8th June 2007

While recent advances in neurosurgery have made it possible to precisely target areas in the brain with minimum invasiveness -- using a small hole to insert a probe, needle or catheter -- there remains a disadvantage. The small size of the openings reduces or eliminates direct site visibility and requires greater dexterity, stability and precision by the surgeon.

Now, an invention by a Hebrew University of Jerusalem researcher has made it possible to retain the advances of such keyhole surgery through utilization of the “services” of a tiny robot that can guide surgical procedures with great accuracy.

Although keyhole brain surgery, based on preoperative CT or MRI images, has obvious advantages for the patient, misplacement of the surgical instrument in these procedures may result in hemorrhage and severe neurological complications.

To overcome this problem, Prof. Joskowicz and his associates have developed a novel, image-guided system for precise, automatic targeting of structures inside the brain. The system is based on a miniature robot that can be programmed with detailed information obtained from preoperative electronic scans of the patient.

During surgery, the robot is directly affixed to a head clamp or to the patient's skull. It automatically positions itself with great accuracy in respect to the surgical targets. Once positioned, the robot locks itself in place and serves as a guide for insertion by the surgeon of a needle, probe, or catheter to carry out the procedure.

The main advantages of the system are the reduced pain for the patient, its compactness and ease of use, and its applicability to a wide variety of neurosurgical procedures.

Meanwhile, the Remote Presence Robotic System (RP-7), developed by InTouch Health in Santa Barbara, California, will allow nursing faculty members to interact with students from remote locations. The Nursing Institute, headquartered at Wright State, will be the first location in Ohio to have access to this robotic technology and be the first nurse education center in the nation to use the RP-7 for educational purposes.

“We will be using the RP-7 for a year in a pilot project to determine how it enhances the teaching environment,” said Debi Sampsel, executive director of the institute. “It will allow the professor to move, see, hear and talk as though they were actually with the students. As baby boomer nurses in education approach retirement, this technology will provide them with a new career option. This cutting-edge technology makes it possible for nursing faculty with chronic disorders or disabilities to continue to contribute to nursing education. It provides a seasoned workforce faculty with an option to work while on vacation or in retirement from anywhere in the world. The RP-7 is an innovative way to address the faculty nursing shortage.”

Patricia Martin, Ph.D., dean of the WSU-Miami Valley College of Nursing and Health, said this robotic technology puts the Nursing Institute ahead of the curve. “I am very excited about the unlimited potential and futuristic possibilities of the RP-7. It provides us with a glimpse of how technically savvy faculty can continue to be engaged in nursing education,” Martin said.

Sampsel explained that the RP-7 “will provide a means for faculty to try new teaching approaches, expand their technological skills and explore the world of different health care modalities that may be incorporated in future delivery sites.”

InTouch Health has deployed more than 100 robots to hospitals nationally and internationally. The value of the robotic system in these situations is supported by studies showing patients would rather talk with their doctor through the robot than to be attended to by a physician they don’t know. “In the future, we want to bring the bedside success of this project to a clinical training site,” added Martin.

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