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CRANIO - Robot-assisted Craniotomy with and without individual prefabricated implant

Partner

Prof. Dr. med. Dr. med. dent. Harald Eufinger,
Academic Teaching Hospital Recklinghausen, Ruhr-University Bochum, Knappschafts-Krankenhaus Recklinghausen

Univ.-Prof. Dr.-Ing. Klaus Radermacher,
Chair for Medical Engineering, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University

Priv.-Doz. Dr. med. Kirsten Schmieder,
University Hospital, Ruhr-University Bochum, Knappschafts-Krankenhaus

Priv.-Doz. Dr. med. Martin Scholz,
University Hospital, Ruhr-University Bochum, Knappschafts-Krankenhaus

Feedback from the DFG experts on the project (german document)

CRANIO_Abschlussgutachten.pdf

Funding

The work in the CRANIO project was funded within the framework of the DFG Priority Programme 1124 "Medical Navigation and Robotics".
(RA548/2-1, RA548/2-2, RA548/3-3)
(Project term: 12/2001-06/2009)

Projekt Overview

Tumor Segmentation

Objective:

  • Computer aided detection and segmentation of calvarial tumors in CT images

Approach:

  • Knowledge-based segmentation algorithms using a priori knowledge
  • Statistical parameter optimization

Resection Planning

Objective:

  • Virtual computer-based planning of bone resection
  • Simulation of the resection outcome
  • Affected tumor resection and effective planning sessions

Approach:

  • User-defined selection of an appropriate resection path, angle, and tool type/size
  • Interactive support (2D/3D images, thickness information) during the resection planning
  • Visualization of the outcome and volume measurements
  • Usability and evaluation regarding the effectiveness and the efficiency of user guidance and planning, error tolerance, learnability and user satisfaction

Implant Design

Objective:

  • Preoperative design and manufacturing of implants for cranial reconstruction
  • Optimal functional and cosmetic outcomes
  • Time and cost efficiency of planning and manufacturing procedures

Approach:

  • Computer-assisted defect geometry reconstruction and implant modeling based on statistical knowledge and 3D model database
  • Advanced algorithms for matching and deformable modeling - Workflow optimization

Surgical Navigation

Objective:

  • Minimally invasive registration of preoperative planning data and intraoperative anatomy
  • Modular coupling of conventional navigation and robot assistance during surgery

Approach:

  • Surface-based transcutaneous registration using 3D tracked A-mode Ultrasound probe
  • Improved user guidance during the US Palpation
  • Intra-operative navigated modular robotics

Robotic System

Objective:

  • Robot assisted skull resection for higher precision (fitting of customized implants) and higher efficiency during the micromilling process
  • Adaptation of existing surgical tools to be compatible with special requirements of the robotic system
  • Development of optimally adapted surgical robot

Approach:

  • New concept of the Hexapod robot, CRANIO 2, positioned under the OR-table
  • Modified Mayfield clamp for stability improvement and space optimisation of using surgical hexapod robot
  • Workflow and system adapted to the surgical context of the application

Safety

Objective:

  • Risk analysis of preoperative and intraoperative usage of the CRANIO system in the operating theatre
  • Identification of critical steps and components
  • Development of counter measures to reduce the risk for patients and subsequently the operating team

Approach:

  • Computer-based risk analysis software CARAD (SurgiTAIX, Aachen)
  • Risk analysis (coupled FMEA & FTA) and documentation of the entire operational process
  • Development and implementation of a redundant safety hardware system

