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Published on: 10/10/2007
Last Visited: 11/8/2007
"In neurosurgery, an error of two millimeters can be fatal or cause paralysis, loss of sight or memory, hemorrhages," said Prof Leo Joskowicz of Hebrew University, who along with two PhD students, Rudi Shamir and Moti Freiman, devised the sophisticated algorithms and programming that empowers MARS, a small, lightweight robot that has already revolutionized spinal surgery.
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Developed by Professor Moshe Shoham of the Department of Mechanical Engineering, at the Technion in Haifa, the MARS, as programmed by Joskowicz, has already proven itself in delicate orthopedic surgery via the SpineAssist, a device specifically for fusing vertebrae with screws in spinal surgery.The FDA-approved device, developed into a commercial product by Mazor Surgical Technologies, has already been used in over 400 spinal operations, and was ranked as the second 'Clinical Achievement of 2005' by the prestigious Cleveland Clinic.
The move to take the MARS from orthopedic surgery to keyhole surgery fell to Joskowicz.Precise targeting of tumors, lesions, and anatomical structures cannot be done without support systems.Existing navigation support systems, using optical and mechanical guidance are limited by size, cost, and the requirement for manual passive arm positioning which can be time-consuming and error-prone.And the few robotic devices currently available are cumbersome and expensive.
"We had the platform; we needed to devise a new protocol according to the flow of surgery and the user's needs, and develop software," said Joskowicz, founder and head of the Computer-Aided Surgery and Medical Image Processing Laboratory at HU's School of Engineering and Computer Science
The robot itself (encased in a sterile blue plastic wrap) weighs in at only 230 grams.For keyhole surgery of the skull, it was fitted with a rigid arm (150 grams) that can guide a needle, probe or catheter to the exact spot that the surgeon wants to target.
Targeting is the key word here, Joskowicz told ISRAEL21c.
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"The computerized robotic system connects the image to the surgical action, providing a quantitative link between the image and the surgical action," said Joskowicz.
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"The surgeon sits at his PC and clicks on the image," said Joskowicz.
Joskowicz brings out a "phantom" to demonstrate.A phantom, in professional lingo is a plastic object that demonstrates a concept, in this case a plastic skull model with facial features (one of the students).An opening in the skull reveals "tumors."Affixing the miniature blue robot, Joskowicz explains that an important task is to get the right trajectory, which is especially difficult in a small opening.
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"We have tested the algorithms with humans in the operating room, without doing actual robotic-assisted surgery," said Joskowicz.
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Joskowicz founded the HU Computer-Aided Surgery and Medical Image Processing Laboratory in 1996.
Joskowicz' work on the mini-robot algorithms won him a Kaye Innovation Award, presented during the 70th Board of Governors meeting of HU last June.
"I asked them to give the award to the team who worked on the development," said Joskowicz, modestly, referring to his PhD students, as well Shoham, Shoshan and Prof. Felix Umansky of the Department of Neurosurgery at Hadassah Hebrew University Medical Center.
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