Systems, devices, and methods for minimally invasive brain surgery

Abstract

A brain surgery system has a robotic arm for guiding insertion of a retractor into the brain of a subject. The system includes an imaging system having a radiation source and a detector adapted to output imaging data based on the measured radiation. The system further includes a computer system having a processor and a memory. The mechanical arm is installed on the imaging system and controlled through software. An end effector is attached to the robotic arm and adapted to retain the retractor. The end effector includes a linear slide having a fixed portion adapted to be attached to the robotic arm and a movable portion. The linear slide is adapted to move the retractor in a length direction of the retractor to insert the retractor into the brain of the subject. The end effector further includes a bracket attached to the linear slide and adapted to retain the retractor.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims priority to U.S. Provisional Patent Application No. 63 / 482,231, filed on January 30, 2023, the contents of which are incorporated herein by reference. Technical Field

[0003] The present disclosure relates to systems, devices, and methods for minimally invasive brain surgery, and in particular to brain surgery in which a surgeon is guided by a surgical navigation system using robotics and imaging. Background Art

[0004] For brain surgeries involving hemorrhagic stroke or tumor removal, a device called a brain retractor is often used. This device consists of an outer vial with two open ends and an inner trocar. Correct placement of the retractor is crucial. Summary of the Invention

[0005] In one aspect, the disclosed embodiments provide a brain surgery system having a robotic arm for guiding the insertion of a vial into a subject's brain. The system includes an imaging system comprising a radiation source and a detector adapted to measure radiation emitted by the radiation source, the detector further adapted to output imaging data based on the measured radiation. The system further includes a computer system having at least one processor and memory, and a robotic arm mounted on the imaging system and controlled by software running on the at least one processor. The system further includes an end effector attached to the robotic arm and adapted to hold a retractor. The end effector includes a linear slide having a fixed portion and a movable portion, the fixed portion adapted to be attached to the robotic arm, the linear slide adapted to move the retractor along its length to insert the retractor into the subject's brain. The end effector further includes a bracket attached to the linear slide and adapted to hold the retractor.

[0006] Embodiments may include one or more of the following features, alone or in any feasible combination.

[0007] The imaging system may be a computed tomography (CT) imaging system. The radiation source may be adapted to emit X-rays. The computer system may be implemented as part of the imaging system. The computer system may be external to the imaging system and may communicate with the imaging system via a direct connection and / or a network. The imaging data may be in Digital Imaging and Communications in Medicine (DICOM) format. The computer system may be adapted to receive the imaging data, determine an insertion position and orientation, and control a robotic arm to move the end effector to the insertion position and orientation. The robotic arm may be adapted to position and orient the end effector in at least five degrees of freedom.

[0008] The linear slide may include a sensor to measure movement of the movable portion relative to the fixed portion. The end effector may include a knob that is rotatable to move the movable portion relative to the fixed portion. The knob may be rotatable manually or via a motor. The knob may be rotatable manually and via a motor. The end effector may include a lock adapted to secure the position of the movable portion relative to the fixed portion. The lock may include a second knob that is rotatable to secure the position of the movable portion relative to the fixed portion. The fixed portion of the linear slide may include at least one rail, and the movable portion of the linear slide may include a rod connected to the at least one rail and adapted to move along the at least one rail. The rod may be a substantially flat plate positioned between the at least one rail and the second rail. The rod may include two guides attached to its underside, the guides extending along the length of the rod and positioned to engage with the at least one rail and the second rail, respectively.

[0009] The bracket may be located distally from the movable portion of the linear slide and may extend in a direction substantially perpendicular to the length of the movable portion of the linear slide. The bracket may include an elongated portion and a clamping portion adapted to hold the retractor in place. The clamping portion may include two opposing portions that together form a portion of a circle. The bracket may further include a base attached to the linear slide, the base having a receptacle adapted to receive the elongated portion of the bracket and lock the elongated portion in place.

[0010] The retractor may include a vial with a trocar positioned inside the vial, the retractor being adapted to be inserted into a brain of a subject. The retractor may be adapted to enable the trocar to be removed from the retractor while retaining the vial in place in the brain of the subject. The trocar may include a tapered tip at its distal end, the tapered tip adapted to be inserted into the brain of the subject. The trocar may include a base at its proximal end, the base adapted to connect to a corresponding base of the vial. The base of the trocar and the base of the vial may cooperate to prevent the trocar and the vial from separating when the retractor is inserted into and / or removed from the brain of the subject.