Publications

Journal Article

  • Bast P, Engelhardt M, Popovic A, Schmieder K, Radermacher K: CRANIO— Entwicklung eines Systems zur Computer- und Roboterunterstützten Kraniotomie. Biomedizinische Technik, Band 47, Teil 1, S. 9-11, 2002.
  • Bast P, Engelhardt M, Lauer W, Schmieder K, Rohde V, Radermacher K.: Identification of Milling Parameters for Manual Cutting of Bicortical Bone Structures. Comput Aided Surg. 2003; 8(5): 257-63.
  • Bast P, Engelhardt M, Lauer W, Schmieder K, Rohde V, Radermacher K: Approaches Towards Optimized Robot Kinematics for Surgical Applications. Paul Drews (eds), Proc. IEEE Mechatronics & Robotics 2004, pp 1436-1440.
  • P. Bast, W. Lauer, A. Münzebrock, M. Engelhardt & K. Radermacher: Safety Architecture of a Neurosurgical Robot System. Biomedizinische Technik, 50(1), 2005, pp. 1539-1540
  • Bast P, Ibach B, Radermacher K: System Architecture and redundant safety unit for surgical robotics. Int. J. Computer Assisted Radiology and Surgery, Vol1, Suppl. 1:487-515.2006.
  • P. Bast, A. Popovic, T. Wu, S. Heger, M. Engelhardt, W. Lauer, K. Radermacher & K. Schmieder: Robot- and computer-assisted craniotomy: resection planning, implant modelling and robot safety. Int J Med Robot, 2006, 2(2), pp. 168-178
  • V. Cunha-Cruz, A. Follmann, A. Popovic, P. Bast, T. Wu, S. Heger, M. Engelhardt, K. Schmieder & K. Radermacher: Robot and Computer Assisted Craniotomy (CRANIO): From Active Systems to Synergistic Man-Machine Interaction. Proc. ImechE, Part H: J.Engineering in Medicine, 2010, 224(3), pp. 441-452
  • Engelhardt M, Wehmöller M, Eufinger H, Scholz M, Schmieder K: Ossäre Prozesse des Schädels - Anforderungsanalyse für robotergestütztes Operieren. Biomedizinische Technik, Band 47, Teil 1, S.16-18, 2002.
  • Engelhardt M, Bertlich N, Eufinger H, Harders A, Schmieder K: Indications, surgical management and pathological aspects of cranial and craniofacial bone resection. J Cranio Maxillofac Surg 30 Suppl 1: 172, 2002.
  • Engelhardt M, Bast P, Lauer W, Rohde V, Schmieder K, Radermacher K: Manual vs. Robotic milling parameters for development of a new robotic system in cranial surgery. In: Lemke HU, Vannier MW, Inamura K, Farmann AG, Doi K, Reiber JHC: CARS 2004, Computer Assisted Radiology and Surgery, 533-538, Elsevier, 2004.
  • Engelhardt M, Uhlenbruch S, Scholz M, Eufinger H, Christmann A, Miede C, Schmieder K: Accidential dural tears occuring during supratentorial craniotomy – predisposing factors. Zentralbl Neurochir. 2005 May; 66(2):70-4.
  • Engelhardt M, Bast P, Jeblink N, Lauer W, Popovic A, Eufinger H, Scholz M, Christmann A, Harders A, Radermacher K, and Schmieder K: Analysis of surgical management of calvarial tumours and first results of a newly designed robotic trepanation system. Minimal Invasive Neurosurgery, 49(2):98–103, April 2006.
  • Fieten L, Heger S, Pasalic L, Engelhardt M, Schmieder K, Radermacher K: Fast and accurate registration of cranial CT images with A-mode ultrasound. International Journal of Computer Assisted Radiology and Surgery, Vol 3, Supp 1, 2008, pp. 275–276.
  • Fieten L, Schmieder K, Engelhardt M, Pasalic L, Radermacher K, Heger S:Fast and accurate registration of cranial CT images with A-mode-ultrasound. Int J CARS 4:225–237. 2009.
  • Heger S, Popovic A, Engelhardt M, Schmieder K, Radermacher K: Efficient A-Mode Ultrasound based Registration in Skull surgery. Biomedizinische Technik, Vol. 50, Ergänzungsband 1, Teil 2., S.645-646, 2005.
  • Lauer W, Bast P, Engelhardt M, Rohde V, Radermacher K: Experimentelle Bestimmung der Fräsparameter bei der manuellen Knochenbearbeitung in der Neurochirurgie. Biomedizinische Technik, Band 48, Ergänzungsband 1, S. 120-121, 2003.
  • Popovic, A., M. Engelhardt, T. Wu, F. Portheine, K. Schmieder, K. Radermacher: CRANIO – computer-assisted planning for navigated and robot-assisted surgery on the skull. in: H.U. Lemke, M.W. Vannier et al.  (eds.) CARS 2003, Elsevier Science (2003), 1269-1275
  • Popovic A, Engelhardt M, Wu T, Portheine F, Radermacher K: Development of the Planning System for Computer Assisted Craniotomy. Biomedizinische Technik, Band 48, Ergänzungsband 1, S. 502-503, 2003.
  • A. Popovic, S. Heger, M. Engelhardt, K. Schmieder & K. Radermacher: Efficient non-invasive registration with A-mode ultrasound in skull surgery. International Congress Series, 2005, 1281, pp. 821-826
  • A. Popovic, P. Bast, M. Engelhardt & K. Radermacher: Computed Tomography Based Assessment of Cranial Thickness: Methods and Applications. Biomedizinische Technik, 50(1), 2005, pp. 1276-1277
  • A. Popovic, T. Wu, M. Engelhardt & K. Radermacher: Modeling of intensity priors for knowledge-based level set algorithm in calvarial tumors segmentation. Med Image Comput Comput Assist Interv, 2006, 9(Pt 2), pp. 864-871
  • A. Popovic, M. de la Fuente, M. Engelhardt & K. Radermacher: Statistical validation metric for accuracy assessment in medical image segmentation. International Journal of Computer Assisted Radiology and Surgery, 2007, 2(3), pp. 169-181
  • A. Popovic, S. Heger, A. Follmann, T. Wu, M. Engelhardt, K. Schmieder & K. Radermacher: Efficient Non-Invasive Registration with A-mode Ultrasound in Skull Surgery. In: V. Bozovic (ed.): Medical Robotics, 2008, pp. 323-340
  • Radermacher K, Rau G: Navigation und Robotik unterstützen die minimal-invasive Chirurgie, RWTH-Themen, RWTH-Aachen, 2/2002, S. 34-35.
  • Wu T, Portheine F, Popovic A, Bast P, Wehmöller M, Radermacher K: An Interface for the Data Exchange between CAS and CAD/CAM Systems. In: H.U. Lemke, M.W. Vannier et al. (eds.) CARS 2003, Elsevier Science (2003), pp. 703-709.
  • Wu T, Engelhardt M, Fieten L, Popovic A, Radermacher K: Anatomically constrained deformation for design of cranial implant: Methodology and validation. In R. Larsen, M. Nielsen, and J. Sporring, editors, Medical Image Computing and Computer-Assisted Intervention (MICCAI 2006), volume 4190 of Lecture Notes on Computer Science, pp. 9–16. Springer, 2006.
  • Wu T, Fieten L, Engelhardt M, Schmieder K, Radermacher K: Knowledge-based Individual Implant Design Based on Reference Models for Craniofacial Reconstruction. Int. J. Computer Assisted Radiology and Surgery 1 (Suppl. 1): 259-261, 2006.

