In what sounds more like the lead-up to a punchline, not the latest in state-of-the-art medicine, Canadian rocket scientists and brain surgeons have teamed up to create a one-of-a-kind tool for the operating room.
The surgical robot, dubbed neuroArm, unveiled yesterday at the University of Calgary, removes the physical constraints of the neurosurgeon to offer a rock-steady hand for precision procedures and superhuman vision to the microscopic level.
At the same time, it has been engineered using plastics, titanium and other non-conductive material to create the only robot in the world that can work on a patient who is placed inside a magnetic resonance imaging machine.
Any metallic material -- including jewellery on a patient -- is banned from such a room for safety reasons because of the strength of the magnetic field emitted by all MRIs.
The invention allows surgeons to see real-time pictures of what is happening in the brain -- to blood vessels, tissue and tumours -- with every poke, cut and stitch being performed by the robot.
"The goal of this is to make difficult surgery easier and make impossible surgeries possible," said Alex Greer, a robotics engineer at the University of Calgary who helped design neuroArm and yesterday took the controls during a demonstration.
The $27-million project began in 2001 with the backing of a number of individual philanthropists and foundations as well as with federal and provincial government grants.
MacDonald Dettwiler and Associates Ltd. was called on five years ago to introduce their space technology to Earth-bound medical applications.
The Richmond, B.C.-based company designed the Canadarm and Canadarm2 for the Canadian Space Agency and is now working on a robotic arm called Dextre for use on the International Space Station.
Bruce Mack, a vice-president with the company's space missions group, said neuroArm is a prototype based on his company's existing space engineering know-how, but the robot could be used in hospitals around the world.
"It could be modified for lower cost, new capabilities," he said.
Garnette Sutherland is credited with inventing the robot, but the professor of neurosurgery at the University of Calgary is humble in describing the genesis as more of a "cumulative event" involving a number of scientists, researchers and engineers who shared a dream to improve patient health.
"That little eureka moment took six years to accomplish," Dr. Sutherland said.
NeuroArm, which is about the size of a dishwasher with two robotic arms, is small enough for one arm to work within the tube of an MRI machine. But the surgeon operates it from a separate room.
Yesterday, Mr. Greer sat at the controls. In each hand was a handle he worked as if they were chopsticks.
Those handles have been designed so that whoever is holding them can sense the weight and texture of whatever objects the robot is touching.
Healthy tissue and tumours feel different to the trained surgeon.
The work station is surrounded by screens.
One showed the MRI of a brain. Another was a view of the work being done by the robot's left arm, the other of its right arm. A touch screen can be used to manipulate the view of the robot itself.
A speaker set up on a desk pipes in sounds from the operating floor. Healthy tissue and tumours also sound different to an expert.
In front of him was a set of eyepieces that provide stereoscopic vision -- a close-up, three-dimensional view of the surgery.
Inside the operating theatre, each hand of the robot was responding to Mr. Greer's commands by opening and closing as if it were picking up tools and performing tricky tasks such as picking up elastics bands.
Unlike a surgeon who cannot escape shaky hands -- especially as he or she ages -- neuroArm eliminates tremors and can extend a surgeon's shelf life in the operating room, Dr. Sutherland said.
It could also ease the nerves of patients.
Tracy Durfy, who had surgery 18 months ago on a benign brain tumour, still remembers her pre-op jitters.
"I'm thinking to myself the night before the surgery, I sure hope he doesn't sneeze," she recalled.
"It could be a leap of faith going in, but you know we're all open to human error in whatever job we're in and if you're doing brain surgery and you have to sneeze, there's no warning to that. You could just do it. What happens?"
NeuroArm could also allow procedures never done before, Dr. Sutherland added.
Even with his many years of practice, Dr. Sutherland said he is accurate within one to two millimetres while working on side-by-side vessels in the brain.
The robot has something called "motion scaling" which allows the surgeon to be precise within 0.01 mm.
"Now I can join together vessels that are much smaller," Dr. Sutherland said.
Assessing brain tumours will be more precise while speed and accuracy will also be increased, officials said.
They hope this could mean better results for patients and lower overall costs to the health-care system.
Among the first to see the merit of the project was Calgary's Seaman family, who donated $2-million.
"A robot doing brain surgery," recalled Daryl (Doc) Seaman, an oilman and co-owner of the Calgary Flames.
"It's a bit of a tough sell."
NeuroArm, which is housed at the Seaman Family MR Research Centre, a joint venture of the University of Calgary and the Calgary Health Region's Foothills Hospital, will be put through its paces in the next month during preclinical trials.
Tests will be conducted on mannequins, cadavers and tissues to prove to Health Canada and the U.S. Food and Drug Administration that it is safe for people.
Officials hope neuroArm will be used to treat its first patient this summer.