Tech Briefs Magazine - June 2022 - MD-20

A Telerobotic System to Help Surgeons Remotely
Treat Stroke Patients
Joystick-operated robot can help patients receive time-critical treatment.
Massachusetts Institute of Technology, Cambridge, MA
M
IT engineers have developed a telerobotic
system to help surgeons
quickly and remotely treat patients experiencing
a stroke or aneurysm. With a
modified joystick, surgeons in one hospital
may control a robotic arm at another
location to safely operate on a patient
during a critical window of time that
could save the patient's life and preserve
their brain function.
The robotic system, whose movement
is controlled through magnets, is designed
to remotely assist in endovascular
intervention- a procedure performed
in emergency situations to treat strokes
caused by a blood clot. Such interventions
normally require a surgeon to
manually guide a thin wire to the clot,
where it can physically clear the blockage
or deliver drugs to break it up.
One limitation of such procedures is
accessibility: Neurovascular surgeons are
often based at major medical institutions
that are difficult to reach for patients in
remote areas, particularly during the
" golden hour " - the critical period
after a stroke's onset, during which treatment
should be administered to minimize
any damage to the brain.
The MIT team envisions that its robotic
system could be installed at smaller
hospitals and remotely guided by trained
surgeons at larger medical centers. The
system includes a medical-grade robotic
arm with a magnet attached to its wrist.
With a joystick and live imaging, an operator
can adjust the magnet's orientation
and manipulate the arm to guide a
soft and thin magnetic wire through arteries
and vessels.
The researchers demonstrated the system
in a " phantom, " a transparent
model with vessels replicating complex
arteries of the brain. With just an hour
of training, neurosurgeons were able to
remotely control the robot's arm to
guide a wire through a maze of vessels to
reach target locations in the model.
" We imagine, instead of transporting a
patient from a rural area to a large city,
they could go to a local hospital where
20
With a modified joystick, surgeons may control a robotic arm at another hospital to operate on a patient.
(Image: Courtesy of the researchers)
nurses could set up this system. A neurosurgeon
at a major medical center could
watch live imaging of the patient and use
the robot to operate in that golden hour.
That's our future dream, " said Xuanhe
Zhao, a professor of mechanical engineering
and of civil and environmental
engineering at MIT.
Zhao and his team have published
their findings in Science Robotics. The
team's new system builds on work from
2019, in which they demonstrated steering
a magnetically controlled thread
through a life-sized silicone model of the
brain's blood vessels. They did so at the
time using a handheld magnet, about
the size of a soup can, that they manually
manipulated.
They have since affixed the magnet to
the end of a medical-grade robotic arm,
which can be steered using a small joystick
knob on a mouse. By tilting the
joystick, researchers can tilt the magnet
in an orientation that a magnetic wire
can follow. Buttons on the mouse control
a set of motorized linear drives,
which advance and retract the wire to
make it move forward and back.
The wire is as thin and flexible as a
conventional neurovascular guidewire,
with a soft, magnetically responsive tip
that follows and bends in the direction
of a magnetic field.
The robotic system was tested in
MGH's Catheter Lab - an operating
room with standard medical imaging
equipment used in endovascular procedures.
The researchers installed the robotic
arm in the lab, along with a lifesized
silicone model of blood vessels.
They set the joystick, along with a monitor
displaying a live video of the model,
in a control room. After just one hour of
training, neurosurgeons were able to
successfully operate the system to guide
the wire through complex vessels that
are difficult to navigate with a manual
guidewire.
The team also used the robotic system
to clear simulated clots in difficult-to-reach
areas in the model. They
steered the guidewire through vessels,
Motion Design, June 2022
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5/18/22 10:17 AM

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Tech Briefs Magazine - June 2022

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