Robot cuts down risks in brain surgery
By Stevie Emilia
SINGAPORE (JP): In the old days, surgeons performing brain surgery used to be like blind people when drilling into the patient's skull to remove a tumor, risking damage to the brain. A single wrong move could paralyze the patient.
Now, thanks to a new computer-operated robot called SurgiScope, surgeons can perform delicate brain surgeries more accurately and quickly with minimal damage to the brain tissues.
The robot, which has been available at the Gleneagles Medical Center in Singapore since last year, is the first of its kind in Southeast Asia. It combines the advantages of computer aided surgery with three main features: a position sensor system, a robotic microscope holder and advanced image handling software.
So far, there are only about 30 of such robots available worldwide -- seven in China and Japan, and the rest in Europe and the United States.
According to Balaji Sadasivan, consultant neurosurgeon at Gleneagles, the robot, which cost around S$1.7 million (US$1 million), will reduce operation time and risks. Patients recovery period is shorter too.
"With the aid of the machine and the use of modern neurosurgery techniques, the risks in most brain tumors surgeries would be is less than 2 percent," he told The Jakarta Post after a recent Parkway Medical Congress here.
"So nowadays, patients' other health problems such as heart or lung diseases or their advanced age can pose a greater risk than the actual surgery itself."
Patients would be unconscious during the procedure.
"We find that the patients who had undergone surgery with SurgiScope, recover more quickly. We have had patients who were discharged two days after a brain tumor surgery," Balaji said.
With the old operating technique, he added, the patients had to remain in hospital for at least a week and it was not uncommon for patients to stay even two to three weeks after undergoing brain surgery.
"Patients are also very surprised to find how well they felt after surgery using SurgiScope and even more surprised when we tell them that they are ready to go home in two or three days," Balaji said.
And according to Balaji, the costs for surgery using SurgiScope is not very much more than using older surgical techniques. The hospital charges patients S$3,000 for the use of SurgiScope.
"I think, over all the costs are the same. Although there's an additional S$3000 for the use of SurgiScope, there will be reduction in other expenses as the operation time is shorter and patients do not have to stay long in the hospital after the surgery," Balaji said.
This new technology in brain surgery is not only good news for patients but also for neurosurgeons.
For instance, SurgiScope reduces brain surgery operation time from the usual six to seven hours to between three and four hours.
"SurgiScope makes the surgery easier, more direct, we cut less tissue and we cause less harm to the brain. We're also happy because the patients recover faster and the patients and their families are also happier." Balaji said.
Process
During the surgery, the robot can fashion a three-dimensional model of the patient's head, brain and tumor and display them on a computer screen, only with the help of brain scans taken before the operation.
The surgeon can then pinpoint the tumor's precise location and plan the safest and least invasive entry point into the patient's brain before instructing the microscope to move to the desired position.
During the operation, a mini hi-tech satellite system in the operating theater will update the images, showing the surgeon which part of the brain he is looking at. And two red converging laser beams will help guide the surgeon who is operating while looking through the microscope.
"By making only one pass I can get to the tumor, something that is difficult to do if I have to solely depend on my eyes," Balaji said. "This means that it will be far less likely to make mistakes when cutting through brain tissue to locate the tumor."
SurgiScope can also be used for certain ear, nose and throat operations, such as sinus and certain spinal surgeries, especially those involving pedicle screw fixation.