Intra-operative pathology interrogation and cellular-level visualization remain significant challenges in surgery. Advances in genetic and molecular disease understanding, combined with biomedical innovation, suggest a need for an intelligent robotic surgical system. CellARM represents a state-of-the-art robotic device designed for minimally invasive, precise surgery. Equipped with a dexterous robotic arm, endoscopic camera, and sensors, CellARM offers real-time data and feedback, enhancing surgeons’ capabilities. It integrates machine learning, allowing the system to learn and improve from each procedure. By democratizing access to advanced surgical tools and data, CellARM promises to level the playing field in healthcare, making high-quality surgery accessible globally. This technology aims to standardize care, improve patient outcomes, and reduce costs by providing detailed, real-time information on patient tissues and cells during surgery.

The chapter discusses the evolution of neurosurgical visualization techniques, drawing an analogy to Plato’s “Allegory of the Cave.” Traditional medical imaging provides an incomplete view of reality, similar to shadows on a cave wall. Neurosurgeons, however, can “escape the cave” by directly observing the body’s internal structures during surgery. The chapter highlights the advancements in magnification and visual augmentation tools, such as operating microscopes, endoscopes, and exoscopes. These tools have significantly improved surgical precision and outcomes. Fluorescent molecules such as fluorescein and 5-ALA enhance the surgeon’s ability to distinguish between normal and abnormal tissues. The chapter also explores the future potential of augmented reality (AR) and virtual reality (VR) in neurosurgery, which could further revolutionize surgical practices by providing enhanced visualization and planning capabilities.

The integration of computers in neurosurgery has revolutionized the field, transitioning it from reliance on anatomical knowledge to leveraging advanced technology for enhanced precision and outcomes. Since the mid-twentieth century, the adoption of computers facilitated significant advancements in diagnosis, surgical precision, and three-dimensional orientation. Technologies such as stereotactic neuro-navigation, virtual reality (VR), intra-operative imaging, and artificial intelligence (AI) have been pivotal. Stereotactic navigation aids real-time visualization during surgery, while VR assists in surgical simulations and planning. Intra-operative imaging such as CT and MRI provides updated visuals for accurate navigation. AI and machine learning enhance diagnosis, risk assessment, and surgical planning. The integration of these technologies has improved patient outcomes, but also presents challenges such as ethical considerations and potential overreliance on AI. The future of neurosurgery will continue to intertwine with technological advancements, requiring neurosurgeons to stay abreast of emerging tools and techniques.