Mount Sinai uses emerging robotic tech for neurosurgery
Mount Sinai Health System is one of the first U.S. hospitals to use a hands-free, robotic digital microscope that provides advanced visualization to surgeons in the operating room during neurosurgery.
Developed by Toronto-based Synaptive Medical, the Modus V is the company’s second-generation, high-powered digital microscope with a surgical robotic arm that is based on Canadarm technology, the remote manipulator system used on the International Space Station to deploy, capture and repair satellites.
The fully automated, robotically controlled digital microscope provides a clear view of critical anatomical structures using a high-definition camera during brain surgery that provides an enlarged view of neuroanatomy on large monitors to help surgeons see magnified images of the brain.
“We used an optical microscope previously,” says Constantinos Hadjipanayis, MD, professor and site chair of Neurosurgery at Mount Sinai Union Square and director of neurosurgical oncology for the Mount Sinai Health System. “But this provides tremendous magnification. The illumination is amazing.”
Hadjipanayis contends that the Modus V system offers “better tissue contrast and less glare” than traditional binocular surgical microscopes used in neurosurgery. In addition, he adds that the robotic digital microscope can be positioned at different angles. “It allows us to really see things better,” observes Hadjipanayis. “Visualization is key, especially during brain tumor operations.”
“High-definition images of brain tractography, fibers inside the central nervous system that control movement and function, improve our ability to navigate in the brain with our surgical instruments,” notes Hadjipanayis, who relates how he was able to preserve speech in the recent case of a 46-year-old man with a glioma near the language portion of his brain because Modus V enabled the patient’s language tracks to be monitored and stimulated during surgery.
“As critical information streams into multiple viewpoints in the operating room, much like in the cockpit of an aircraft, the surgeon’s goal is to utilize that information and move beyond critical structures, preserve neurologic function, and safely perform the procedure,” says Joshua Bederson, MD, professor and system chair for the Department of Neurosurgery at Mount Sinai Health System.
Bederson believes that a major advantage of Modus V’s ability to project real-time images of the brain onto a video screen is that information sources from outside the microscope can be overlaid on the monitor.