[0011] The computer system can be adapted to execute software on at least one processor to: display imaging data on a display to provide one or more images of a subject's brain; receive user input specifying a target location within a selected image of the one or more images of the subject's brain; and receive user input specifying an insertion point for a retractor. The computer system can be further adapted to execute software on at least one processor to: determine an insertion position and an insertion orientation based at least in part on the specified insertion point and the specified target location; and control a robotic arm to move an end effector attached to the robotic arm and holding the retractor to the insertion position and insertion orientation. The system can further include a controller having a processor and configured to control the robotic arm based on communication with the software executing on the at least one processor.

[0012] In another aspect, disclosed embodiments provide an end effector adapted to be attached to a robotic arm and adapted to hold a retractor, the retractor comprising a vial, wherein a trocar is positioned within the vial, the retractor being adapted to be inserted into a subject's brain. The end effector includes a linear slide having a fixed portion and a movable portion, the fixed portion being adapted to be attached to the robotic arm, the linear slide being adapted to move the retractor lengthwise to insert the retractor into the subject's brain. The end effector further includes a bracket attached to the linear slide and adapted to support the retractor.

[0013] Embodiments may include one or more of the following features, alone or in any feasible combination.

[0014] The linear slide may include a sensor to measure movement of the movable portion relative to the fixed portion. The end effector may include a knob that is rotatable to move the movable portion relative to the fixed portion. The knob may be rotatable manually or via a motor. The knob may be rotatable manually and via a motor. The end effector may include a lock adapted to secure the position of the movable portion relative to the fixed portion. The lock may include a second knob that is rotatable to secure the position of the movable portion relative to the fixed portion.

[0015] The fixed portion of the linear slide may include at least one track, and the movable portion of the linear slide may include a rod connected to the at least one track and adapted to move along the at least one track. The rod may be a substantially flat plate positioned between the at least one track and the second track. The rod may include two guides attached to its underside, the guides extending in a lengthwise direction of the rod and positioned to engage the at least one track and the second track, respectively. The bracket may be located distally from the movable portion of the linear slide and may extend in a direction substantially perpendicular to the lengthwise direction of the movable portion of the linear slide. The bracket may include an elongated portion and a clamping portion adapted to hold the retractor in place. The clamping portion may include two opposing portions that together form a portion of a circle. The bracket may further include a base attached to the linear slide, the base having a receptacle for receiving the elongated portion of the bracket and locking it in place.

[0016] In another aspect, disclosed embodiments provide a method for guiding insertion of a retractor into the brain using a brain surgical system. The brain surgical system includes a robotic arm, an imaging system, and a computer system having at least one processor and memory. The imaging system includes a radiation source and a detector, the detector adapted to measure radiation emitted by the radiation source, the detector further adapted to output imaging data based on the measured radiation. The method comprises receiving, by the detector, radiation emitted by the radiation source, including radiation that has passed through a subject's brain located between the radiation source and the detector. The method further comprises receiving, by the processor, imaging data output by the detector based on receipt of the emitted radiation. The method further comprises displaying the imaging data on a display to provide one or more images of the subject's brain. The method further comprises receiving user input specifying a target location within a selected one of the one or more images of the subject's brain. The method further comprises receiving user input specifying an insertion point for the retractor. The method further comprises determining an insertion position and an insertion direction based at least in part on the specified insertion point and the specified target location. The method further comprises controlling the robotic arm to move an end effector, attached to the robotic arm and holding the retractor, to the insertion position and insertion direction. The method further includes moving the retractor in a lengthwise direction of the retractor using the linear slide to insert the retractor into the brain of the subject.

[0017] Embodiments may include one or more of the following features, alone or in any feasible combination.

