Neurosurgical Robotics: Current Systems, Clinical Evidence, and the Path Toward Autonomous Assistance

Robotic platforms have entered neurosurgical practice across cranial, spinal, and stereotactic applications, offering the potential for enhanced precision, reproducibility, and surgeon ergonomics. This chapter reviews the architecture and clinical evidence for currently available neurosurgical robotic systems — including those used for pedicle screw placement, stereotactic biopsy, laser interstitial thermal therapy, and cochlear implantation — and examines their comparative outcomes against conventional approaches. The chapter concludes with a forward-looking discussion of the trajectory toward semi-autonomous and fully autonomous surgical assistance, including regulatory and safety considerations.