Master's Thesis

Adaptation of a miniature robotic system to perform neurosurgical deep brain stimulation procedures using the Leksell Vantage Stereotactic System

Author of thesis: Peter Koppensteiner

Acad. year: 2025/2026

Supervisor: Ing. Martin Mézl, Ph.D.

Reviewer: Dipl.-Ing. Dr.techn. Gernot Kronreif

Abstract:

Deep Brain Stimulation (DBS) is a therapy method where electric impulses from an electrode are emitted to a specific brain region, in order to stimulate these areas. The electrodes are placed using a stereotactic system such as a stereotactic frame, which is attached to the patient’s skull. The most  commonly treated diseases are movement disorders, for example, Parkinson’s syndrome, essential tremor and dystonia.

This thesis focuses on the integration of a robotic positioning system with a stereotactic frame (Leksell Vantage Stereotactic System (LVSS)) to enhance DBS procedures. The primary research investigates how this integration can improve patient safety and system usability, while quantitatively comparing its accuracy to conventional manual methods. The motivation stems from the clinical demand for robotic DBS guidance, which offers the potential to eliminate human coordinate-setting errors, increase precision, and reduce procedure time. The methodology encompasses the development, and
prototyping of the hardware integration. A mechanical interface for attaching the robot to the stereotactic frame, a newly developed and enhanced cardan joint for instrument guidance with complete sterility concept and a phantom head with a suitable test environment for conducting preclinical trials are the outcomes of this development.

In a preclinical trial, neurosurgeons evaluated the accuracy and trajectory-setting time of the robot-assisted DBS variant against the traditional, non-robotic variant on the test platform designed for this purpose. Both approaches showed excellent accuracy, however the robot-assisted version aligned with a predetermined trajectory significantly faster.

Keywords:

Deep Brain Stimulation, Robotics, Stereotactic Neurosurgery, 3D-printing, Prototyping

Date of defence

16.06.2026

Date of publish

15.06.2031

Result of the defence

Defended (thesis was successfully defended)

znamkaAznamka

Grading

A

Process of defence

Student presented the results of his master thesis and the committee members were acquainted with the reviews. Prof. Glowacki asked question relevenace of time decrease with the miniature robotic system use. What is the percentage time that could be safed using this system. Doc. Rožánek asked how Multiple Sclerosis patients could benefit from this device. Doc. Kolář asked about the following methodology for the use of device in operating room. Student defended the master thesis and answered the questions.

Language of thesis

English

Faculty

Department

Study programme

Bioengineering (Double Degree) (MPAD-BIO)

Composition of Committee

doc. Ing. Martin Rožánek, Ph.D. (předseda)
doc. Ing. Radim Kolář, Ph.D. (místopředseda)
doc. Mgr. Zdenka Fohlerová, Ph.D. (člen)
prof. Eric Daniel Glowacki, Ph.D. (člen)
Ing. Martin Vítek, Ph.D. (člen)

Supervisor’s report
Ing. Martin Mézl, Ph.D.

Peter prepared his thesis in collaboration with the Austrian Center for Medical Innovation and Technology, ACMIT GmbH. Throughout the process, he consulted primarily with his thesis advisor, Wolfgang Ptacek. All formal requirements are met at an excellent level, and the final presentation of both the theoretical foundation and the results is exemplary. The preliminary results are interesting and will be further tested in preclinical experiments. The presented work is of a high standard; I recommend a grade of Excellent (A – 100 points).

Evaluation from the consultant of the thesis - Dipl.-Ing. Wolfgang Ptacek:
Mr. Koppensteiner did a fantastic job implementing our robotic platform to be compatible with the Leksell Vantage stereotactic system, enabling a smooth integration into the current clinical workflow, based on a thorough state-of-the-art examination of medical robotics in the neurosurgical sector. Starting with the collection of user needs and system requirements he derived suitable design specifications that led to a prototype design which he build-up in a working mock-up, using 3D printing technologies. Derived from a real MR dataset he created a phantom head providing the possibility to evaluate system accuracy in all clinically relevant DBS targets. Using this phantom a pre-clinical study was conducted at the Medical University Hospital in Graz to evaluate the robotic setup in comparison to the manual setup by means of achievable accuracy and time needed to align to the planned trajectories. Mr. Koppensteiner carried out the tasks assigned to him with great dedication, extreme care, and a consistent focus on finding optimal solutions, as reflected in the successful outcome of the pre-clinical trial. Points proposed by supervisor: 100

Grade proposed by supervisor: A

Regarding presentation quality the work gives a well balanced overview from the clinical use case, to existing treatment options (i.e. state of the art), to finally the new development in question. What could have been a bit more elaborated are the specific requirements for the system, but this is a minor issue. Also the chapter "Materials and Methods" is a bit short - but only because most of the description has been included in chapter "Results". But this might be more of a question of taste and does not really limit the high quality of the work.
Both formatting of the technical report and language quality is excellent - use of references is fully sufficient.
The main result of the work, i.e. the design of a robot adapter for DBS procedures is excellent, meticulously thought out in every detail. First test results and the feedback from the clinicians were very promising. All together, the setup shows high potential for a successful clinical application and - together with Mr. Koppensteiner - we already trying to bring the system to the next level (i.e. to a first cadaver trial).
Based on the aforementioned assessment, my overall grading of the work are 96 points. Points proposed by reviewer: 96

Grade proposed by reviewer: A

Reasons for publication postponement

Publication of the final thesis has been postponed in compliance with the provisions of Section 47b (4) of Act No. 111/1998 Coll., on the Higher Education Institutions and on amendments and supplements to other acts, as amended.

The final thesis was developed in close cooperation with an R&D company and contains proprietary information regarding a novel system that i currently being evaluated for commercial protection. Public disclosure would compromise the company's trade secrets and the potential intellectual property value of the system. Additionaly, the results are intended for a forthcoming journal publication, which requires the work to remain confidential until then.

Responsibility: Mgr. et Mgr. Hana Odstrčilová