Conference Contribution

  • Bast P, Engelhardt M, Popovic A, Schmieder K, Radermacher K: CRANIO—Entwicklung eines Systems zur Computer- und Roboterunterstützten Kraniotomie. 36. Jahrestagung der Deutschen Gesellschaft für Biomedizinische Technik, Karlsruhe, 25.-27.09.02.
  • Bast P, Lauer W, Engelhardt M, Rohde V, Radermacher K: Bestimmung von Fräsparametern beim manuellen Bearbeiten von bicortikalen Knochenstrukturen CURAC 2003 – 2. Jahrestagung der Deutschen Gesellschaft für Computer- und Roboterassistierte Chirurgie, 4.-7. November 2003, Nürnberg.
  • Bast P, Engelhardt M, Lauer W, Schmieder K, Rohde V, Radermacher K: Approaches Towards Optimized Robot Kinematics for Surgical Applications. Paul Drews (eds), IEEE Mechatronics & Robotics Conf., Sept 13-15, 2004, Aachen.
  • P. Bast, W. Lauer, A. Münzebrock, M.Engelhardt, K. Radermacher: Safety Architecture of a Neurosurgical Robot System. 39^th Congress of the German Society for Biomedical Engineering and 14th Interational Conference on Medical Physics, Sept. 2005, Nürnberg.
  • Bast P, Weber H, Ibach B, Popovic A, Engelhardt M, Radermacher K: System Architecture and Redundant Safety Unit for Surgical Robotics. CARS 2006, Osaka, Japan.
  • Demonstration der bildbasierten robotergestützten Fräsbearbeitung des Schädelknochens und Interview im Rahmen von Aufnahmen des Zweiten Deutschen Fernsehens (ZDF) zur Wissenschaftssendereihe „Nano“, 2003.
  • Engelhardt M, Bertlich N, Eufinger H, Harders A, Schmieder K: Indications, surgical management and pathological aspects of cranial and craniofacial bone resection. Congress 2002 of the EACMFS, Münster, 03.-07.09.02.
  • Engelhardt M, Wehmöller M, Eufinger H, Scholz M, Schmieder K: Ossäre Prozesse des Schädels - Anforderungsanalyse für robotergestütztes Operieren. 36. Jahrestagung der Deutschen Gesellschaft für Biomedizinische Technik, Karlsruhe, 25.-27.09.02.
  • Engelhardt M, Folkers W, Yüksel A, Harders AG, Schmieder K: Akzidentelle Verletzungen der Dura bei Trepanationen – eine prospektive Studie. Jahrestagung der DGNC in Saarbrücken 26.05.2003.
  • Engelhardt M, Bast P, Lauer W, Scholz M, Eufinger H, Schmieder K, Radermacher K: Integration eines robotergestützten Trepanationssystems in die neurochirurgische Operation“. CURAC 2003 – 2. Jahrestagung der Deutschen Gesellschaft für Computer- und Roboterassistierte Chirurgie, 4.-7. November 2003, Nürnberg.
  • Engelhardt M, Bast P, Lauer W, Rohde V, Schmieder K, Radermacher K: Manual vs. Robotic milling parameters for development of a new robotic system in cranial surgery. In: Lemke HU, Vannier MW, Inamura K, Farmann AG, Doi K, Reiber JHC: CARS 2004, Computer Assisted Radiology and Surgery, Chicago 23.- 26. June 2004.
  • Engelhardt M, Radermacher K, Scholz M, Harders A, Schmieder K: Integration of a robot assisted trepanation system into the neurosurgical intraoperative setting. World Congress of Neurological Surgery, 2005, June 19-24th, Marrakesh, Marocco.
  • Engelhardt M, Scholz M, Radermacher K, Harders A, Schmieder K: Manual vs. Robotic milling – Identification of Parameters for the development of a new robot system for cranial surgery. World Congress of Neurological Surgery, 2005, June 19- 24th, Marrakesh, Marocco.
  • Engelhardt M, Bast P, Popovic A, Lauer W, Scholz M, Radermacher K, Schmieder K: Analyse neurochirurgischer Trepanationen als Grundlage eines robotergestützten Trepanationssystems. CURAC 2005, 22.-24.9.2005, Berlin.
  • Engelhardt M, Bast P, Popovic A, Lauer W, Scholz M, Radermacher K, Schmieder K: Integration eines robotischen Systems in den neurochirurgischen OP. CURAC 2005, 22.-24.9.2005, Berlin.
