of this strategy. It provides a flexible yet highly repeatable platform for precision functional neurosurgery. It can integrate neatly with your established...

Precise and repeatable surgical localisation Improving patient outcomes and safety In functional neurosurgery, when targeting structures such as specific nuclei of the basal ganglia, thalamus or midbrain, precision is vital. To achieve a consistent, safe and efficacious therapeutic outcome, you have to be sure that any errors in positioning of implantable devices and neurosurgical instruments are minimised. “The integration of a tailored computerized environment, CT and MRI imaging and the stereotactic robot developed by the neurosurgical and scientific teams in Grenoble has simplified many procedures...

Allowing you to focus on patient care apply innova,ion Using a neuro | mate® means there is more opportunity to concentrate on the clinical aspects of procedures, neuro | mate® provides a stable platform to support the safe use of a number of tools. This may either reduce the dependence upon the use of two surgeons or ensure that both are fully focused on the procedure With its VoXim® software and integrated surgical planning system neuro | mate® is a compelling solution for accuracy, consistency and efficiency - benefitting both you and your patients.

Frameless operations Physiological and image-guided procedures Free yourself from your stereotactic frame Physiological targeting Whilst stereotactic frames provide excellent localisation and multiple fiducials that act as references for instrument positioning, they place a significant burden on the patient that cannot be tolerated for long periods. This necessarily compresses the period between imaging and operating, reducing the time that is available for surgical planning. The neuro | mate® system operating in frameless mode is at least as accurate as a stereotactic frame alone1/2. This enables...

Compatible with a range of imaging technologies Pre- and peri-operative imaging The neuro | mate® surgical robot is able to operate with your current preand peri-operative CT or MRI imaging methods. Its VoXim®* planning software can accept tomography data from any source that conforms to the DICOM standard. After planning of the stereotactic approach, the software calculates both the surgical trajectory(s) and the neuro | mate® control parameters. Intra-operative imaging neuro | mate® also integrates with intra-operative imaging. For instance, the robot can be adapted to suit Medtronic’s O-arm®**...

Procedure: implantation of depth electrodes for epilepsy monitoring Pre-surgical assessment of epilepsy in a fraction of the time Millions of patients worldwide, many of them children, suffer from epilepsy, a third of which are refractory to drug treatment14. In many such cases, invasive brain surgery is indicated to identify regions of the brain in which the epilepsy originates. The conventional method involves implanting a subdural electrocorticography grids or strips, but is limited to accessible cortex areas and can exhibit high complication rates15. By contrast, stereo-electroencephalography...

Procedure: deep brain stimulation Transformative therapies Deep brain stimulation (DBS) can provide remarkable therapeutic benefits for otherwise treatment-resistant movement and affective disorders such as chronic pain, Parkinson’s disease, essential tremor, dystonia, obsessive-compulsive disorder, and major depression. It is a technique that relies on precise placement of electrodes, targeting structures deep within the brain. Reduction in the risk of human error combined with a very stable, rigid platform makes neuro | mate® ideal for DBS lead delivery. It is here that a surgical robot once...

Procedure: biopsy Rapid & safe tumour diagnosis Progress in medical imaging and treatment modalities for brain tumours are driving a re-evaluation of the role of stereotactic biopsies. Their appeal derives from their reliability and innocuousness, enabling a confident diagnostic, without clinical aggravation or delay in treatment. From this, a suitable, often multi-modal therapeutic approach can be developed. “The frameless registration system frees up surgical space and expands possible trajectories whatever the head orientation. This considerable increase in working space provides a huge advantage,...