[0018] When the end effector can be in the insertion position, the determination of the insertion position and insertion direction can result in: (i) the insertion direction being aligned with an axis passing through the target position and the insertion point; and (ii) the retractor being spaced apart from the insertion point in an outward direction along the axis passing through the target position and the insertion point. The method can further include removing the trocar from the retractor while leaving the vial in an appropriate position in the subject's brain. The method can further include inserting one or more surgical tools into the vial to perform a surgical procedure in the subject's brain. The surgical tools can include an aspirator or an endoscope. The one or more images of the subject's brain can represent one or more calculated cross-sections of the subject's brain. User input specifying the target position can be received via a graphical user interface displayed on a display. User input specifying the target position can be received via user input of position coordinates. BRIEF DESCRIPTION OF THE DRAWINGS

[0019] Figure 1A Depicted is a brain surgery system having a robotic arm for guiding insertion of a retractor into a subject's brain in accordance with disclosed embodiments.

[0020] Figure 1B Depicted are components of a retractor according to disclosed embodiments, including a vial and a trocar positioned within the vial to form an assembled retractor.

[0021] Figure 1C A retractor inserted into the brain of a subject is depicted according to disclosed embodiments.

[0022] Figure 1D Depicted are imaging of a subject's brain and determined navigation geometry of an end effector according to disclosed embodiments.

[0023] Figure 2 is a block diagram of a brain surgery system according to the disclosed embodiments.

[0024] Figure 3 An end effector according to the disclosed embodiments is depicted, the end effector comprising a linear slide adapted for attachment to a robotic arm.

[0025] Figure 4 Depicted is the underside of a linear slide of an end effector according to disclosed embodiments.

[0026] Figure 5A and Figure 5B Depicted is a bracket attached to a linear slide of an end effector and adapted to hold a retractor in accordance with disclosed embodiments.

[0027] Figure 6A retractor according to disclosed embodiments is depicted and can include a vial with a trocar positioned inside the vial, the retractor being suitable for insertion into the brain of a subject.

[0028] Figure 7 is a flow chart of a method for guiding insertion of a retractor into a subject's brain using a brain surgery system having a robotic arm and an imaging system in accordance with the disclosed embodiments.

[0029] Where considered appropriate, reference numerals may be repeated among the figures to indicate corresponding or analogous elements. Additionally, some of the blocks depicted in the figures may be combined into a single functionality. DETAILED DESCRIPTION

[0030] In the following detailed description, numerous specific details are set forth in order to provide a thorough understanding of the embodiments of the present invention. However, one of ordinary skill in the art will appreciate that the embodiments of the present invention may be practiced without these specific details. In other instances, well-known methods, procedures, components, and circuits have not been described in detail in order to avoid obscuring the present invention. Figure 1A A brain surgery system 100 is depicted having a robotic arm 110 for guiding the insertion of a retractor 150 into a subject's brain 105. As discussed in further detail below, the system 100 enables surgeons to perform minimally invasive brain surgery by providing navigation systems, imaging, and specialized robotics, including specialized end effectors, for surgical applications such as intracerebral hemorrhagic stroke and tumor resection. The system 100 can be used for endoscopic brain tumor surgery (neuroendoscopic surgery), which is a minimally invasive procedure in which a tumor can be removed through an opening in the skull. Overall, neuroendoscopic surgery results in less pain and scarring, and faster recovery, compared to traditional surgery. Types of brain tumors that can be treated using neuroendoscopic surgery include, for example, pineal region tumors, pituitary tumors, Rathke's cleft cysts, skull base tumors, and intraventricular tumors.

[0031] Brain surgery system 100 includes an imaging system 120. In an embodiment, imaging system 120 may be, for example, a computed tomography (CT) imaging system having a radiation source 122, such as an X-ray source, and a detector 125 adapted to measure radiation emitted by radiation source 122. Detector 125 is adapted to output imaging data based on the measured radiation. In certain embodiments, the imaging data may be in Digital Imaging and Communications in Medicine (DICOM) format.

[0032] Figure 1B Depicted are components of a retractor 150, including a vial 510 and a trocar 520 to be positioned within the vial to form an assembled retractor (see also FIG. Figure 6The tubular retractor essentially moves the folds and delicate tissue of the brain aside, with less risk of injury than other surgical methods—that is, it moves tissue rather than cuts it. This can be particularly useful in cases where the tumor is located deep within the brain. It also offers a less invasive alternative to traditional open surgery (i.e., craniotomy).

