Hydrocephalus Surgery 2.0: A Systematic Review of the Robotic Effectiveness in Neurosurgical Interventions

Background: Hydrocephalus is a neurological condition characterizing the accumulation of cerebrospinal fluid in the ventricles of the brain, causing an increased intracranial pressure that may injure the neurological tissue. Traditional surgical treatment, with ventriculoperitoneal (VP) shunt and endoscopic third ventriculostomy (ETV), may lead to complications such as shunt obstruction and inaccurate catheter placement. Robotics-assisted (RA) surgery is promising for enhanced precision with improved outcomes. The objective of this systematic review is to assess the clinical effectiveness, complications, and benefits of robotic-assisted surgical interventions in the case of hydrocephalus. Methods: PRISMA-guided literature search was done in databases including PubMed, Web of Science, Cochrane Reviews, Scopus, and Embase. Inclusion criteria encompassed English language, original, peer-reviewed journal articles in robotic-assisted surgical interventions in hydrocephalus. Patient demographics, robotic systems used, procedural results, and complication details were extracted. Results: In total, 12 of the articles discussed robotic-assisted interventions for hydrocephalus. The robotic systems used included ROSA, NaoTrac, Remebot, and more. The findings established that the robotic systems are very accurate. Almost all the studies showed successful outcomes with minimum robot-related complications like minor bleeding or conversion to manual surgery. As researchers get more experience, robotic systems are improving surgical efficiency and precision after the learning curve. Conclusions: Robotic assistance in hydrocephalus offers potential for advancement in achieving surgical precision and, thereby, reducing complications associated with conventional methods. Their high costs act as a limitation; however, their potential to enhance patient outcomes makes robotic systems an integral asset to neurosurgery practice. Future research should focus on large scale trials, long term outcomes, and cost-effectiveness analysis to optimize the integration of robotic systems in hydrocephalus management.