Intelligent Surgeon's Arm Supporting System iArmS in Microscopic Neurosurgery Utilizing Robotic Technology.BACKGROUND
 We developed the robotic intelligent surgeon's arm supporting system iArmS, which automatically follows the surgeon's arm and fixes it at an adequate position.


 iArmS has 3 states-free, hold, and wait-which can be carefully chosen automatically as follows: In free state, the armholder follows the surgeon's arm.  In hold state, iArmS supports the surgeon's arm weight by fixing the armholder.  From February 2015 to January 2017, iArmS was used in 108 microsurgeries at 3 of the authors' institutions by 14 board-certified neurosurgeons, including the authors.  After using iArmS, to quantify neurosurgeons' satisfaction, a scaling evaluation guide based on visual analog scales was designed to be completed by contributing neurosurgeons, including authors.


 iArmS decreased fatigue and reduced hand trembles experienced by surgeons.  There were no complications related to use of iArmS.


 iArmS allows continuous precise manipulations that provide high-quality surgical results in neurosurgical techniques.  Moreover, iArmS is a useful automatic tool for holding and following the surgeon's arm.
iArmS