NeuroArm

Abstract: Intraoperative imaging disrupts the rhythm of surgery despite providing an excellent opportunity for surgical monitoring and assessment. To allow surgery within real-time images, neuroArm, a teleoperated surgical robotic system, was conceptualized. The objective was to design and manufacture a magnetic resonance-compatible robot with a human-machine interface that could reproduce some of the sight, sound, and touch of surgery at a remote workstation. University of Calgary researchers worked with MacDonald, Dettwiler and Associates engineers to produce a requirements document, preliminary design review, and critical design review, followed by the manufacture, preclinical testing, and clinical integration of neuroArm. During the preliminary design review, the scope of the neuroArm project changed to performing microsurgery outside the magnet and stereotaxy inside the bore. neuroArm was successfully manufactured and installed in an intraoperative magnetic resonance imaging operating room. neuroArm was clinically integrated into 35 cases in a graded fashion. As a result of this experience, neuroArm II is in development, and advances in technology will allow microsurgery within the bore of the magnet. neuroArm represents a successful interdisciplinary collaboration. It has positive implications for the future of robotic technology in neurosurgery in that the precision and accuracy of robots will continue to augment human capability.

Abstract: Introduction: Technologies such as microscopy have pushed surgeons to the limits of their dexterity and endurance. Robotic advances such as tremor filtration and motion scaling permit maximal use of magnification, and enable precise, tremor-free tool manipulation during microsurgery. To our knowledge, however, no such device exists for image-guided, ambidextrous microneurosurgery, prompting us to develop our own system. Methods: We approached a company with exceptional experience in space robotics to design and construct an appropriate system. A systematic and structured approached was followed for the design of neuroArm. Engineers studied the operating room environment with the assistance of surgeons and nursing staff. A preliminary design was developed, and subsequently evaluated by surgical staff. Selected materials were tested at 3.0 T to ensure MR compatibility and performance characteristics of the robot actuators and encoders were evaluated. Results: We have developed an MR compatible ambidextrous robot capable of both microneurosurgery and stereotaxy. The design is based on a SCARA configuration and has 8-DOF (including tool actuation). The end-effector is designed to interface with standard neurosurgical tools and is equipped with a 3-DOF optical force sensor for haptic feedback. Comprehensive testing of materials was conducted in a 3-T magnet to ensure compatibility. Breadboard testing results suggest a tool tip resolution of 30 μm. Discussion: A systematic approach has been applied to the development of a unique and dexterous neurosurgical robot. The system promises to enhance surgical performance, reduce fatigue, and improve surgical outcomes. This seamless integration of robotics with iMRI will further revolutionize neurosurgery.

Abstract: Object It has been over a decade since the introduction of the da Vinci Surgical System into surgery. Since then, technology has been advancing at an exponential rate, and newer surgical robots are becoming increasingly sophisticated, which could greatly impact the performance of surgery. NeuroArm is one such robotic system. Methods Clinical integration of neuroArm, an MR-compatible image-guided robot, into surgical procedure has been developed over a prospective series of 35 cases with varying pathology. Results Only 1 adverse event was encountered in the first 35 neuroArm cases, with no patient injury. The adverse event was uncontrolled motion of the left neuroArm manipulator, which was corrected through a rigorous safety review procedure. Surgeons used a graded approach to introducing neuroArm into surgery, with routine dissection of the tumor-brain interface occurring over the last 15 cases. The use of neuroArm for routine dissection shows that robotic technology can be successfully integrated into mi...

Abstract: Robotic systems are being introduced into surgery to extend human ability. NeuroArm represents a potential change in the way surgery is performed; this is the first image-guided, MR-compatible surgical robot capable of both microsurgery and stereotaxy. This paper presents the first surgical application of neuroArm in an investigation of microsurgical performance, navigation accuracy, and Phase I clinical studies. To evaluate microsurgical performance, 2 surgeons performed microsurgery (splenectomy, bilateral nephrectomy, and thymectomy) in a rodent model using neuroArm and conventional techniques. Two senior residents served as controls, using the conventional technique only (8 rats were used in each of the 3 treatment groups; the 2 surgeons each treated 4 rats from each group). Total surgery time, blood loss, thermal injury, vascular injury, and animal death due to surgical error were recorded and converted to an overall performance score. All values are reported as the mean ± SEM when normally distribut...