Remote robotic surgery in our sights
Imagine a scenario where a person is having a stroke. The patient lives too far away from a major hospital and expert neurovascular surgeons, but they can get to a smaller medical facility. Here, a neurovascular surgeon remotely treats the brain aneurysm using a robotic system. Sounds like science fiction, you say? A robot trained to treat brain aneurysms demonstrates that this technology of the future may not be so far away.
Canadian research presented at this year’s International Stroke Conference reported surgical success using a robotic system specifically adapted for neurovascular procedures. Software and hardware adaptations enabled the system to accommodate microcatheters, guidewires and other devices used for endovascular procedures in the brain, providing the operator with fine motor control.
Reported to be the first time that robotic technology has been adopted for brain vascular procedures, the researchers said using a robot to treat brain aneurysms is feasible and could allow for improved precision when placing stents, coils and other devices. The robotic system could also be adopted for remote surgery.
“This experience is the first step towards achieving our vision of remote neurovascular procedures,” said lead researcher Vitor Mendes Pereira, a neurosurgeon and neuroradiologist at Toronto Western Hospital and Professor of Medical Imaging and Surgery at the University of Toronto in Canada.
“The ability to robotically perform intracranial aneurysm treatment is a major step forward in neuro-endovascular intervention.”
The researchers described the case of a 64-year-old female presenting with an unruptured aneurysm at the base of her skull. Employing the robot, the surgical team successfully placed a stent and then, using the same microcatheter, entered the aneurysm sac and secured the aneurysm by placing various coils. All intracranial steps were performed with the robotic arm.
Since this case, the team has successfully performed five additional aneurysm treatments using the robot, which included deploying various devices such as flow-diverting stents.
“The expectation is that future robotic systems will be able to be controlled remotely. For example, I could be at my hospital and deliver therapy to a patient hundreds or even thousands of kilometres away,” Professor Mendes Pereira said.
“The ability to deliver rapid care through remote robotics for time-critical procedures such as stroke could have a huge impact on improving patient outcomes and allow us to deliver cutting-edge care to patients everywhere, regardless of geography.
“Our experience, and that of future operators of this technology, will help develop the workflows and processes necessary to implement successful robotic programs, which will ultimately help establish remote care networks in the future,” Professor Mendes Pereira said.
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