Robotic arms lend a healing touch: neuroArm and its legacy
The delicate touch that successfully removed an egg-shaped tumour from Paige Nickason's brain got a helping hand from a world-renowned arm—a robotic arm, that is. The technology that went into developing neuroArm, the world's first robot capable of perform¬ing surgery inside magnetic resonance machines, was born of the Canadarm (developed in collaboration with engineers at MacDonald, Dettwiler and Associates, Ltd. (MDA) for the US Space Shuttle Program) as well as Canadarm2 and Dextre, the Canadian Space Agency's family of space robots performing the heavy lifting and maintenance aboard the International Space Station.
neuroArm began with the search for a solution to a surgical dilemma: how to make difficult surgeries easier and impossible surgeries possible. MDA worked with a team led by Dr. Garnette Sutherland at the University of Calgary to develop a highly precise robotic arm that works in conjunction with the advanced imaging capa¬bilities of magnetic resonance imaging (MRI) systems. Surgeons wanted to be able to perform surgeries while a patient was inside an MRI machine, which meant designing a robot that was as dexterous as the human hand but even more precise and tremor-free. Operat¬ing inside the MRI also meant it had to be made en¬tirely from safe, MRI-compatible materials (for instance, ceramic motors) so that it would not be affected by the MRI's magnetic field or, conversely, disrupt the MRI's images. The project team developed novel ways to control the robot's movements and give the robot's operator a sense of touch via an intuitive, haptic hand-controller located at a remote workstation—essential so that the surgeon can precisely control the robot and can feel the tool-tissue interface during the surgery.
Robotic specialists and surgeons sought to make difficult surgeries easier and impossible surgeries possible.
Since Paige Nickason's surgery in 2008, neuroArm has been used in the initial clinical experience of 35 patients who were otherwise inoperable. In 2010, the neuroArm technology was licenced to IMRIS Inc., a private, publicly traded medical device manufacturer based in Winnipeg, Manitoba, Canada, for development of the next-generation platform and for wide distribution under the name "SYMBIS Surgical System."
IMRIS is advancing the design to commercialize mini¬mally invasive brain tumour resection procedures, which allow surgeons to see detailed, 3-D images of the brain as well as use surgical tools and hand controllers that allow the surgeon to feel tissue and apply pressure when he or she operates. SYMBIS has been undergo¬ing calibration, testing and validation at Dr. Sutherland's research facility since March 2015. SYMBIS is expect¬ed to be able to perform microsurgery and stereotactic biopsy within the bore of the magnet while real-time MR images are being acquired. The system is more compact, with improved haptics, safety no-go zones, motion scaling and tremor filters. SYMBIS is currently being reviewed by the FDA, and once approved, the system will be made available commercially for other centres worldwide to establish its clinical efficacy through clinical trials.
MDA is also continuing to apply its space technologies and know-how to medical solutions for life on Earth. The company has partnered with the Hospital for Sick Children (SickKids) in Toronto, Ontario, to collaborate on the design and development of an advanced tech¬nology solution for pediatric surgery. Dubbed KidsArm, the sophisticated, teleoperated surgical system is being designed specifically to operate on young children and babies. KidsArm is intended for use by surgeons in conjunction with high-precision, real-time imag¬ing technology to reconnect delicate vessels such as veins, arteries or intestines.
In collaboration with the Centre for Surgical Invention and Innovation (CSii) in Hamilton, Ontario, MDA is also developing an advanced platform to provide a more accurate and less invasive identification and treatment of breast tumours in the MRI. The Image-Guided Autonomous Robot (IGAR) will provide increased access, precision and dexterity, resulting in more accurate and less invasive procedures. IGAR is currently in the second phase of clinical trials in Hamilton, Ontario, Canada, and Quebec City, Quebec, Canada.
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