Robotic-Assisted Systems in Minimally Invasive Neurosurgical Techniques: A Review

Abstract

Over the last decade, the integration of robotic-assisted systems into minimally invasive neurosurgery (MIN) has significantly transformed the field of neurosurgical care. Previously constrained by the anatomical complexity, limited visibility, and surgical fatigue, but nowadays, neurosurgical care has become safer, more precise, and reproducible by the synergy of robotics, artificial intelligence (AI), and image-guided technologies. This review offers in-depth technologies in progress, clinical adoption, and future innovations in robotic-assisted neurosurgery from 2015 to 2025. It outlines the innovation from basic stereotactic frames to sophisticated robotic platforms like ROSA®, NeuroMate®, Excelsius GPS®, and Mazor X™, emphasizing their role in procedures such as deep brain stimulation, stereotactic biopsies, spinal instrumentation, and stereo-electroencephalography-guided epilepsy surgery. These technologies have led to notable advancements, including enhanced surgical precision, reduced intraoperative bleeding, decreased operating time, and fewer postoperative complications. Currently, the integration development of AI-driven technology supports the augmented and virtual reality, improved haptic interfaces, and magnetically controlled microrobots, which have broadened the capabilities of robotic neurosurgery. By synthesizing a decade of innovation, this review not only underscores the transformative potential of robotic-assisted neurosurgery but also provides a forward-looking roadmap for clinicians, researchers, and developers working at the intersection of neurosurgery, robotics, and intelligent systems. Robotic-assisted neurosurgery stands at the cusp of a new era, shifting from assistive technology to intelligent surgical partnership. Future trajectories point toward semi-autonomous surgical execution, real-time intraoperative diagnostics, and brain–computer interface procedures within AI-enabled smart operating rooms. This review provides an indispensable foundation for guiding innovation, clinical adoption, and policy frameworks in the next generation of neurosurgical robotics.