When a person has experienced a stroke or aneurysm, they may need an internal procedure known as surgery. A new robotic system designed by MIT can ensure that they receive treatment quickly, even if a doctor is not nearby.

MIT engineers have developed a tele robotic system to help surgeons quickly and remotely treat patients with a stroke or aneurysm. With a modified joystick, surgeons at a hospital may place a robotic arm at other control locations to safely operate the patient in a time-sensitive window that can save the patient and maintain brain function. .

The magnetic-powered robotic system is designed to remotely assist in internal intervention – a method used to treat blood clots in an emergency. Such interventions usually require the surgeon to manually guide the thin wire to the clot, where it can physically clear the blockage or deliver drugs to break it.

One of the limitations of such methods is access: Medical neurosurgeons are located in large institutions that have access to patients in remote areas, especially during the “golden hour” – the critical period after the onset of stroke, during which treatment must be performed. . be done. To minimize brain damage

The MIT team predicts that its robotic system could be installed in smaller hospitals and remotely operated by training surgeons in larger medical centers. It consists of a robotic arm of a medical system with a magnet attached to its wrist. With joystick and live imaging, the operator can adjust the direction and manipulate the arm to guide a soft, thin magnetic wire through arteries and veins.

The researchers built the system into a “phantom”, a transparent model with a sign that replicates the complex arteries of the brain. With just one hour of training, the neurosurgeons have chosen to guide the robot arm remotely from the controller to the wire through the maze to reach the desired locations in the model.

“Imagine, instead of transferring a patient from a village to a city, they can go to a local hospital to have nurses in the large area set up the system,” said Professor Xuan Zhao, a senior scientist. “A neurosurgeon at a large medical center can watch a live imaging of a patient and use a robot to operate on that golden hour. This is our future dream.”

Endovascular surgery is a specialized, minimally invasive procedure that involves twisting and guiding a thin medical wire through the body’s arteries and veins to the target site to prevent wall damage. This procedure usually requires years of training to master the surgeon.

Robotic systems are being explored as assistive technologies in endovascular surgery. These systems include motor actuators that are pulled forward and retracted as they twist through body wires.

“But having a robot with the same level of complexity [as a surgeon] is challenging,” Kim comments. “Our system is fundamentally different based on a mechanism.”

The team’s new system is based on 2019 work, in which they demonstrated that a magnetically controlled strand is guided through a life-size silicon model of the brain’s blood vessels. They did this at the time using a hand magnet, the size of a can of soup, which they manipulated by hand.

They have since attached a magnet to the end of a medical grade robotic arm that can be steered using a small joystick on the mouse. By tilting the joystick, it can place more in the direction that a magnetic wire can follow. The mouse buttons control a set of motor linear drives that pull the wire back and forth to move it back and forth.

This wire is as thin and comprehensible as a normal general guide wire, with a soft, magnetic tip that follows and bends in the direction of the magnetic field.

The team tested the robotic system in the MGH catheter laboratory – an operating room with standard medical imaging equipment used in endovascular procedures. The specialist installed the robotic arm in the laboratory along with the silicon model of life-size blood vessels. They set the joystick in the control room with a monitor that shows a live video of the model. From there, an operator watches the video while using the joystick to remotely navigate ships.

The team trained a team of neurosurgeons to use the robotic system. Only after an hour

areas in the model. They steered the guidewire through vessels, and around sharp corners and turns, to reach regions where the researchers simulated clots. Once they guided the wire to the clot, the surgeons proceeded with standard endovascular methods to thread a microcatheter along the wire to the site of the clot. They retracted the wire, leaving the catheter, which they then applied to successfully remove the clot.

“The primary purpose of the magnetic guidewire is to get to the target location quickly and safely, so that standard devices like microcatheters can be used to deliver therapeutics,” Kim says. “Our system is like a pathfinder.”

He hopes that the teleoperated system can help more patients receive time-critical treatment. He also sees benefits for surgeons, who typically perform such vascular procedures in the same room as the patient, while being exposed to radiation from X-ray imaging.

“The neurosurgeons can operate the robot in another room or even in another city without repeated exposure to X-rays,” Zhao says. “We are truly excited about the potential impact of this technology on global health, given that stroke is one of the leading causes of death and long-term disability.”

Source : newatlas disabilityinsider

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