HealthWatch: Flexible Robot For Surgery

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Brain cancer is one of the deadliest cancers. The surgery to remove the tumor is often very invasive. But now engineers at Vanderbilt University have designed a device that can make surgery easier for both doctor and patient, and the same technology also holds promise for lung cancer diagnosis.
Removing a brain tumor in the center of the head is not an easy task for surgeons. 
“Basically you’re having to go through a lot of healthy brain tissue to get to that central part of the head,” said Andria Remirez, a PhD Student at Vanderbilt University.
But a technique that allows surgeons to go through the nose can save that healthy tissue. However, one problem still exists. 
“When they do this, they’re using these straight, rigid tools, basically chopsticks that they have to put through your nose,” Remirez explained.
A team of engineers designed flexible, steerable needles made up of metal tubes that can bend and twist as they move, giving easier access to the site of the tumor. The team has also used the same tools for diagnosing lung cancer. For current tools … 
“One of the problems they have is at the far out areas of the lung, they have no visualization out there and they also can’t steer their biopsy tools to get to those areas,” said Margaret Rox, a PhD student at Vanderbilt University.
The success rate of diagnosis with existing tools for tumors that are difficult to reach is 60 to 70 percent. With this new technology adding to existing tools like the bronchoscope … 
“We think we could hopefully get that to a hundred,” Rox stated.
Which means for those with possible lung cancer … 
“The faster you can get that diagnosis, confirmation of lung cancer, the faster you can get treatment,” Rox said.
Saving lives, one twist at a time.
Risks for current methods for lung biopsy include lung collapse or bleeding due to the surgeon not being able to see clearly to get to a difficult to reach lung lesion. This new technology would allow the surgeon much better visibility, reach and to more accurately target far- off tumors.
Contributors to this news report include: Milvionne Chery, Field Producer; Cyndy McGrath, Supervising Producer; Hayley Hudson, Assistant Producer; Roque Correa, Videographer; Roque Correa, Editor.

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MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

TOPIC:     FLEXIBLE ROBOT FOR SURGERY
REPORT:    MB #4541

BACKGROUND: Brain cancer takes the lives of over 16,000 people a year. There are over 28,000 children that live with brain tumors in the U.S. Most tumors are benign, or do not cause cancer, but there are still another 30 percent that will be diagnosed as cancerous, or malignant. Brain tumors are abnormal growths of normal cells. There is not a common cause of brain cancer, but radiation, smoking and HIV have been linked to the cancer. The most common symptoms associated with brain cancer are headache, dizziness walking, weakness and seizures. Other symptoms include nausea and vomiting, abnormalities in vision and difficulty speaking.    
(Source: https://www.webmd.com/cancer/brain-cancer/brain-cancer http://braintumor.org/brain-tumor-information/brain-tumor-facts/) 

DIAGNOSING: There are a number of tests that are administered to patients to determine the extent of the tumor. A neurological exam looks at  vision, hearing, balance, coordination, strength and reflexes. A CT scan, MRI or PET scan can be used to look at the brain as well. A biopsy can also be taken to help determine the stage of the cancer. There are four grades that can be given to tumors. Grade 1 means that the tissue is benign but grows very slowly. Grade 2 means that the tissue is malignant, and it looks less normal. Grades 3 and 4 do not look like normal tissue at all and grow much more rapidly. From there, there are five stages, 0-4, with the stage 4 meaning that the cancer has spread to other parts in the body. 
(Source: https://www.medicinenet.com/brain_cancer/article.htm https://www.mayoclinic.org/diseases-conditions/brain-tumor/diagnosis-treatment/drc-20350088) 
 
NEW TECHNOLOGY: The most common treatments for brain cancer are radiation therapy, radiosurgery, chemotherapy, targeted drug therapy and minimally invasive brain surgery. Both surgeries allow patients to go home either the same day or one to two days later, but the therapies require multiple trips. One difficulty that surgeons have is when the tumor is in the center of the brain. Usually surgeons must go through a lot of healthy tissue to access it. Ph. D. student, Andria Remirez, said that with such rigid tools this has been challenging, but she and her team have engineerd a less invasive solution. They created a robot that is snake-like to go through the nose to access the tumor. Remirez compared the surgery to having sinus surgery.   
(Source: https://www.medicinenet.com/sinus_surgery/article.htm http://research.vuse.vanderbilt.edu/MEDlab/sites/default/files/papers/GlibertRobotERMD14_0.pdf https://www.mayoclinic.org/diseases-conditions/brain-tumor/diagnosis-treatment/drc-20350088) 

FOR MORE INFORMATION ON THIS REPORT, PLEASE CONTACT:

Heidi Hall, Media Relations
 heidi.hall@vanderbilt.edu

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