The Brain Surgeon's New Toolbox

The No-Harm Robo-Arm

Sticking your head in an MRI scanner while robotic hands cut into your brain may sound like a terrifying proposition—but at least they won't accidentally nick your optic nerve. After five years and $27 million spent, the University of Calgary and the Calgary Health Region health-care system have unveiled the neuroArm, the first surgical robot that operates inside an MRI scanner, combining high-precision surgery with near real-time imaging. Most surgeons operate within one- or two-millimeter accuracy, says project leader Garnette Sutherland. The neuroArm can make incisions accurate to 50 microns—about half the diameter of a human hair.

A surgeon using the neuroArm doesn't even need to be in the same room as the patient—a pair of high-definition cameras mounted on a microscope streams images to the doctor's control station. The controls filter out hand tremors, while a haptics system provides tactile feedback. The haptics can also help prevent accidental damage. "I can set a zone between the optic nerve and carotid artery, and the machine won't let me touch either of them," Sutherland says.

Pending a successful debut surgery—most likely a brain-tumor operation this fall—and FDA approval, Sutherland says the robot will reduce surgical error and HMO bureaucracy in one office visit. Typically a patient will undergo an MRI, come back for a consultation, and finally return for a biopsy. "Now," Sutherland says, "if we see a lesion in MR imaging, we could biopsy it on the spot."—Michael Slenske

Robotic Arsenal

The neuroArm is outfitted with a cauterizer, 12 micro-dissectors, a suction hose, bayonet-shaped micro-scissors, and needle drivers to hold sutures.