Brain surgery is a complex, delicate business with little room for error. As surgery becomes more automated, patients may one day have the option to choose between human surgeons, subject to the trials that come with being human, such as fatigue and imprecision, and robot surgeon, strong on precision, but lacking human judgment. While you don’t have that choice yet, researchers at the University of Utah have designed a robotic drill that can perform a complex cranial surgery, which would take a human surgeon two hours, in less than three minutes. This proof of principle study, which demonstrates the effectiveness of the robot, was published in the journal Neurosurgical Focus.
The robotic drill is mainly being used on a surgery specific to noncancerous tumors associated with hearing loss. Since the drill cuts swiftly and cleanly, it reduces the length of time the wound is open, and the patient is under anesthesia. This decreases likelihood of infection, costs less than paying a surgeon’s time, and reduces the possibility of human error, the researchers recently told CNN.
The robot takes its cues from data that is programmed from CT scans. This allows it to move around other areas of the skull that are at risk and allows the programmer to pinpoint nerves, veins and other vulnerable areas of the brain to avoid. In particular, they must be careful to avoid the venous sinus, whose job is to drain blood out of the brain. The robot is programmed to cut within one to two millimeters of those areas.
“We can program [it] to drill the bone out safely just by using the patient’s CT criteria,” The team’s lead neurosurgeon William Couldwell, told CNN. “It basically machines out the bone.”
Though it’s unlikely the machine would go rogue, a second surgeon stands by to turn off the machine should the need arise. As extra safeguards, the robot can sense some nerves and will shut off if it gets too close.
Before testing it on live humans, the research team tested it on plastic blocks and cadaver skulls. It has gone through several iterations to improve accuracy and make it portable enough to be moved quickly and easily.
The next step is to make the drill available more commercially. The team estimates it could be available clinically in as little as one year for a cost of roughly $100,000, which might sound pricey but is not in the long run.
"If it saves two and a half hours per case, that's a significant amount of savings over time," Couldwell told CNN.
The robotic drill also has other applications in skull or spine surgeries, and as an educational tool. It can also be applied to other surgical procedures, such as other complex openings of the skull or spine, say the researchers.
"I would like to see it being used in major teaching hospitals because I think it would be a great teaching aid," Couldwell said.
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