  • Fieten L, Wu T, Engelhardt M, Schmieder K, Radermacher K: Ein Modul zum wissensbasierten Entwurf von Schädelimplantaten. Jahrestagung der Schweizerischen, Deutschen und Österreichischen Gesellschaft für Biomedizinische Technik, Zürich, 6.-9. September 2006.
  • Fieten L, Heger S, Pasalic L, Engelhardt M, Schmieder K, Radermacher K: Registration of Cranial CT Images with A-Mode-Ultrasound Data Using the Random-ICP Algorithm -- A Cadaver Study. 41. Jahrestagung der Deutschen Gesellschaft für Biomedizinische Technik BMT 2007, Aachen, Sept. 2007.
  • Fieten L, Heger S, Pasalic L, Engelhardt M, Schmieder K, Radermacher K: Fast and accurate registration of cranial CT images with A-mode ultrasound. CARS International 2008, Barcelona, 25.-28. Juni 2008.
  • A. Follmann, A. Popovic, T. Wu, V.C. Cunha-Cruz, K. Schroeder, B. Ibach, M. Engelhardt, K. Schmieder & K. Radermacher: CRANIO system for robot and computer assisted removal of calvarial tumors. In: H.U. Lemke, K. Inamura, K. Doi, M.W. Vannier & A.G. Farman (ed.): Int J Comput assist Radiol Surg, 2(Suppl 1), 2007, pp. 484-485
  • A. Follmann, T. Wu, A. Popovic, K. Schroeder, V.C. Cunha-Cruz, B. Ibach, M. Engelhardt & K. Radermacher: CRANIO – Evaluierung eines Systems zur roboter- und computerunterstützten Kraniektomie. Biomedizinische Technik, 52 (Ergänzungsband, CD-ROM), 2007
  • Heger, St., Portheine, F., Ohnsorge, J., Radermacher, K.: Visuelle Benutzerführung zur Referenzierung auf Basis von A-Mode Ultraschall. Biomedizinische Technik, Band 47, Ergänzungsband 1,Teil1 2002, S. 61-64
  • Heger, S., de la Fuente, M, Ohnsorge, J.A.K., Radermacher, K. : Automatische Kalibrierung optisch geführter A-Mode Ultraschall basierter Referenzierung, Biomedizinische Technik, Band 48, Ergänzungsband 1, 2003, S. 114-115
  • S. Heger, A. Popovic, M. Engelhardt, K. Schmieder & K. Radermacher: Efficient A-mode Ultrasound Registration in Skull Surgery. Biomedizinische Technik, 50, 2005, pp. 645-646
  • S. Heger, F. Portheine, J.A. Ohnsorge, E. Schkommodau & K. Radermacher: User-Interactive Registration of Bone with A-Mode Ultrasound. IEEE Engineering in Medicine and Biology Magazine, 2005, 24(2), pp. 85-95
  • Lauer W, Bast P, Engelhardt M, Rohde V, Schmieder K, Radermacher K: Experimentelle Bestimmung manueller Fräsparameter im Rahmen neurochirurgischer Knochenbearbeitung. Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizer Gesellschaft für Biomedizinische Technik, 25.-27. September 2003, Salzburg.
  • L. Pasalic, L. Fieten, S. Heger, M. Engelhardt, K. Schmieder & K. Radermacher: A Random-Based ICP Algorithm for Registration of Cranial CT Images with A-Mode-Ultrasound Data. Proceedings Biomedizinische Technik, 52 (Ergänzungsband, CD-ROM), 2007
  • Popovic A, Engelhardt M, Wu T, Portheine F, Radermacher K: Development of the Planning System for Computer Assisted Craniotomy. Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizer Gesellschaft für Biomedizinische Technik, 25.-27. September 2003, Salzburg.
  • Popovic A, Engelhardt M, Wu T, Portheine F, Radermacher K: CRANIO – Computer assisted planning for navigated and robot assisted surgery on the skull. 17^th International Congress on Computer Assisted Radiology and Surgery (CARS 2003), June 25-28th, 2003, London, UK. Popovic A, Engelhardt M, Heger S, Schmieder K, Radermacher K: Efficient Non- Invasive Registration with A-mode Ultrasound in Skull Surgery: Method and First Clinical Trials. 17th International Congress on Computer Assisted Radiology and Surgery (CARS 2005), June 22-25th, 2005, Berlin.
  • Popovic A, Bast P, Engelhardt M, Radermacher K: Computed Tomography Based Assessment of Cranial Thickness: Methods and Applications. DGBMT/ICMP 2005, Nürnberg, Sept. 14.-19th, 2005.
