title: Merging machines with microsurgery: clinical experience with neuroArm.
abstract: OBJECTIVE
  It has been over a decade since the introduction of the da Vinci Surgical System into surgery. Since then, technology has been advancing at an exponential rate, and newer surgical robots are becoming increasingly sophisticated, which could greatly impact the performance of surgery. NeuroArm is one such robotic system.
  
  
  METHODS
  Clinical integration of neuroArm, an MR-compatible image-guided robot, into surgical procedure has been developed over a prospective series of 35 cases with varying pathology.
  
  
  RESULTS
  Only 1 adverse event was encountered in the first 35 neuroArm cases, with no patient injury. The adverse event was uncontrolled motion of the left neuroArm manipulator, which was corrected through a rigorous safety review procedure. Surgeons used a graded approach to introducing neuroArm into surgery, with routine dissection of the tumor-brain interface occurring over the last 15 cases. The use of neuroArm for routine dissection shows that robotic technology can be successfully integrated into microsurgery. Karnofsky performance status scores were significantly improved postoperatively and at 12-week follow-up.
  
  
  CONCLUSIONS
  Surgical robots have the potential to improve surgical precision and accuracy through motion scaling and tremor filters, although human surgeons currently possess superior speed and dexterity. Additionally, neuroArm's workstation has positive implications for technology management and surgical education. NeuroArm is a step toward a future in which a variety of machines are merged with medicine.
authors.affiliation: Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Alberta, Canada. garnette@ucalgary.ca
authors.forename: Garnette R
authors.initials: GR
authors.lastname: Sutherland
authors.forename: Sanju
authors.initials: S
authors.lastname: Lama
authors.forename: Liu Shi
authors.initials: LS
authors.lastname: Gan
authors.forename: Stefan
authors.initials: S
authors.lastname: Wolfsberger
authors.forename: Kourosh
authors.initials: K
authors.lastname: Zareinia
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000503:physiopathology / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008866:Microsurgery / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods; D011446:Prospective Studies; D012371:Robotics; D025321:Surgery, Computer-Assisted / Q000295:instrumentation; D013997:Time Factors; D016896:Treatment Outcome; D014794:Visual Fields