[0033] Figure 1C The vial 510 is depicted in an operative position after the retractor 150 has been inserted into the subject's brain 105 and subsequently removed. In this position, the vial 510 enables a surgeon to access the subject's brain 105 through the interior of the vial 510, such as with a surgical tool, to minimize interference, navigate, and penetrate the subcortical space through the sulci. In general, the retractor 150 displaces tissue of the subject's brain 105 rather than destroying it. Other advantages include that the system 100 enables the surgeon to accurately place the vial 510 in the subject's brain 105 to minimize potential damage to the gray and white matter of the subject's brain 105.

[0034] Figure 2 is a block diagram of a brain surgery system 100. As described above, the system 100 includes an imaging system 120 and a computer system 130 having at least one processor 135, a memory 137, and a display / user interface 139. In embodiments, the computer system 130 may be housed within the imaging system 120 or otherwise implemented as part of the imaging system 120. In certain embodiments, the computer system 130 may be a separate component or components, such as a standalone computer and computer display, that are in electronic communication with the imaging system 120, for example, via a direct connection and / or a network.

[0035] Refer again Figure 1A In an embodiment, the robotic arm 110 is mounted on the imaging system 120 and is controlled by navigation software running on the computer system 130 (see Figure 2 ). For example, the robotic arm 110 can be a six-degree-of-freedom robotic arm. In embodiments, the robotic arm 110 can be part of a collaborative robotic system designed to be used without requiring protective measures by users (e.g., surgeons and their assistants). The end effector 140 is adapted to be attached to the robotic arm 110, such as at the distal end of the robotic arm 110, and is adapted to hold the retractor 150. In embodiments, the system 100 can include a robotic controller 112 having a processor and configured to control the robotic arm 110 based on communication with software executed by at least one processor 135 of the computer system 130.

[0036] Figure 1DDepicted are imaging of the subject's brain 105 and the determined navigation geometry of the end effector 140, for example, as presented by the display / user interface 139 of the computer system 130. In certain embodiments, the navigation software is adapted, i.e., designed, to receive and process the imaging data to determine an insertion position and orientation of the end effector 140. The navigation software also controls the robotic arm 110 to move the end effector 140 to the insertion position and orientation.

[0037] In certain embodiments, there may be three relevant points for defining the insertion location and insertion direction. The target location (or "target point") may be specified by the user, for example, by inputting location coordinates via a graphical user interface. For example, a surgeon may select the target location based on CT imaging presented via the user interface, for example, Figure 1D As shown. The insertion point (or "proximal point") can be designated as being near the skull surface at which the retractor 150 will enter the skull to contact the subject's brain 105. As shown, the target position and the insertion point define a straight line, i.e., an axis. A "distal point" can be defined that is spaced apart from the skull surface in an outward direction along the defined axis. As described in further detail below, the distal point effectively provides a starting point for inserting the retractor 150 into the subject's brain 105 through the action of the end effector 140. Thus, when the end effector is in the insertion position, determining the insertion position and insertion direction results in: (i) the insertion direction being aligned with the axis passing through the target position and the insertion point; and (ii) the retractor being spaced apart from the insertion point in an outward direction along the axis passing through the target position and the insertion point.

[0038] As described above, the robotic arm 110 can be adapted to position and orient the end effector 140 with six degrees of freedom—three dimensions for positioning and three dimensions for orientation. In an embodiment, the end effector 140 may include a retractor 150 having a symmetrical shape about its longitudinal axis, such as a cylindrical shape. In this case, only five degrees of freedom may be required because it may not be necessary to define rotation about the longitudinal axis of the retractor 150. However, a sixth degree of freedom can be used to define rotation about the longitudinal axis of the retractor 150 to allow the end of the robotic arm 110 to rotate about the longitudinal axis, thereby better accommodating the robotic assembly within the surgical scene.

[0039] Thus, a brain surgery system may include a computer system that communicates with a radiographic imaging system, a robotic arm, and a sensing end effector. The computer system may communicate with a display and a graphical user interface. The computer system may include navigation software that is capable of calculating an insertion position and insertion direction of the end effector, thereby allowing an operator to determine and set the insertion position. The computer system may instruct the robotic arm to move the end effector to align with the set insertion position and insertion direction. Images from the radiographic imaging system may be sent to the computer system and displayed, which may enable the surgeon to observe the target area to be treated, such as a lesion. Using the images from the radiographic imaging system, the navigation software may enable the surgeon to find the optimal axis for the intervention point, i.e., the insertion point.

