Image-Guided Medical Robotics Program

Program Lead: Dr. Garnette Sutherland

The importance of intra-operative imaging for lesion localization and resection control in neurosurgery, ushered in the world’s first intraoperative MRI (iMRI) technology based on ceiling-mounted moveable high field magnet developed by Dr. Garnette Sutherland. The initiative, 20 some years ago, resulted in the build of the Seaman Family MR Research Centre at University of Calgary - Foothills Hospital. Now with interlinked MR Research Program based on a fixed magnet, this centre has become a world-class entity on advanced clinical imaging research including stroke and other CNS disorders. The recent inclusion of MR-guided Focus Ultrasound Technology for patient care further validates its importance.

Linked to the iMRI environment is another world’s first - the image-guided MR-compatible robot called neuroArm. Again developed by Dr. Sutherland in collaboration with MacDonald, Dettwiler and Associates, Brampton ON, (MDA - that built Canadarm and Dextre), neuroArm is Canada’s gift to the world of medical robotics, unique to microsurgery and stereotaxy within the iMRI suite. Project neuroArm, the internationally visible Image-guided Medical Robotics Program at the University of Calgary, thus established, continues to advance surgical robotics and smart technologies that incorporate sensors and machine learning. With neuroArm continuing to be clinically used in neurosurgical patients here at the Foothills Medical Centre, and SYMBIS (2nd generation neuroArm, FDA approved for stereotaxy through IMRIS-Deerfield MN, USA), in early 2019 Project neuroArm team began the build of the 3rd generation system called the neuroArmPLUS. Funding support from various governmental and philanthropic organizations, and generous individuals, has made this possible.

Pipeline Technologies - Robotics and Intelligent Systems

The neuroArmPLUS: The neuroArmPLUS is a compact, efficient and intelligent robotic system for brain surgery and whole body applications. The system will incorporate the recently developed microsurgery-specific haptic handcontroller neuroArmPLUSHD as the intuitive human-machine interface. As stated above, thanks to ongoing governmental and philanthropic funding support, the technology has multiple scientific manuscripts, an international patent filed in various countries, product development ensued early 2020 with immersive workstation and innovative toolset prioritized for stage 1 milestone. OrbSurgical Ltd., Project neuroArm spin-off for IP protection and commercialization, continues the quest to digitize surgical performance and increase accessibility globally through state-of-the-art robotic technologies and data-driven platforms.

The SmartForceps System: Continuing technology assessment of the medical grade SmartForceps System here at the Foothills Medical Centre, the SmartForceps System recently passed the IEC 60601-1-2 Compliance mandated by FDA and Health Canada, pending final approvals for both. Systematically validated through multiple high impact publications including JAMA Surgery and a patent, commercialization process is in place with 10 early adopters identified and pre-orders secured. Focused on big-data mining and machine learning, the SmartForceps technology pushes the envelop towards data-rich proactive surgeon experience and performance of surgery. Using cloud computing for global connectivity, remote access and learning in real time, a future of standardized surgical care and improved safety seems much closer - much similar to that set forth by aerospace standards.

Linked Research & Development (R&D)

The underlying principle of Project neuroArm remain “Seeing what you cannot see; Feeling what you cannot feel; Hearing what you cannot hear – the augmented reality for robotics and linked technologies”. All ongoing R&D thus fall under this philosophy and include but are not restricted to:

  1. Molecular Neuroscience-Brain Tumour and Trauma (Seeing what you cannot see): Ongoing national phase entry of patent (awarded 2018, with NRC, Ottawa) has re-enforced the translatability of molecular and genetic interrogation of CNS disorders, including brain tumour, trauma and neurodegenerative disease. The idea and innovation form the basis of cell-specific contrast agents for intra-operative visualization and/or diagnostics – A paradigm for transforming surgery from the present organ level to cellular, i.e. the invention of CellARM robotic system.
  2. Computer Science/Simulation/Software (Feeling what you cannot feel): Various in-house and acquired haptic technologies and interface allow for advanced surgical performance and training paradigms. Skull base and CNS pathology, spine and hepatobiliary surgery simulation platforms form the current library.
  3. Atomic Force Microscopy-Vibrational Profiling of CNS Neoplasia (Hearing what you cannot hear): Collaboration with Microscopy & Imaging Facility has enabled the translation-modulation of nanoscale cellular frequency to the hearing domain. Again, the innovation and its transferability would be valuable in its incorporation to smart robotic toolset for neuroArmPLUS and CellARM.
  4. Project neuroArm Space endeavours: True to its heritage, the team continues its long-term vision of advancing and applying the neuroArm telerobotic platform back to space! Aligning with NASA’s Deep Space Exploration and recent Lunar Gateway Mission (CSA-MDA for Canadarm3), the team has aspirations of siting a lightweight tele-operated robot (a version of neuroArmPLUS) in the International Space Station or beyond, with a sensory-immersive control station on earth.

Highlight

In January 2020, the Canadian Space Agency hosted Dr. Garnette Sutherland to present and educate the Advisory Council on Deep Space Healthcare. With a shared recognition amongst space-faring nations of the need for humans to now reach beyond low Earth orbit and to explore the Moon and Mars, the session held at CSA Headquarters Montreal and chaired by Dr. Robert Thirsk (Retired Astronaut and Chancellor Emeritus-University of Calgary), discussed Canada’s edge in robotics for ongoing and future leadership in space exploration and healthcare innovations.

The neuroArmPLUS project received funding award from NRC-IRAP (OrbSurgical Ltd.) and the Government of Alberta Major Innovation Funds for Autonomous System Initiative (UofCalgary co-lead with UofAlberta).

Members
(includes collaborators/students/trainees)

Engineering: Hamidreza Hoshyarmanesh, Amir Baghdadi, Mohammadsaleh Razmi, Kazi Ishfaq Ahmed, Rahul Singh (Data Science and Business Dev), Starr Tze (Business Consultant), Mojtaba Esfandiari, Rachael L’Orsa, Mahdi Tavakoli, Chris Macnab, Qiao Sun, Yaoping Hu, Salvatore Federico

Science: Dustin Proctor (in Clinical Biochemistry sabbatical), Corrina Fowlow, Fahad Iqbal, Sonny Chan, Boguslaw Tomanek, Mehdi Arbabi, Frank van Veggel, Matthias Amrein, Guido van Marle

Medicine: Andrea Becking, Melissa Nielsen, Joseph Dort, Francis Sutherland, Andrew Kirkpatrick, Paul McBeth, Abdulrahman Albakr, Madeleine de Lotbiniere-Bassett, Fangwei Yang, Phil Park, Sanju Lama, Garnette Sutherland

Administrative Support: Miwa Shibuya, Randi Nicole Pearson

Industrial Partners: MDA (Brampton, ON); Deerfield-IMRIS (Minnetonka, MN); Medtronic (Minneapolis, MN); Stryker Corporation (Kalamazoo MI); Bissinger GmbH Teningen Germany; Improving Inc., (Calgary; OrbSurgical Ltd. (Calgary)

Institutional Partners: National Research Council Canada, Canadian Space Agency, University of Manitoba, University of Alberta, University of Victoria, Queen’s University, University of Vienna - Austria, Hokkaido University School of Medicine - Sapporo, Japan, National Hospital for Neurology and Neurosurgery, London UK

The Project neuroArm (and OrbSurgical Ltd.) team acknowledges the multiple funding institutions (provincial, federal, international), individuals, families and foundations for their generous support and trust in Project neuroArm’s ongoing endeavours; special thanks to all DCNS, and Section of Neurosurgery members for support and participation in ongoing clinical integration and projects.