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Graphic element Research > Growth > Research projects > Previous projects > Medicine and Health > Supersensitive tools make surgery safer
Graphic element Supersensitive tools make surgery safer
There can be little doubt as to the high degree of skill and professionalism displayed by modern surgeons, but no amount of skill can guarantee the outcome of many of today's complex, lengthy and highly sensitive medical procedures. Quality of life is at stake for patients waiting for the highly skilled specialists required to carry out many advanced. The objective of this Brite-EUram project was to advance the use of mechatronics in surgical operations. Novel sensors and software were introduced to provide safer, more consistent operating techniques where previously exceptionally skilled and experienced surgeons were indispensable.

As modern medical advances allow increasingly accurate diagnoses, there is a clear expectation among the public that surgical intervention can be carried out with comparable speed and precision. But as such treatments increase in complexity, the skills required to carry them out become ever more rare and costly. Often, for example, there is a need to work through deep and narrow access points, where the surgeon is unable to sense the action at the tip of the tool. Adjacent soft tissues can be easily damaged, even by the most skilled of human hands. Mechatronic technologies can be applied in a broad range of medical and surgical applications, reducing the level of skills required and the costs incurred.
The term mechatronics refers to systems for sensing and controlling the movement and deformation of materials under forces applied by automatic surgical tools. When dealing with soft tissues, changes in tool action need to respond to tissue movement. In this project, sensing schemes to infer tissue behaviour and to automatically achieve precise tool action with respect to deforming tissues were developed for tools working in different tissue types. Intelligent software analyses the changes in sensory data and makes microfine adjustments in tool operations.

Techniques under the microscope

This project's goal was to advance the use of mechatronics in very difficult surgical procedures. From the outset, four separate surgical applications were targeted, all representing concrete opportunities for commercial exploitation.
First, a new system for mechatronic stapedotomy was developed. Stapedotomy involves drilling a hole through one of the small bones in the inner ear. The new, automatic breakthrough detection system stops the drill as soon as the bit has broken through the bone, thus avoiding damage to sensitive tissues on the other side. Until now, the low drilling forces used have made this a delicate operation with high risk of accidental damage.
Secondly, an improved epidural puncture procedure was developed, including a force simulator for surgeon training. Penetrating spinal tissue to inject pain-relieving fluids is a procedure widely used in surgery but one which carries a risk of spinal damage or ineffectual injection if the needle is positioned inaccurately.
New methods were developed for drilling in the osteosynthesis of long bones, very similar to the stapedotomy procedure described above. Finally, improved laser ablation techniques were designed for the removal of deep-seated brain tumours. New software helps to guide the ablation probe, avoiding blood vessels which must not be damaged, and removes the need for intervention by a specialist surgeon.

Sensors and software

All the new systems involve the introduction of novel sensors and software to provide safer, more reliable operations where previously skilled and experienced surgeons were required. Particular innovation was displayed in the application of software and sensor techniques to improving positional accuracy and force feedback. Each new technique has the potential to improve patient recovery times and to reduce the incidence of cross infection between surgeon and patient, thanks to their limited invasiveness.
These and other developments could make certain delicate surgical operations more widely available by enabling less-experienced surgeons to perform the work without any increase in risks. Shorter recovery times, lowered risk of infection and greater availability of operations will also contribute substantially to lower costs for health service providers.

Remote control comes closer

Although it was not a declared goal of the project, the new technology could ultimately contribute to groundbreaking developments in telemedicine. The ability of expert surgeons to manage operations remotely currently relies on local surgeons working to expert's instructions via audio and video links. The sensors developed under this project can now provide surgeons with live feedback, enabling them to actually conduct some operations remotely themselves. This opens up the possibility of bringing specialist surgery to patients unable to travel to conventional hospitals, for example after major disasters.
Project partners included the Universities of Bristol, Siegen and Thessaloniki and the Scuola Superiore Santa Anna in Italy, four distinguished research institutions well known to each other through academic networks, demonstrating that original, focused applied research can be successfully concluded without the support of industrial partners.

Cordis RCN: 21539
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