[0040] Typically, the surgeon can use radiographic images to locate the lesion and decide on a strategy and / or an effective path to reach the lesion. The path can be determined, at least in part, based on minimizing the depth of brain matter to be traversed and / or minimizing the formation of additional damage that may result from inserting the retractor into the white / gray matter of the subject's brain. In addition to the radiographic images, any data from the patient monitoring or tracking device can also be sent to the computer system. Navigation software on the computer system can display the axis of the intervention point and can determine or help determine the axis of the safest and most effective intervention point.

[0041] Figure 3 An embodiment of an end effector 140 is depicted that includes a linear slide 210 having a fixed portion 215 and a movable portion 220, the fixed portion 215 being adapted to be attached to the robotic arm 110. The linear slide 210 is adapted to move the retractor 150 in a lengthwise direction of the retractor 150 so that the retractor 150 can be inserted into the subject's brain in a substantially linear motion according to the shape and function of the vial 510. In certain embodiments, the linear slide 210 includes a sensor 225 to measure movement of the movable portion 220 relative to the fixed portion 215. A rotatable knob 230 can be adapted to move the movable portion 220 relative to the fixed portion 215. For example, the knob 230 can be rotatable manually, such as by a surgeon, and can have a gear (not shown) formed on a rear portion that interacts with other mechanical components, such as a toothed track 247 (see FIG. 2 ). Figure 4 In certain embodiments, the knob can be rotatable manually, by a motor, or by both. The end effector 140 can include a lock, such as a second knob 235 , adapted to fix the position of the movable portion 220 of the linear slide 210 relative to the fixed portion 215 .

[0042] Figure 4The underside of the linear slide 210 of the end effector 140 is depicted. In certain embodiments, the fixed portion 215 of the linear slide 210 includes a first track 238, and the movable portion 220 of the linear slide 210 includes a rod 240 connected to and adapted to move along the first track 238. The rod 240 can be a substantially flat plate positioned between the first track 238 and a second track 242. The rod 240 can include two guides 245 attached to the underside of the rod 240. The guides 245 can extend in a lengthwise direction of the rod 240 and can be positioned to engage the first track 238 and the second track 242, respectively.

[0043] Figure 5A and Figure 5B A bracket 410 is depicted, attached to the linear slide 210 of the end effector 140 and adapted to hold the retractor 150. In certain embodiments, the bracket 410 is located distally to the movable portion 220 of the linear slide 210 and extends in a direction substantially perpendicular to the movable portion 220 of the linear slide 210. In certain embodiments, the bracket 410 may include an elongated portion 415 and a clamping portion 420 having two opposing portions that together form a portion of a circle. The clamping portion 420 may be adapted to clamp onto the retractor 150 to hold it in place. The bracket 410 may further include a base 435 attached to the linear slide 210, the base 435 having a receptacle 437 to receive the elongated portion 415 of the bracket 410 and lock it in place. The holder 410 can be implemented in various sizes based at least in part on the corresponding size of the retractor 150 , and in particular on the size of the vial 510 .

[0044] Figure 6 A retractor 150 is depicted, which may include a vial 510 with a trocar 520 positioned within the vial 510, the retractor 150 being suitable for insertion into a subject's brain. In certain embodiments, the vial 510 may be hollow and substantially tubular, such as cylindrical. The vial 510 may be made of glass or other material suitable for insertion into the human body, particularly the brain. The retractor 510 is adapted to allow the trocar 510 to be removed from the retractor 510 while retaining the vial 510 in place within the subject's brain.

[0045] The trocar 520 can include a tapered tip 525 at its distal end, which is suitable for insertion into the brain of a subject. In certain embodiments, the tapered tip 525 of the trocar can be between about 10 mm and about 20 mm in length, or between about 14 mm and about 16 mm in length, along the length of the retractor 150. The trocar 520 can be formed from titanium or other materials suitable for insertion into the human body, particularly the brain.