  • Popovic A, Engelhardt M, Radermacher K: Segmentation of Skull-infiltrated Tumors Using ITK: Methods and Validation. Proceeding of ISC / NAMIC Workshop on Open-Source Software at 8th International Conference on Medical Image Computing and Computer Assisted Intervention 2005, Insight Journal
  • Popovic A: Computer Aided Segmentation for Resection Planning in Calvarial Tumor Surgery. Lehrstuhl für Bildverarbeitung, RWTH Aachen, April 2006.
  • Popovic A, Engelhardt M, Radermacher K: Knowledge-based Segmentation of Calvarial Tumors in Computed Tomography Images. Workshop Bildverarbeitung für die Medizin 2006, Hamburg.
  • Popovic A, Engelhardt M, Radermacher K: Automatic Segmentation of Calvarial Tumors in Computed Tomography Images. 4. Jahrestagung der Deutschen Gesellschaft für Computer- und Roboterassistierte Chirurgie, CURAC 2006.
  • Popovic A, Engelhardt M, Wu T, Radermacher K: Towards Automatic Parameter Optimization for Medical Image Segmentation Algorithms. Vision, Modeling, Visualization, VMV 2006, Aachen, November 2006.
  • Popovic A, Wu T, Follmann A, Engelhardt M, Radermacher K: Robot Milling Path Generation in Calvarial Tumor Surgery. 41. Jahrestagung der Deutschen Gesellschaft für Biomedizinische Technik BMT 2007, Aachen, Sept. 2007.
  • Popovic A, Bast P, Engelhardt M, Radermacher K: Computed Tomography Based Assessment of Cranial Thickness: Methods and Applications. Biomedizinische Technik. In Joint Congress of the German Society for Biomedical Engineering and 14th International Conference on Medical Physics. 2007.
  • Radermacher K.: Synergie von Mensch und Maschine in der computerunterstützten und bildgeführten Chirurgie. Kolloquium Medizinische Physik, Institut für Medizinische Physik, Universität Erlangen-Nürnberg, 19.1.2004 (auf Einladung).
  • Radermacher K: Synergy of man and machine in computer assisted smart surgery. 7^th Israeli Symposium on Computer-Aided Surgery, Medical Robotics and Medical Imaging – ISRACAS 2004, May 13th, 2004, Tel-Aviv, Israel (auf Einladung).
  • Radermacher K.: Systemintegration Bildgebung, Navigation und Chirurgierobotik. Symposium Operationssaal der Zukunft; XXXV. Kongress der DGE-BV, 9. März 2005, Stuttgart (auf Einladung).
  • Schmieder K, Engelhardt M, Scholz M, Wehmöller M, Eufinger H, Radermacher K: Robotergestützte Kraniotomie mit und ohne individuell vorbereiteter Sofortrekonstruktion – Entwicklung eines robotergestützten Trepanationssystems. CURAC 2003 – 2. Jahrestagung der Deutschen Gesellschaft für Computer- und Roboterassistierte Chirurgie, 4.-7. November 2003, Nürnberg.
  • Schmieder K, Radermacher K, Engelhardt M, Scholz M, Wehmöller M, Eufinger H: Robotergestützte Kraniotomie mit und ohne individuell vorbereiteter Sofortrekonstruktion – Entwicklung eines robotergestützten Trepanationssystems. CURAC 2004 – 3. Jahrestagung der Deutschen Gesellschaft für Computer- und Roboterassistierte Chirurgie, October 2004 München.
  • Wu T. Portheine, F., Popovic A., Bast P., Wehmöller, M., Radermacher K.: An Interface for the Data Exchange between CAS and CAD/CAM Systems. in: H.U. Lemke, M.W. Vannier et al.  (eds.) CARS 2003, Elsevier Science (2003), pp. 703-709
  • T. Wu, L. Fieten, M. Engelhardt, K. Schmieder & K. Radermacher: Knowledge-based Individual Implant Design Based on Reference Models for Craniofacial Reconstruction. Proceedings CARS (Suppl. 1), 1, 2006, pp. 259-261
  • T. Wu, M. Engelhardt, L. Fieten, A. Popovic & K. Radermacher: Anatomically Constrained Deformation for Design of Cranial Implant: Methodology and Validation. Medical Image Computing and Computer-Assisted Intervention - MICCAI 2006, 9, 2006, pp. 9-16
  • T. Wu, G. Qtaishat, A. Popovic, A. Follmann, F. Portheine, M. Engelhardt & K. Radermacher: A Knowledge Base to Support the Cranial Implant Design Process. Biomedizinische Technik, 52 (Ergänzungsband, CD-ROM), 2007

