Robots Make Excellent Brain Surgery Assistants

To the list of things robots can do better than humans, you may now add "cutting open the skull." And, believe it or not, that's important progress.

A team of neurosurgeons and mechanical engineers at the University of Utah have developed a low-cost robotic surgical drill that can perform one type of complex cranial surgery in two and a half minutes, where previously a surgeon would spend around 2 hours. Putting the scalpel in a robot's "hands" means safe, clean cuts, with less likelihood of human error. It also lowers costs and brings down the chance of infection by shortening the amount of time the wound is open and the patient under anesthesia; it may even help improve post-operative recovery.

For certain operations, doctors use hand drills to cut intricate openings in the skull. It's a long, laborious process—grunt work that's both high-stakes and monotonous and delays the start of the actual surgery. It's fatiguing and not exactly the best use of a highly trained surgeon's time. In other words, it's a prime candidate for automation.

The new device works similarly to an automated mill, which carves material based on a pre-existing design. First, patients undergo a CT scan to create a customized bone map. Using that data, surgeons can program a cutting path via custom software that avoids important things like nerves and major veins and arteries. They can even create safety barriers: If the drill comes within 1 millimeter of something sensitive, it slows down to prevent any errors.

Researchers wanted to test their device on a particularly tricky cut for proof of principle; they settled on the translabyrinthine opening, which traces a jigsaw-like path around the ear, where the bone is hard and the angles get strange. It's a cut that's performed thousands of times a year to treat tumors around auditory nerves, but it's difficult and gets close to facial nerves. Accidentally cutting those nerves could lead to facial paralysis. So the robotic drill takes that into account: It monitors the patient's facial nerve and if there's any irritation during the procedure, the drill automatically shuts down.

Once the drill has been programmed, surgeons can pretty much just let it do its thing, kind of like drills that cut auto parts. "It's like Monster Garage, except instead of machining a part, we are machining the skull," University of Utah neurosurgeon William Couldwell said in a statement. The comparison makes it sound fun to watch, but you might be a little more leery if you're the one going under the knife, err, drill. If that's the case, though, don't worry: You'd be heavily sedated.

His team also believes it could be used for other kinds of procedures, like "machining" the socket for a hip replacement, but they have yet to test it.

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