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Cirq for Functional NeurosurgeryAutomating frameless
stereotactic neurosurgery

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Cirq® is a lightweight, versatile and modular robotic surgical system designed to assist surgeons precisely when and where support is needed. Cirq can be used for safe and effective sEEG electrode placement for epilepsy. The sEEG workflow is based on clinically proven optical navigation that enables surgeons to monitor accuracy and increase efficiency.

Image displaying Cirq with platform monitor, table-mounted with head mount and patient phantom
Frame Courtesy of Elekta: Leksell® Stereotactic System.

Seamless integration with software

The Cirq Arm System seamlessly integrates with powerful software for trajectory planning, image fusion and lead localization with an accurate optical navigation workflow. This can support clinical teams during trajectory planning, electrode placement and brain segment resection.

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Screenshot of the Alignment Software Cranial depicting an sEEG procedure with Cirq robotic assistance

Designed for time-saving efficiency in the O.R.

sEEG procedures require the precise implantation of several electrodes which can be time intensive. Cirq was created to facilitate an efficient surgical workflow that saves surgeons and patients time in the O.R. As part of its design, the arm can be easily set up and the Alignment Software Cranial provides multiple registration options and accurate alignment.

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Cirq works synergistically with Loop-X and Curve Navigation for real-time tracking and more

Powerful synergy with the Robotic Suite for real-time tracking & more

As one product within the Brainlab Robotic Suite, Cirq works synergistically with Loop-X® and Curve® Navigation, providing users with the benefits of robotic precision, faster than manual registration methods, and accurate automatic image registration and precise navigation as well as real-time tracking of the instrument axis with adjustable deviation monitoring.

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Cirq in a functional neurosurgery workflow

Streamlining epilepsy workflows through collaborative robotics

Brainlab assists surgeons with the alignment and placement of sEEG electrodes by offering solutions with advanced planning features, accurate registration options and real-time optical tracking. When these solutions are combined with Cirq, users can benefit from steady, unified and uninterrupted support.

For example, surgeons can first manually align the Cirq Arm System in the vicinity of the patient’s head and then use the Cirq Robotic Alignment Module to automatically align to the preplanned trajectory. This also removes the need to fixate the patient to a frame before the surgery, thereby increasing patient comfort.

Screenshot of the Cirq Robotic Alignment Module assisting with alignment and placement of sEEG electrodes

Accuracy and stability through tracking and navigation

The real-time tracking of instruments with deviation monitoring enables accurate bone anchor placement while the sEEG Drill Kit minimizes movement during the procedure and enables controlled drilling through the Alignment Guide Tube. Advanced Alignment Software Cranial features also allow for assisted skull thickness measurement for each trajectory.

In addition, by using the buttons on the Cirq Robotic Alignment Module, the navigation system can be controlled from the sterile field O.R. without screen interaction. The pointer measurement feature also uses information from the navigation system to automatically measure the required length of the electrodes.

Image displaying Cirq with platform monitor, table-mounted with head mount and patient phantom
Frame Courtesy of Elekta: Leksell® Stereotactic System

Robotics in functional neurosurgery

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Interchange modules for more flexibility

The future of robotic surgery is modular. With its interchangeable modules, Cirq is a highly adaptable and versatile robotic surgical system.

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High clearance between robot and skull

After implantation, sEEG anchor bolts are quite fragile and may protrude from the patient’s skull. As a result, any collision with the anchor bolts must be avoided.

During manual pre-alignment, the Cirq Alignment Software Cranial accounts for the height of the anchor bolts. This results in a high clearance between the skull, implanted sEEG anchor bolts and the Cirq Robotic Alignment Module.

Cirq Alignment Software Cranial: Manual pre-alignment with anchor bolt height consideration

Modify anchor bolts and trajectories with ease

Surgical plans including anchor bolt placements and trajectories may need to change due to unforeseen circumstances in the O.R.

When necessary, the entry point of the anchor bolt or trajectory can be easily modified with the navigation pointer. The updated trajectory can then be reviewed and integrated into a seamless intraoperative workflow.

Navigation pointer in action: modify anchor bolt or trajectory entry points seamlessly

Effortlessly integrate Cirq into unique workflows

When it comes to highly accurate registration workflows, Alignment Software Cranial is agnostic and can effortlessly integrate into other workflows such as Automatic Image Registration and landmark registration.

Effortless integration of Cirq into diverse workflows with Alignment Software Cranial
Image of Cirq: Demonstrating easy attachment to most O.R. tables

Automatic assistance
anytime, anywhere

Cirq Arm System fits into almost any operating room allowing surgeons to leverage the advantages of robotics for all kinds of procedures – standard to complex. The system attaches easily to most O.R. tables and accommodates multiple imaging devices.

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