Neurosurgery is by excellence a field of application for robots, based on multimodal image guidance. Specific motorized tools have been already developed and routinely applied in stereotaxy to position a probe holder or in conventional neurosurgery to hold a microscope oriented towards a given target. The potentialities of these approaches have triggered industrial developments currently commercially available. These systems use data bases, primarily coming from multimodal numerical images from X-ray radiology to magnetic resonance imaging. These spatially encoded data are transferred through digital networks to workstations where images can be processed and surgical procedures are preplanned, then transferred to the robotic systems to which they are connected. We have been using a stereotactic robot since 1989 and a microscope robot since 1995 in various surgical routine procedures. The future of these applications mainly rely on the technical progress in informatics, about image recognition to adapt the preplanning to the actual surgical situation, to correct brain shifts for instance, about image fusion, integrated knowledge such such as brain atlases, as well as virtual reality. The future developments, covering surgical procedure, research and teaching, will sure be far beyond our wildest expectations.

Neurosurgery is by excellence afield of application for robots, based on multimodal image guidance Specific motorized tools have been already developped and routinely applied in stereotaxy to position ii probe holder or in conventional neurosurgery to hold a microscope oriented towards a given target. The potentialities of these approaches have triggered industrial developments currently commercially available These systems use data bases, primarily, coming from multimodal numerical images from X-ray radiology to magnetic resonance imaging. These spatially encoded data are transfered through digital networks to workstations where images can be processed and surgical procedures are preplanned then transferred to the robotic systems to which they are connected. We have been using a stereotactic robot since 1989 and a microscope robot since 1995 in various surgical routine procedures The future of these applications mainly rely on the technical progress in informatics, about image recognition to adapt the preplanning to the actual surgical situation to correct brain shifts for instance about image fusion, integrated knowledge such such as brain atlases, as well as virtual reality. The future developments, covering surgical procedure, research and teaching, will sure be far beyond our wildest expectations.

A 6-axis stereotactic robot has been designed and linked to a stereotactic frame for routine use. Robot software allows the positioning of a probe holder in order to reach a given target. A calibration step enables the robot to compute the position of the x-ray beam and correct its final position to avoid parallax errors. The co-ordinates of the target are presently taken from anteroposterior and lateral X-rays using a digitizing table. Connection with a digitized angiography system is in progress and will allow direct sampling of numerical data from the x-ray data. Further steps will include connections with a 3D-reconstructed image from MRI and CAT as well as with a resident computerized atlas. Present experience after 14 months of daily practice represents 140 stereotactic procedures which can be extended to any special use, including endoscopic approaches.