{
  "abstract": "Background Robotic neurointerventions have demonstrated promising initial clinical results. Claims of enhanced precision during robotic navigation have been reported, but objective quantification of such precision is limited. Precision during intracranial navigation and device deployment is crucial in neurovascular interventions, and lack of precision can lead to intraprocedural complications. This study compared quantitative metrics of precision in manual and robotic procedures using a virtual simulator.Methods Using three different simulated aneurysm procedures with different levels of difficulty (easy, medium, and hard), 12 operators with different levels of experience were assigned a defined task for each case. Each procedure was performed both manually and under robotic assistance. Precision was assessed using the length of translations and the total degree of rotations of the microwire and microcatheter needed to complete the assigned tasks, as well as recorded safety metrics. Results were compared between the manual and robotic groups.Results We analyzed 78 procedures (robotic, n=34; manual, n=34) performed by 12 operators with various levels of neurointerventional surgical experience (high, n=5; low, n=7). For the difficult case, operators used significantly less microwire translations when operating with robotic assistance (38.7 cm vs 108.4 cm, P=0.023). There were no significant differences for the easy and medium cases. Safety metrics and procedural times were not significant different.Conclusions Operators demonstrated increased precision during microwire navigation when using robotic assistance to navigate a difficult aneurysm in a controlled simulated experimental set-up compared with manual navigation.",
  "authors": [
    {
      "affiliations": [
        "Interventional Neuroradiology Department, CHU de Besançon, Besançon, France",
        "UMR INSERM 1322 LINC, Université Marie et Louis Pasteur, Besançon, France",
        "RADIS Lab, Li Ka-shing Knowledge Institute, Toronto, Ontario, Canada"
      ],
      "name": "Guillaume Charbonnier"
    },
    {
      "affiliations": [
        "RADIS Lab, Li Ka-shing Knowledge Institute, Toronto, Ontario, Canada",
        "Department of Neurosurgery, St Michael’s Hospital, Toronto, Ontario, Canada"
      ],
      "name": "Nicole M Cancelliere"
    },
    {
      "affiliations": [
        "RADIS Lab, Li Ka-shing Knowledge Institute, Toronto, Ontario, Canada",
        "Hopital Foch, Suresnes, France"
      ],
      "name": "Arturo Consoli"
    },
    {
      "affiliations": [
        "RADIS Lab, Li Ka-shing Knowledge Institute, Toronto, Ontario, Canada",
        "Department of Neurosurgery, Juntendo University, Bunkyo, Japan"
      ],
      "name": "Hidehisa Nishi"
    },
    {
      "affiliations": [
        "RADIS Lab, Li Ka-shing Knowledge Institute, Toronto, Ontario, Canada",
        "Neuroradiology, University Hospital of Tours, Tours, France"
      ],
      "name": "Kevin Janot"
    },
    {
      "affiliations": [
        "RADIS Lab, Li Ka-shing Knowledge Institute, Toronto, Ontario, Canada",
        "Department of Medical Imaging, University of Toronto and Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada"
      ],
      "name": "Ze’ev Itsekson Hayosh"
    },
    {
      "affiliations": [
        "RADIS Lab, Li Ka-shing Knowledge Institute, Toronto, Ontario, Canada",
        "Department of Radiology, Interventional Neuroradiology Service, Centre Hospitalier de l’Université de Montréal, Montreal, Ontario, Canada"
      ],
      "name": "Ange Diouf"
    },
    {
      "affiliations": [
        "RADIS Lab, Li Ka-shing Knowledge Institute, Toronto, Ontario, Canada",
        "Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Toronto, Ontario, Canada"
      ],
      "name": "Aruma Jiménez-O’Shanahan"
    },
    {
      "affiliations": [
        "RADIS Lab, Li Ka-shing Knowledge Institute, Toronto, Ontario, Canada",
        "Division of Neurosurgery, Neuro MSK Program, Trillium Health Partners, Mississauga, Ontario, Canada"
      ],
      "name": "Zamir Merali"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, St Michael’s Hospital, Toronto, Ontario, Canada"
      ],
      "name": "Thomas R Marotta"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, St Michael’s Hospital, Toronto, Ontario, Canada"
      ],
      "name": "Julian Spears"
    },
    {
      "affiliations": [
        "RADIS Lab, Li Ka-shing Knowledge Institute, Toronto, Ontario, Canada",
        "Department of Neurosurgery, St Michael’s Hospital, Toronto, Ontario, Canada"
      ],
      "name": "Vitor M Pereira"
    }
  ],
  "title": "Human versus machine: are neurointerventionists more precise in manual or robotically assisted procedures?",
  "uid": "bb32c3bd-a66d-5bff-9c4e-2a353c908f3f"
}