Contribution to a Book

  • Popovic A, Engelhardt M, Radermacher K. Knowledge based segmentation of calvarial tumors in computed tomography images. In Bildverarbeitung für Medizin, BVM 2006, Informatik-Aktuell, pp. 151–155. Springer, 2006.
  • Popovic A, Heger S, Follmann A, Wu T, Engelhardt M, Schmieder K, Radermacher K: Efficient Non-Invasive Registration with A-mode Ultrasound in Skull Surgery. In: V. Bozovic: Medical Robotics. pp. 323-340. I-Tech Education and Publishing, Vienna, Austria. 2008.

Phd Thesis

  • A. Popovic: Knowledge-based segmentation of calvarial tumorswith automatic parameter screening, 2008
  • P. Bast: Sicherheitsstrategie für ein Parallelrobotersystem beim Einsatz in der cranialen Neurochirurgie. In: S. Leonhardt, K. Radermacher & T. Schmitz-Rode (ed.): 5, Aachener Beiträge zur Medizintechnik (ISBN 978-3-8322-9160-0), Shaker, 2010, pp. 170
  • V.C. Vargas da Silveira Cunha Cruz: Development and Evaluation of Alternative Concepts for Interactive Control of Robot Aided Craniectomies in Neurosurgery. In: S. Leonhardt, K. Radermacher & T. Schmitz-Rode (ed.): 18, Aachener Beiträge zur Medizintechnik (ISBN 978-3-8440-2137-0), Shaker, 2013, pp. 184

Patent

  • Follmann A, Heger S, Radermacher K: Vorrichtung und Verfahren zur Materialbearbeitung. DE 10 2007 050 017A1, 23.04.2009.

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