Revolutionary procedure a world first

By Marta Cyperling and Jordanna Heller

A surgical team at the Foothills Medical Centre has successfully performed groundbreaking neurosurgery on May 12 with a robot developed by a team at the University of Calgary Faculty of Medicine.

Paige Nickason, 21, is recovering after having a tumour removed from her brain with the assistance of neuroArm, a surgical robotic system developed by a team led by Dr. Garnette Sutherland, a Calgary Health Region neurosurgeon and professor of neurosurgery in the University of Calgary Faculty of Medicine.

“I had to have the tumour removed anyway so I was happy to help by being a part of this historical surgery,” says Nickason.

neuroArm is the world’s first MRI-compatible surgical robot capable of both microsurgery and image guided biopsy. The surgical robotic system is controlled by a surgeon from a computer workstation, working in conjunction with intraoperative MR (magnetic resonance) imaging. Dr. Sutherland developed the intraoperative MRI machine with Winnipeg-based IMRIS Inc. The technology allows a high field MRI scanner to move into the operating room on demand, providing imaging during the surgical procedure without compromising patient safety.

Using neuroArm in the operating room has significant advantages for both surgeons and patients.

“This system has exceptional capabilities. This is a turning point in the performance and teaching of neurosurgery,” says Dr. Sutherland. “neuroArm will improve surgical outcomes as it is less invasive and more delicate in its touch.”

neuroArm also aims to revolutionize neurosurgery and other branches of operative medicine by liberating doctors from the constraints of the human hand.

“neuroArm allows us to harness the capabilities and advantages of both human and machine. We enhance the surgeon's manual skills with tremor filtering. By providing updated imaging and navigation, the surgeon has the tools to better plan and execute complex neurosurgical procedures.” says Alex Greer, the project’s robotics engineer.

“The neuroArm will change the way patients undergo neurosurgery,” says Dr. Chris Eagle, president and CEO of the Calgary Health Region. ”We are thrilled to be part of a project that is more precise and improves the quality of life for patients with neurological disease.”

The research, and now the reality of a human surgery using neuroArm, has garnered attention from neuroscientists and specialists across the globe.

“For many years now we have been hoping that robotics might have a place in neurosurgery. Dr. Sutherland has brilliantly envisioned that place by combining the potential of robotic remote control with image-guided minimally invasive neurosurgery. We look forward with great excitement to the adoption of this technology at other centers." says Dr. Peter Black, PhD, Franc D. Ingraham professor of neurosurgery, Harvard Medical School.

neuroArm is one of the most advanced robotic systems ever developed. It was designed and built in collaboration with MacDonald, Dettwiler and Associates Ltd. (MDA), known for creating Canadarm and Canadarm2. Bringing neuroArm to life required a unique partnership between medicine, engineering, physics, and education; some of Calgary’s most visionary philanthropists; the high-tech sector, and research funding organizations.

“We believe in the translation of research into practical processes and tools that improve health care. This is a wonderful example of just that. This advance will lead the way in modern neurosurgery,” says Dr. Tom Feasby, dean, University of Calgary Faculty of Medicine.

Calgary philanthropists and brothers Doc, B.J. and Don Seaman provided $2 million to begin planning neuroArm seven years ago.

“This project demonstrates what is possible when dedicated, innovative and highly skilled individuals come together in pursuit of excellence for the purpose of improving and extending the lives of others,” says Doc Seaman.

The Seaman family’s donation, combined with funding from Western Economic Diversification Canada, allowed for detailed planning and design of the project. That set the stage for substantial support from the Canada Foundation for Innovation (CFI), the National Research Council of Canada, Alberta Advanced Education and Technology, Reach!, Alberta Heritage Foundation for Medical Research and additional philanthropists. The result is a one-of-a-kind machine and a comprehensive medical robotics program.

The president and CEO of the CFI is proud of the role his organization played to make this achievement possible. Dr. Eliot Phillipson says, “This is a shining example of Canadian-led science resulting in major breakthroughs that will benefit people here and around the world. The CFI is proud to have played a role in the remarkable partnership that has made this exciting achievement possible.”

“The Government of Canada is proud to be part of the tremendous partnership effort that has helped usher in this new era for the field of medical robotics,'' said Rona Ambrose, Minister of Western Economic Diversification. ''I am proud of this landmark achievement and the positive impact the neuroArm will have on neurosurgery and medical research for communities in Alberta and across Canada.”

"Our government places great emphasis on the important contributions of science and technology to our quality of life and to our economy," said Doug Horner, Minister of Advanced Education and Technology.

Developing neuroArm required an international collaboration of experts to build a robot capable of operating safely in a surgical suite and within the strong magnetic field of the intraoperative MRI environment.