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. 2015 Feb 13;6(Suppl 1):S1-8.
doi: 10.4103/2152-7806.151321. eCollection 2015.

Robotics in the neurosurgical treatment of glioma

Garnette R Sutherland  1 , Yaser Maddahi  1 , Liu Shi Gan  1 , Sanju Lama  1 , Kourosh Zareinia  1
Affiliations

Robotics in the neurosurgical treatment of glioma

Garnette R Sutherland et al. Surg Neurol Int. .

Abstract

Background: The treatment of glioma remains a significant challenge with high recurrence rates, morbidity, and mortality. Merging image guided robotic technology with microsurgery adds a new dimension as they relate to surgical ergonomics, patient safety, precision, and accuracy.

Methods: An image-guided robot, called neuroArm, has been integrated into the neurosurgical operating room, and used to augment the surgical treatment of glioma in 18 patients. A case study illustrates the specialized technical features of a teleoperated robotic system that could well enhance the performance of surgery. Furthermore, unique positional and force information of the bipolar forceps during surgery were recorded and analyzed.

Results: The workspace of the bipolar forceps in this robot-assisted glioma resection was found to be 25 × 50 × 50 mm. Maximum values of the force components were 1.37, 1.84, and 2.01 N along x, y, and z axes, respectively. The maximum total force was 2.45 N. The results indicate that the majority of the applied forces were less than 0.6 N.

Conclusion: Robotic surgical systems can potentially increase safety and performance of surgical operation via novel features such as virtual fixtures, augmented force feedback, and haptic high-force warning system. The case study using neuroArm robot to resect a glioma, for the first time, showed the positional information of surgeon's hand movement and tool-tissue interaction forces.

Keywords: Force feedback; glioma; haptic warning; intraoperative magnetic resonance imaging; robot-assisted microsurgery; virtual fixture.

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Figures

Figure 1
Figure 1
Electronic highways for tool placement creating no-go zones thereby improving the safety of surgery
Figure 2
Figure 2
Left: Preoperative T1 MR image, Right: Postoperative T1 MR image, with superimposed speech cortex and its connections to the thalamus, using a noun–verb task-based fMRI. Green arrow shows how an articulated tool could access residual tumor (within the yellow margin)
Figure 3
Figure 3
Top left: Surgeon's posture in conventional surgery, top right: Surgeon at the robot workstation, bottom: NeuroArm robot operating in conjunction with the surgical assistant in the operating room; inset: NeuroArm tools within the surgical corridor
Figure 4
Figure 4
A cylindrical no-go zone defined to maintain the bipolar forceps within the virtual cylinder, restricting any penetration beyond that virtual wall. The no-go zone is defined according to the shape of the surgical corridor geometry required to conduct the surgery
Figure 5
Figure 5
Example of a no-go zone virtual fixture (shown as circular solid lines) and robot positional configuration. Several no-go zones can be defined for a surgical task. The region of interest, in which the robot performs surgery, is shown with dotted area. Dashed areas are critical structures in brain, for example, speech cortex and motor cortex
Figure 6
Figure 6
Titanium Nano17 force sensor used in neuroArm (arrows)
Figure 7
Figure 7
The neuroArm robotic arms with bipolar forceps on the right and suction tool on the left arm
Figure 8
Figure 8
Position components of the bipolar forceps located at the end-effectors of the right neuroArm manipulator
Figure 9
Figure 9
Force measured by the force sensor for the trajectory given in Figure 8
Figure 10
Figure 10
3D reconstruction of the bipolar forceps position. As seen, during the chosen time period, the end-effectors has moved by 25, 50, and 50 mm along x, y, and z axes, respectively
See this image and copyright information in PMC

References

    1. Abbott JJ, Hager GD, Okamura A. Proceedings ROMAN 2003 The 12th IEEE International Workshop on; 2003. Steady-hand teleoperation with virtual fixtures. Robot and Human Interactive Communication, 2003; pp. 145–51.
    1. Abbott JJ, Okamura AM. Stable forbidden-region virtual fixtures for bilateral telemanipulation. J Dyn Syst Meas Control. 2005;128:53–64.
    1. Assaf Y, Pasternak O. Diffusion tensor imaging (DTI)-based white matter mapping in brain research: A review. J Mol Neurosci. 2008;34:51–61. - PubMed
    1. Banthia V, Maddahi Y, Balakrishnan S, Sepehri N. Intelligent Robots and Systems. IEEE/RSJ International Conference; 2014. Haptic-enabled teleoperation of base-excited hydraulic manipulators applied to live-line maintenance; pp. 1222–1229.
    1. Black PM, Moriarty T, Alexander E, 3rd, Stieg P, Woodard EJ, Gleason PL, et al. Development and implementation of intraoperative magnetic resonance imaging and its neurosurgical applications. Neurosurgery. 1997;41:831–42. - PubMed