Newswise — A prototype surgical robot has the potential to make brain surgery more accurate and precise than ever while re-creating the "sound, sight, and feel" of conventional neurosurgery, according to an article in the March issue of Neurosurgery.
Dr. Deon F. Louw of University of Calgary and colleagues describe the design and initial "breadboard" testing of the neurosurgical robot, dubbed neuroArm. The neuroArm—the first robot created for the specific purpose of performing microneurosurgery—was developed by the Canadian company MD Robotics, on commission from University of Calgary.
The neuroArm system consists of two robot arms, each with eight-degrees-of-freedom movement, which are manipulated by the surgeon. The independently operated robot arms can be fitted with special surgical tools, such as forceps or dissectors, and so forth.
The surgeon uses sophisticated hand controllers to translate his or her hand movements into motions of the robot arms. In initial tests, the controller accurately positioned surgical tools to within 30 micrometers—even better than the 100-micrometer resolution called for in the system design.
The hand controllers include force sensors to provide the surgeon with tactile feedback, lending a realistic "feel" to the operation. The neuroArm system uses filtering to eliminate the natural tremor of the hand. It also scales down the surgeon's hand motions to achieve greater precision than possible with the unaided human hand—for example, moving the controller ten centimeters will move the "effector" holding the tool by only five millimeters. Safety switches are incorporated to prevent accidental movements from being transmitted to the robot arm.
The surgeon operates the neuroArm from a workstation with displays showing the live three-dimensional magnetic resonance imaging (MRI) scan of the patient's brain, including the position of the tool currently being used. Another display shows a color video view of the brain through a surgical microscope, while a third provides system data and control settings.
The robot arms and all associated systems are designed to be fully compatible with the MRI scanner in which the neuroArm operates. Under MRI guidance, the surgeon can navigate safely and accurately within the brain, with the tools' positioning confirmed by registration with the patient's MRI scan. Using the neuroArm's image guidance system, the surgeon can plan and even practice virtual operations before the actual surgical procedure.
In addition to use in brain surgery, the neuroArm is likely to find uses in surgical training and distance surgery (telesurgery). It may also prove helpful for other types of surgery demanding high precision, such as eye surgery.
Final construction on the neuroArm system will be completed this spring. Preliminary studies of its capabilities will then begin, eventually working up to live human studies. The neuroArm promises to enhance the neurosurgeon's fine motor control, while reducing fatigue during lengthy brain operations. Dr. Louw and colleagues conclude, "Embracing medical manipulators will allow neurosurgery to transcend these restraints and enter a new era in which robots supplement, not supplant, surgeons and together perform tasks better than either can do individually."
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