University of Utah researchers have shown that a robot drill they have devised can make cuts safely – and as much as 50 times faster than hand drills now used for cranial surgery.

That means that a procedure that takes a skilled surgeon 2 hours can be done robotically in about 2.5 minutes.

"It's a time-saving device, more than anything," University of Utah Health neurosurgeon William Couldwell told CNNTech.
His team reported their efforts in the journal Neurosurgical Focus today.

The drill “produces fast, clean, and safe cuts, reducing the time the wound is open and the patient is anesthetized, thereby decreasing the incidence of infection, human error, and surgical cost, according to a university report.

It can also free up OR rooms faster and boost patient throughput.

Doing these cuts by hand, Couldwell explained, “was like doing archaeology. We had to slowly take away the bone to avoid sensitive structures."

The hours this added to procedures led him to seek a solution outside of the health care sector. "We knew the technology was already available in the machine world, but no one ever applied it to medical applications."

He turned to Associate Professor A.K. Balaji and the university. "My expertise is dealing with the removal of metal quickly, so a neurosurgical drill was a new concept for me," he stated, adding that, "I was interested in developing a low-cost drill that could do a lot of the grunt work to reduce surgeon fatigue."

One key to the drill is its software, which can identify safe cuts through bone, nerves veins and arteries using data from a CT scan. "The software lets the surgeon choose the optimum path from point A to point B, like Google Maps," said Balaji.

The drill can be programmed “to drill the bone out safely just by using the patient's CT criteria," Couldwell told CNN. "It basically machines out the bone."

Safety is increased by “barriers” that the surgeon can establish along the path. "Think of the barriers like a construction zone," said Balaji. "You slow down to navigate it safely."

The drill mills out most of the bone in a fashion similar to industrial metalworking applications. "It's like Monster Garage, except instead of machining a part, we are machining the skull," Couldwell advised.

To test the device, the team tackled a particularly tricky surgical challenge involving the translabyrinthine opening. "The access is through the temporal bone, which is a hard bone with strange angles," said Balaji.

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