In a joint study with Carl Zeiss Meditec AG, researchers from the Department of Neurosurgery at Inselspital, Bern University Hospital, have demonstrated how artificial intelligence (AI) and robotics can support microsurgical practice in the future. The results were published in the renowned journal Neurosurgical Focus and featured as the cover story of the July 2025 issue.
Automated microscope control optimizes surgical procedures
Surgical microscopes provide magnified, razor-sharp visualization and optimal illumination of the surgical field during microsurgical procedures – both of which are essential for safe and precise surgery in the millimeter range on the brain and spine. To ensure optimal visibility, the microscope must be manually readjusted by the surgeon on a regular basis during the operation – a task that requires fine motor skills and concentration and can interrupt the surgical workflow
A preclinical study has now tested a novel robot-assisted assistance system that uses AI to automatically detect the area to be operated on by locating the position of the surgical instrument tips and automatically re-centering the microscope's field of view using robotics.
Compared to conventional control via hand grip or mouth switch, the system showed a significant reduction in cognitive and physical strain, fewer interruptions in the workflow, and longer effective operating times—while also providing more precise centering of the field of view.
A glimpse into the future of neurosurgery
«This work exemplifies how intelligent assistance systems can optimize surgical procedures, not to replace humans, but to provide targeted support and relief at crucial moments so that surgeons can focus even more on the actual operation,» says Dr. Michael Murek, neurosurgeon and co-first author of the publication.
«Our project highlights the huge potential that combining artificial intelligence and robotics offers for neurosurgery. It also illustrates how crucial close collaboration between research, clinics, and industry is for innovation in medical technology,» adds Dr. Markus Philipp, co-lead author and research associate in advance development at ZEISS.
The system was initially tested successfully in a phantom model; further clinical trials are already being planned. In addition to neurosurgery, other microsurgical fields such as ophthalmology, ear, nose, and throat medicine, plastic surgery, and oral and maxillofacial surgery could also benefit from such technological advances in the future.
Publication
Murek M, Philipp M, Gutt-Will M, et al. Streamlining microsurgical procedures: a phantom trial of an artificial intelligence-driven robotic microscope assistant. Neurosurg Focus. 2025;59(1):E2. doi:10.3171/2025.4.FOCUS25142