Researchers from the University of Utah have developed a new computer-controlled robotic drill that may make skull surgery 50 times faster than current procedures in the upcoming future. The team was led by neurosurgeon William Couldwell. The automated drill resembles those used in machine auto parts and produces fast, clean, and safe cuts, reducing times for both keeping patients under anesthesia and for the time the wound is open. Studies about the new technology reported in the Neurosurgical Focus journal observe added benefits, including minimizing the incidence of infection, human error, and surgical treatment costs. Hitherto, complex cranial surgeries involved surgeons having to use hand drills to make openings which could add hours to the overall procedure. The new automated drill can reduce bone removal times from 2 hours to 2 and a half minutes.
Several prototypes of the drill were tested on plastic blocks and cadaver skulls to improve accuracy and make the final version portable and light enough to move around. Medical robots have already been used for certain surgical applications e.g. putting screws in the spine and assisting in hip replacements. Current neurosurgical applications using robotic technology include removing non-cancerous tumors in the ears which can lead to hearing loss. But it has yet to be used in skull-based surgery.
Prior to drilling, the patient undergoes a CT scan to gather information about bone data and identify delicate structures like major veins, arteries, and nerves that need to be avoided. The information gathered is used to program the cutting path of the drill using special software developed by the engineers on Couldwell’s team, allowing surgeons to choose the optimal path between two points. The surgeon can also program safety barriers along the cutting path to within one millimeter of sensitive structures. It has an automatic emergency shut-off switch which can be activated while monitoring the facial nerves for any irritation during surgery. If the drill gets too close to the facial nerve and irritation is monitored, the drill switches off.
The research team are now looking to commercialize their innovation, either alone or by entering into a partnership with a medical device manufacturer. It might be available in the market within one or two years according to Couldwell and the anticipated price tag would be in the range of $100,000 or less. Couldwell feels that would be cost effective in the long run as running an operating room is very expensive and the device will save anything between two to two and half hours of actual operating time. It can also be used for other applications including complex openings of the skull or spine, and as an educational tool according to the research team.