Prototype British robot could carry out brain operations: Keyhole technique to reach previously untouchable tissue may be used on first patients in London before end of year

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The Independent Online
A SMALL British company is building what could be the first robot in the world to carry out brain surgery.

Armstrong Projects in Beaconsfield, Buckinghamshire, hopes to complete a prototype brain robot by the end of the year, when a London hospital will provide its first patients.

Patrick Finlay, managing director, emphasised that the robot will not replace surgeons but assist them, like an autopilot. The company specialises in medical robots, and yesterday launched the first robot laparoscope - a tube-like instrument that can be fitted with a camera to let surgeons 'see' inside a patient's body.

The Laparobot is linked to the head movements of the surgeon by an electronic headband. As the surgeon's head moves from side to side, so the robot moves the laparoscope to project its view on a television monitor. Moving the head towards the patient produces a close-up.

At the moment, a junior doctor has to position the laparoscope by hand during operations. The robot avoids confusion over vague instructions, and puts the whole process directly under the control of the surgeon.

The Laparobot should cost between pounds 15,000 and pounds 25,000, depending on how it is to be used. Surgeons expect to use it at a private London hospital within the next few weeks. Its first operations should include gall bladder removal, hernia repair and appendicectomies, using 'keyhole' surgery - creating tiny puncture holes in a patient's body, and manipulating instruments from the outside. Less invasive than traditional surgery, this can cut down convalescence dramatically.

Armstrong Projects intends its brain robot to perform biopsies on brain tumours, and even remove abnormal tissue. The robot should be accurate to within one millimetre, and allow surgery on parts of the brain that surgeons would not dare approach using existing techniques. One example is a tumour close to the optic nerve, when one tiny slip could blind the patient.

The surgeon will feed the robot with a version of an image created by an ordinary brain scan. The robot will have its own 'intelligent' software, and will propose the best route into the tumour, causing the least damage to surrounding, healthy tissue. The surgeon will align the drill for the robot to make the hole, and remove the brain tissue.

Dr Finlay said yesterday: 'The current generation are the first computer-literate surgeons, and they are keen to make their mark and to show they have something to contribute. The time has come for robotics.'

Armstrong's robots are far more slow-moving and sensitive than industrial robots. They stop if they bump into an unexpected blood vessel, which they spot by detecting the flow of the blood. The robots can also tell if they have cut into a tumour, by detecting a change in acidity.

Dr Finlay said the UK still leads the world in medical robotics, despite one-off robot operations in the US, mainly in orthopaedic surgery. Development in the US is particularly slow because of the fear of litigation, he said. 'The idea of using a robot is fearful enough. The idea of using a robot for surgery is enough to make a lawyer slobber at the mouth.'

He added: 'I am painfully aware that the first robot to kill or injure a patient will be the end of my career and everybody else's in this field.' He wants the laws that cover medical liability updated to take account of new technology.

Current legislation is stopping surgeons exploiting technology that could help save people's lives, he said. Surgeons who make a mistake can be excused, as long as they are not negligent. Machines have no such excuse in law, and designers are liable even if they have followed the best engineering practices.

(Photograph omitted)

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