Scientists and engineers funded by the National Institutes of Health, National Institute of Biomedical Imaging and Bioengineering (NABIB) are teaming up with neurosurgeons to develop technologies that enable less invasive, image-guided removal of hard-to-reach brain tumors. Novel imaging techniques allows surgeons to see deep within the brain during surgery using robotic systems that enhance precision removal of tumor tissue.
Patients with glioblastomas have a low survival rate, in large part because many pervasive tumors are not entirely accessible or even visible when using current neurosurgical tools and imaging techniques. A group of neurosurgeons and engineers have developed and tested a small neurosurgical robot that could be used to remove this type of deep-seated brain tumors. At the tip of the robot is an electrocautery tool, which uses electricity to heat and ultimately destroy tumors, as well as a suction tube for removing debris. They say that this robotic device can be placed inside a tumor and work its way around from within, removing pieces of diseased tissue.
A key component of the device is its ability to be used while a patient is undergoing MRI. By replacing normal vision with continuously updated MRI, the surgeon is able to visualize deep-seated tumors and monitor the robot’s movement without having to create a large incision in the brain.
Another group of engineers and neurosurgeons at the University of Washington is also working to develop an image-guided, robotically-controlled neurosurgical tool. This team is adapting a scanning fiber endoscope, initially developed to image inside the narrow bile ducts of the liver, so that it can be used to visualize the brain during surgery.
While ultrathin endoscopes have recently been developed, these smaller scopes usually have reduced image resolution. The new type of endoscope that they are developing can fit into tiny crevices in the body while retaining high image quality. The scope consists of a single optical fiber, approximately the size of a human hair, located in the middle of the scope. The fiber releases white laser light (a combination of green, red, and blue lasers) when vibrated at a particular frequency. By directing the laser light through a series of lenses in the scope, it can be reflected widely within the body, providing a 100 degree field of view.