[0046] In certain embodiments, the trocar 520 can include a base 530 at a proximal end that is adapted to connect to a corresponding base 540 of the vial 510. The base 540 of the vial 510 can include a circumferential edge having a textured outer surface to allow for a more secure grip of the vial 510. The base 530 of the trocar 520 and the base 540 of the vial 510 can cooperate to prevent the trocar 520 and the vial 510 from separating when the retractor 150 is inserted into and / or removed from the subject's brain 105. For example, when the trocar 520 is inserted into the vial 510, the inner circumferential surface of the base 540 of the vial 510 can form an interference fit with the outer circumferential surface of the base 530 of the trocar 520. In certain embodiments, a portion of the base 530 of the trocar 520 may be too wide to fit within the vial 510 and may act as a stop when the trocar 520 is inserted into the vial 510 .

[0047] Figure 7 6 is a flow chart of a method 600 for guiding insertion of a retractor into a subject's brain using a brain surgery system having a robotic arm and an imaging system, such as the brain surgery system 100 described above. The method 600 includes receiving, by a detector, radiation emitted by a radiation source, including radiation that has passed through the subject's brain located between the radiation source and the detector (605). The method 600 further includes receiving, by a processor, imaging data output by the detector based on the reception of the emitted radiation (610).

[0048] Method 600 further includes displaying the imaging data on a display to provide one or more images of the subject's brain (615). In certain embodiments, the images of the subject's brain may represent one or more calculated cross-sections of the subject's brain. Method 600 further includes receiving user input specifying a target location within a selected image of the one or more images of the subject's brain (620). In certain embodiments, the user input specifying the target location may be received via a graphical user interface displayed on the display (see Figure 1D ). In addition, the user input specifying the target location may be received via user input of location coordinates.

[0049] The method 600 further includes receiving user input specifying an insertion point for the retractor (625). The method 600 further includes determining an insertion position and an insertion direction based at least in part on the specified insertion point and the specified target position (630). The method 600 further includes controlling a robotic arm to move an end effector to the insertion position and the insertion direction, the end effector being attached to the robotic arm and holding the retractor (635). In particular embodiments, when the end effector is in the insertion position, the determination of the insertion position and the insertion direction can result in: (i) the insertion direction being aligned with an axis passing through the target position and the insertion point; and (ii) the retractor being spaced apart from the insertion point in an outward direction along the axis passing through the target position and the insertion point.

[0050] The method 600 further includes moving the retractor in a lengthwise direction of the retractor using a linear slide to insert the retractor into the subject's brain (640). In certain embodiments, the method 600 may further include removing the trocar from the retractor while leaving the vial in place in the subject's brain (645). The method 600 may further include inserting one or more surgical tools into the vial to perform a surgical procedure in the subject's brain. Surgical tools include, for example, an aspirator, an endoscope, and the like.

[0051] Various aspects of the present invention may be implemented in the form of a system, a computer program product, or a method. Similarly, various aspects of the present invention may be implemented as hardware, software, or a combination of the two. Various aspects of the present invention may be implemented as a computer program product stored on one or more computer-readable media in the form of computer-readable program code implemented thereon.

[0052] The computer-readable medium may be a computer-readable storage medium. The computer-readable storage medium may be, for example, an electronic, optical, magnetic, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any combination thereof.

[0053] The computer program code in the embodiments of the present invention may be written in any suitable programming language. The program code may be executed on a single computer or on multiple computers. The computer may include a processing unit in communication with a computer-usable medium, wherein the computer-usable medium contains an instruction set, and wherein the processing unit is designed to execute the instruction set.

[0054] The above discussion is intended to illustrate the principles and various embodiments of the present invention. Once the above disclosure is fully understood, many changes and modifications will become apparent to those skilled in the art. The following claims are intended to be interpreted as including all such changes and modifications.

Claims

1. A brain surgery system having a robotic arm for guiding insertion of a retractor into a subject's brain, the system comprising: An imaging system comprising a radiation source and a detector adapted to measure radiation emitted by the radiation source, the detector further adapted to output imaging data based on the measured radiation; A computer system having at least one processor and memory; a robotic arm mounted on the imaging system and controlled by software running on the at least one processor; as well as an end effector attached to the robotic arm and adapted to hold the retractor, the end effector comprising: a linear slide having a fixed portion and a movable portion, the fixed portion being adapted to be attached to the robotic arm, the linear slide being adapted to move the retractor in a lengthwise direction of the retractor to insert the retractor into the brain of a subject; as well as A bracket is attached to the linear slide and is adapted to hold the retractor.

