The median survival rate for patients with glioblastomas or high grade primary brain cancer is less than two years. One factor contributing to this low rate is the fact than many deep-seated and pervasive tumors are not entirely accessible or even visible when using current neurosurgical tools and imaging techniques.
The National Institute of Biomedical Imaging and Bioengineering (NIBIB) is funding various research institutions to find ways to do better surgery on the brain. One project funded at the University of Maryland enabled scientists, engineers, and neurosurgeons to work together to develop technologies that enable less invasive image-guided removal of hard-to-reach brain tumors.
The team worked on technologies needed to combine novel imaging techniques to enable surgeons to see deep within the brain during surgery along with the development of robotic systems to enhance the precision needed to remove brain tissue.
Within four years, the team designed, constructed, and tested their first prototype, a finger-like device with multiple joints, allowing the device to move in many directions. At the tip of the robot is an electrocautery tool that uses electricity to heat and ultimately destroy tumors, as well as used as a suction tube for removing debris.
A key component of the team’s devices is the ability for the surgeon to use the device while a patient is undergoing an MRI. By replacing normal vision with a continuously updated MRI, the surgeon is able to visualize deep-seated tumors and monitor the robot’s movement without needing to create a large incision in the brain.
Designing a neurosurgical device that can be used inside of an MRI magnet is not easy and the team was faced with the problem of enabling the surgeon to get their hands on the brain while the patient is in the scanner.
The team’s solution was to enable the surgeon to have robotic control of the device in order to circumvent the need to access the brain directly. The solution enables the surgeon to insert the robot into the brain while the patient is outside of the scanner.
Then when the patient moves into the scanner, the surgeon can sit in a different room, watch the MRI images of the brain on a monitor, move the robot deep inside the brain, and direct it to electro cauterize and aspirate the tissue.
With continued support from NIBIB, the team is working to further reduce image distortion and be able to test the safety and efficacy of their device in animals as well as in human cadavers. However, researchers think that it will be several years before their device finds its way into the operating room.