Image-Guided Medical Robotics Program

Program Lead: Dr. Garnette Sutherland

The Intraoperative MRI (iMRI) Program, developed by Dr. Garnette Sutherland in collaboration with the National Research Council (NRC), uses a ceiling mounted 3.0T magnet and 2017 marked the 20th anniversary of this technology, which is now adopted internationally. At the Foothills Medical Centre, together with the original 1.5T iMRI system, over 2,200 patients have benefited from the iMRI system used for surgical planning, inter-dissection imaging and quality assurance. The Canadian spin-off IMRIS (now IMRIS-Deerfield, USA) has translated the system to 75 international sites, with over 24,000 patients benefiting. 

Into this environment we have integrated neuroArm, the world’s first image-guided, MR-compatible robot, also developed by Dr. Sutherland and team in collaboration with MacDonald, Dettwiler and Associates (MDA). Following the development and FDA approval (stereotaxy) of SYMBIS, Dr. Sutherland’s team is rapidly solidifying the development of thirdgeneration neuroArm, called neuroArmPLUS (CellArm). The system will be a compact, economical and efficient robot for whole body application, with the ability and potential to move robotic procedures from highly specialized tertiary care hospitals to smaller community centres worldwide. Through inclusion of augmented vision, haptics, acoustics and machine learning, this ambitious and disruptive venture is poised to transform surgery from organ to cellular level.

This University of Calgary Office of the Vice President Research-endorsed initiative has allowed the team to already raise ~$1.2M in donations and grants. Dr. Sanju Lama, Clinical Integration for neuroArm Technologies, who oversees the project and liaises with the University Development team, has been helping Dr. Sutherland also consolidate a multi-national joint venture with parties in Shenzhen, China. Indeed, a decade since neuroArm was first used in a young Calgarian in May 2008 at the Foothills Medical Centre, the next few years will see the team readying the next generation robotic technology neuroArmPLUS for surgical suites worldwide.

Project Highlights

SmartForceps Technology: The technology, a force-sensing surgical bipolar forceps, not only allows measurement and quantification of tool-tissue interaction forces, but also, through recent discrimination analysis, is able to classify surgeons based on their skill level and experience. Following publication in JAMA Surgery (March 2018), and with recent funding support for commercialization from the Alberta-Germany Collaboration Fund (GCCIR 2017) and the CIHR, the team is well on its way towards completing the software platform/Intelligent Module. In addition to Bissinger GmbH, a German manufacturer of bipolar forceps, the team has recently contracted a Calgary-based tech group (Quadrus Development Inc.) for an intuitive and immersive user interface v1.0. First clinical application will gather continuous-prospective data towards creation of the Intelligent Module—a machine learning paradigm capable of smart display, automated quantification and analyses of force data, together with a force error warning system. 

Microsurgery-specific Haptic Hand-controller: With the support of CIHR-NSERC, the project has developed a second iteration of the haptic hand controller, Excalibur, for robot-assisted surgery. With a patent filed and manuscripts under submission, the team is finalizing design blueprints towards manufacturing. This novel device will form the unique human-machine interface for microsurgery in the evolving neuroArmPLUS surgical robot. Lead engineer Hamidreza Hoshyarmanesh, neurosurgery resident Dr. Madeleine de Lotbiniere-Bassett and visiting vascular surgeon from S. Korea Dr. Seok Keun Choi have been completing a series of surgeon evaluation of the technology for validation and streamlined translation to clinical domain.

Molecular Neuroscience-Brain Tumour and Trauma: The patent generated from Dr. Lama’s PhD work in collaboration with NRC Ottawa was granted in November 2018! Dr. Dustin Proctor, who leads the molecular neuroscience arm of the project, has made an interesting discovery of novel immune-check point proteins in meningioma and macrophage expression. The work has produced multiple high impact publications (OncoImmunology 2018), grant applications and new intellectual property. Support from all staff neurosurgeons at the Foothills Medical Centre has been most valuable! 

Computer Science/Simulation: Project neuroArm hosts multiple commercially available and in-house surgical simulators used for educating resident surgeons and medical students. Working with Sonny Chan (Assistant Professor Computer Science), neurosurgery chief resident Dr. Andrew Ryu continues to innovate on surgical simulation for spine and skull base surgery, including designing-developing the app Cranium4D(with Justina Lem and Arthur Volpato Batista) for young residents to enhance surgical training and education.

Robot-Assisted Space Telemetry (RAST): Since the first grant by the University of Calgary’s New Earth-Space Technologies (NEST), Dr. Sutherland and collaborators at the University of Manitoba have successfully completed the development of an emulator to account for variable real time delay from Earth to the International Space Station (ISS). With surgeon testing of the emulator underway, the team is also developing an immersive and robust workstation control system for performing robot-assisted surgical tasks on the ISS.

Recognition

In May 2018, Project neuroArm was most honoured to host Her Excellency the Right Honourable Julie Payette, Governor General of Canada, together with Chancellor Emeritus Bob Thirsk. Enquiring and learning about various aspects of robot-assisted surgery such as increased patient safety, simulation for training/education, interplanetary application for astronaut health etc., Her Excellency also emphasized the potential for health care delivery to remote Canadian destinations, e.g. the Northwest Territories.

Education

In March 2018, with University of Calgary Chancellor Emeritus Bob Thirsk, Dr. Sutherland was hosted by the Toronto Ismaili community. He shared his clinical and innovative research and how it may affect the health of our communities, including space exploration. Other highlights included: lectureships in science and innovation in the Chinese cities of Hefei, Guangzhou and Shenzhen, China; Creative Destruction Lab Rockies Dinner Lecture; the Calgary Tesla Society; and the Weekend Robotics Course at the CNS annual meeting in Houston. 

Members

(Active collaborators and students/trainees)

Engineering: Hamidreza Hoshyarmanesh (Chief Engineer), Amir Baghdadi (Eyes High post-doc scholar), Mojtaba Esfandiari, Starr Tze (Chief Consultant), Chris Macnab, Qiao Sun, Yaoping Hu, Salvatore Federico, Mahdi Tavakoli, Ekram Hossein, Kazi Ishfaq Ahmed, Rachael L’Orsa, Mitchell Bashnick, Don Peterson, Renate Ng, Mitchell Park, Hooman Khosravi

Science: Dustin Proctor, Sonny Chan, Kowther Hassan, Desmond Larsen-Rosner,Justina Lem, Arthur Volpato Batista, Zeel Patel, Corrina Fowlow, Jordan Huang, Shanshan Wang, Boguslaw Tomanek, Mehdi Arbabi, Frank van Veggel, Michael Colicos, Matthias Amrein, Guido van Marle 

Medicine: Andrew Ryu, Justin Liu, Madeleine de Lotbiniere-Bassett, Fang Wei Yang, Andrea Becking, Melissa Nielsen, Joseph Dort, Francis Sutherland, Andrew Kirkpatrick, Paul McBeth, Fangwei Yang, Seok Keun Choi, Phil Park, Sanju Lama, Garnette Sutherland

Administrative Support: Miwa Shibuya

Industrial Partners: MDA (Brampton, Ont.); Deerfield-IMRIS (Minnetonka, Minn.); Medtronic (Minneapolis); Stryker Corporation (Kalamazoo, Mich.); Bissinger GmbH (Teningen, Germany); Quadrus Dev. Inc, (Calgary); OrbSurgical Ltd. (Calgary)

Institutional Partners: National Research Council, Canadian Space Agency, University of Manitoba, University of Alberta, University of Victoria, Queen’s University, University of Vienna, Hokkaido University School of Medicine

(Updated Dec. 2018)