2. The system according to claim 1, wherein: The radiation source is adapted to emit X-rays.

3. The system according to any one of claims 1 or 2, wherein: The imaging system is a computed tomography (CT) imaging system.

4. The system according to any one of claims 1 to 3, wherein: The computer system is implemented as part of the imaging system.

5. The system according to any one of claims 1 to 4, wherein: The computer system is external to the imaging system and communicates with the imaging system through a direct connection and / or a network.

6. The system according to any one of claims 1 to 5, wherein: The imaging data is in Digital Imaging and Communications in Medicine (DICOM) format.

7. The system according to any one of claims 1 to 6, wherein: The computer system is adapted to receive the imaging data, determine an insertion position and an insertion direction, and control the robotic arm to move the end effector to the insertion position and the insertion direction.

8. The system according to any one of claims 1 to 7, wherein: The robotic arm is adapted to position and orient the end effector in at least five degrees of freedom.

9. The system according to any one of claims 1 to 8, wherein: The linear slide includes a sensor to measure movement of the movable portion relative to the fixed portion.

10. The system according to any one of claims 1 to 9, wherein: The end effector includes a knob that is rotatable to move the movable portion relative to the fixed portion.

11. The system according to claim 10, wherein: The knob is rotatable manually or via a motor.

12. The system according to claim 10, wherein: The knob is rotatable manually and via a motor.

13. The system of claim 10, further comprising a lock adapted to fix a position of the movable portion relative to the fixed portion.

14. The system according to claim 13, wherein: The lock includes a second knob that is rotatable to fix the position of the movable portion relative to the fixed portion.

15. The system according to any one of claims 1 to 14, wherein: The fixed portion of the linear slide includes at least one track, and the movable portion of the linear slide includes a rod connected to the at least one track and adapted to move along the at least one track.

16. The system according to claim 15, wherein: The bar is a substantially flat plate located between the at least one rail and the second rail.

17. The system according to claim 15, wherein: The rod includes two guides attached to an underside thereof, the guides extending in a lengthwise direction of the rod and positioned to engage the at least one rail and the second rail, respectively.

18. The system according to any one of claims 1 to 17, wherein: The bracket is located at a distal end of the movable portion of the linear slide and extends in a direction substantially perpendicular to a lengthwise direction of the movable portion of the linear slide.

19. The system of claim 1, wherein: The bracket includes an elongated portion and a clamping portion adapted to hold the retractor in place.

20. The system of claim 19, wherein: The clamping portion comprises two opposing parts which together form a portion of a circle.

21. The system of claim 19, wherein: The bracket further includes a base attached to the linear slide, the base having a receptacle for receiving the elongated portion of the bracket and locking the elongated portion of the bracket in place.

22. The system according to any one of claims 1 to 21, wherein: The retractor includes a vial with a trocar positioned inside the vial, the retractor being adapted for insertion into the brain of a subject.

23. The system of claim 22, wherein: The retractor is adapted to enable the trocar to be removed from the retractor while leaving the vial in place in the subject's brain.

24. The system of claim 22, wherein: The trocar includes a tapered tip at a distal end thereof, the tapered tip being adapted for insertion into the brain of a subject.

25. The system of claim 22, wherein: The trocar includes a base at a proximal end adapted to connect to a corresponding base of the vial.

26. The system of claim 25, wherein: The base of the trocar and the base of the vial cooperate to prevent separation of the trocar and the vial when the retractor is inserted into and / or removed from the brain of a subject.

27. The system according to any one of claims 1 to 26, wherein: The computer system is adapted to execute software on the at least one processor to perform: displaying the imaging data on a display to provide one or more images of the subject's brain; receiving user input specifying a target location within a selected one of the one or more images of the subject's brain; as well as User input is received specifying an insertion point for the retractor.

28. The system of claim 27, wherein: The computer system is further adapted to execute software on the at least one processor to perform: determining an insertion location and an insertion direction based at least in part on the designated insertion point and the designated target location; as well as The robotic arm is controlled to move an end effector to the insertion position and the insertion direction, the end effector being attached to the robotic arm and holding the retractor.

29. The system of any one of claims 1 to 28, further comprising a controller having a processor and configured to control the robotic arm based on communication with software running on the at least one processor.

