Raul Olivera, M.D., Assistant Professor of the Department of Neurosurgery and Brain Repair at USF University of South Florida, and Medical Director of the Neurosurgery Service at Florida Hospital, Tampa talks about a new robotic arm with a camera attached, that assists in brain surgeries.
Interview conducted by Ivanhoe Broadcast News in January 2018.
Tell us about the robotic camera and when is it used.
Dr. Olivera: It’s a very novel way to approach brain surgery because we are very used to doing these surgeries with a microscope. There are limitations as to what the microscope can do. You have to drive the microscope, with this robotic arm you actually have the ability of pre-determining the angles that you need and the way you want the light and where you want the camera to go. And then it intuitively kind of does it by itself in the middle surgery so it improves your efficiency, improves your ergonomics and improves the visual position of the tumor and the surrounding brain. Along with the images that you acquire it allows us to do the surgery faster and more accurately and with less damage for the patient on the surrounding tissue around the brain. Brain surgery is different from other surgeries in which you really want to preserve as much good tissue as you want. You don’t want to get good margins of healthy brain along with the tumor. So having the right instruments to get the right angles to go around the tumor and resect it is paramount.
What was used previously before you had this, you said magnifying glasses and microscopes.
Dr. Olivera: In the past intracranial surgery is usually done with a microscope. We use magnifying glasses to do spine surgery or to do the approaches but once you go in to the brain most of the times we use a microscope because you want great detail and you want illumination. You want light to be powerful to be able to see the smaller little details in the patient’s anatomy. The robotic changes the dynamic on it because then you have the light source in the camera acquiring the images. And it works along with you; you don’t have to tell it what to do, it learns it and then follows you and makes that interaction seamless.
So how does this set a new standard for doing brain surgery?
Dr. Olivera: I think that this is going to be the way of the future. Obviously there is a point and a place for every technology. I do not think that this is going to be the only technology available that is going to be perfect for every case but in the cases that it makes a difference it’s really, really going to take the level of quality of care above and beyond of what we had before.
Who is a candidate for this?
Dr. Olivera: At this moment every patient that has a brain tumor or an intra-cerebral hemorrhage will be a very good candidate to take advantage of what this new technology brings. I think in more complex cases like aneurysms or AVM’s or even spine surgery could be incorporated to the repertoire of what the robot can help with.
What can you view that you couldn’t view before?
Dr. Olivera: The optics are more powerful in the way of focusing and in the way of the depth of the visual field along with the different angles that you can achieve with the robot that makes your surgery easier.
And does it tie in with the international space station?
Dr. Olivera: This technology is developed by a Canadian company called Synaptive and it was initially used in the international space station and they just translate that in to surgery in medicine.
Being a doctor and a professor what do you tell your students about this, is this a breakthrough?
Dr. Olivera: I think that it’s something that brings a lot of hope to the future, as a new door that opens to a brand new array of possibilities. I think that the robotic arm is not only good for what it brings now, but because of the possibilities of the future that can come along with this to develop all the modalities of treatment in the future because this is kind of like a virgin road as a new field of how to approach these tumors.
Should we call this a robotic camera that you use? How should I term this new technology?
Dr. Olivera: It’s a robotic arm that has a camera attached that is part of a much broader system that includes intra-operative navigation tissue processing, image processing. It closes the loop with all the different aspects that you need to coordinate when you’re going to do a successful surgery.
So there’s been robots in surgery for a while, this is different because?
Dr. Olivera: It’s different because the robot doesn’t actually perform the procedure like with a da Vinci or other robots. The robot assists you and makes your surgery easier but you still perform the surgery with your hands.
END OF INTERVIEW
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