Researchers from the Technion and Rambam Health Care Campus have won the Best Innovation Award in the Surgical Robotic Challenge 2016. Twelve teams from around the world participated in the competition in London.
The Technion-Rambam team’s development is a robot for minimally invasive neurosurgery, intended for the removal of brain tumors of up to 6 cm in size. The robot is operated through a small keyhole in the skull using laser irradiation and tumor extraction. It does so using novel technologies of a needle assembly, real-time tumor detection and therapy of the cancerous tissue.
The robot was developed by Technion doctoral student Hadas Ziso, supervised by Professor Moshe Shoham, head of the Medical Robotics Laboratory at the Faculty of Mechanical Engineering, and Professor Menashe Zaaroor, faculty member of the Rappaport Faculty of Medicine and Director of the Department of Neurosurgery at Rambam. The robot is protected by a patent registered in the names of the three researchers and its first inventor, Assistant Professor David Zarrouk, who worked on the project in its early stages during his PhD at the Technion.
The needle assembly
The robotic device is composed of a needle assembly: a rigid outer needle and a self-reassembled inner needle. The outer needle is responsible for rotational movement and vertical movement into the tumor, while the inner needle is able to move laterally. Thus, in effect, three degrees of freedom are achieved.
“This project involved many challenges,” says Ziso. “Besides the challenge of miniaturizing the detection and treatment tool, we had to allow the passage of a 90-degree curve in order to minimize the outer needle diameter. For this purpose we developed an inner needle that is flexible enough to pass through the curve, but also strong enough to lead the diagnostic and treatment tool to the tumor accurately, while bearing lateral loads resulted from heterogeneous environment. The inner needle mechanism that we developed is based on a chain of tiny magnetic beads, that are partially separated and self-reassembled while passing through a minimal curvature path, Kevlar fibers (a composite material) that pull the mechanism inward, stainless steel links that hold the optical fibers and suction tube, and a polyurethane cover.”
The robotic treatment includes several preliminary stages. First, prior to surgery, MRI scans are performed, and the physician prepares the treatment plan on the MR images. Second, a few hours before surgery, the patient drinks a fluorescent medium (5-ALA) that accumulates in the tumor during surgery, so that the robot will rely on both the preliminary MR scans and the morphology of the tumor in real time.
Focused laser beam
During surgery, ultraviolet (UV) light is projected at the tumor via optical fibers, causing the emission of red light from the fluorescent medium, accumulated within the tumor. The red light allows accurate identification of the cancerous tissue in real time. Based on the information obtained from the detection tool, a high intensity laser is activated, projected from the tip of an optical fiber on the tumor in close range (1 mm) and ablates the tissue. During treatment, the real time detection is constantly activated to prevent damage to healthy tissue.
Ziso earned her bachelor’s and master’s degrees at the Technion Faculty of Biomedical Engineering. The topic of her master’s thesis, supervised by Professor Eitan Kimmel, was treating malignant tumors using ultrasound and micro-bubbles. On completion of graduate school, she worked at InSightec and other biomedical companies. Four years ago, she began her doctorate under the supervision of Professor Shoham and Professor Zaaroor.
Two Israeli companies are involved in the development process: Prizmatix, which built the optical detection system, and Civan Advanced Technologies, which built the laser system. Hadas Ziso and Roman Shamsutdinov, an electronics engineer and member of the project team, attended the competition and demonstrated the robotic action to the judging panel.