30. An end effector adapted to be attached to a robotic arm and adapted to hold a retractor, the retractor comprising a vial with a trocar positioned inside the vial, the retractor adapted to be inserted into a brain of a subject, the end effector comprising: a linear slide having a fixed portion and a movable portion, the fixed portion being adapted to be attached to the robotic arm, the linear slide being adapted to move the retractor in a lengthwise direction of the retractor to insert the retractor into the brain of a subject; as well as A bracket is attached to the linear slide and is adapted to hold the retractor.

31. The end effector according to claim 30, wherein: The linear slide includes a sensor to measure movement of the movable portion relative to the fixed portion.

32. The end effector according to any one of claims 30 or 31, further comprising a knob rotatable to move the movable portion relative to the fixed portion.

33. The end effector according to claim 32, wherein: The knob is rotatable manually or via a motor.

34. The end effector according to claim 32, wherein: The knob is rotatable manually and via a motor.

35. The end effector of claim 32, further comprising a lock adapted to fix a position of the movable portion relative to the fixed portion.

36. The end effector according to claim 35, wherein: The lock includes a second knob that is rotatable to fix the position of the movable portion relative to the fixed portion.

37. The end effector according to any one of claims 30 to 36, wherein: The fixed portion of the linear slide includes at least one track, and the movable portion of the linear slide includes a rod connected to the at least one track and adapted to move along the at least one track.

38. The end effector according to claim 37, wherein: The bar is a substantially flat plate located between the at least one rail and the second rail.

39. The end effector according to claim 37, wherein: The rod includes two guides attached to an underside thereof, the guides extending in a lengthwise direction of the rod and positioned to engage the at least one rail and the second rail, respectively.

40. The end effector according to any one of claims 30 to 39, wherein: The bracket is located at a distal end of the movable portion of the linear slide and extends in a direction substantially perpendicular to a lengthwise direction of the movable portion of the linear slide.

41. The end effector according to any one of claims 30 to 40, wherein: The bracket includes an elongated portion and a clamping portion adapted to hold the retractor in place.

42. The end effector according to claim 41, wherein: The clamping portion comprises two opposing parts which together form a portion of a circle.

43. The end effector according to claim 41, wherein: The bracket further includes a base attached to the linear slide, the base having a receptacle for receiving the elongated portion of the bracket and locking the elongated portion of the bracket in place.

44. A method of using a brain surgical system to guide insertion of a retractor into the brain, the brain surgical system comprising a robotic arm, an imaging system, and a computer system having at least one processor and memory, the imaging system comprising a radiation source and a detector adapted to measure radiation emitted by the radiation source, the detector further adapted to output imaging data based on the measured radiation, the method comprising: receiving, by the detector, radiation emitted by the radiation source, including radiation that has passed through a brain of a subject located between the radiation source and the detector; receiving, by the processor, imaging data output by the detector based on receipt of the emitted radiation; displaying the imaging data on a display to provide one or more images of the subject's brain; receiving user input specifying a target location within a selected one of the one or more images of the subject's brain; receiving user input specifying an insertion point for the retractor; determining an insertion location and an insertion direction based at least in part on the designated insertion point and the designated target location; controlling the robotic arm to move an end effector to the insertion position and the insertion direction, the end effector being attached to the robotic arm and holding the retractor; The retractor is moved in a lengthwise direction of the retractor using a linear slide to insert the retractor into the brain of the subject.

45. The method of claim 44, wherein: When the end effector is in the insertion position, the determining the insertion position and insertion direction results in: (i) the insertion direction being aligned with an axis passing through the target position and the insertion point; and (ii) the retractor is spaced apart from the insertion point in an outward direction along an axis passing through the target location and the insertion point.

46. ​​The method of any one of claims 44 or 45, further comprising removing the trocar from the retractor while leaving the vial in place in the subject's brain.

47. The method of claim 46, further comprising inserting one or more surgical tools into the vial to perform a surgical procedure in the subject's brain.

48. The method of claim 47, wherein The surgical tool includes an aspirator or an endoscope.

49. The method according to any one of claims 44 to 48, wherein The one or more images of the subject's brain represent one or more calculated cross-sections of the subject's brain.

50. The method according to any one of claims 44 to 49, wherein User input specifying the target location is received via a graphical user interface displayed on the display.

51. The method according to any one of claims 44 to 50, wherein The user input specifying the target location is received via user input of location coordinates.

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