Biotechnology has made many advancements in the last 40 years in all aspects of food, the environment and health such as medical devices and vaccines which have played important roles in improving the challenges with regards to human health. Biotechnology has minimised these problems by the use of biotechnological advances. One of them is the ROSA.
The ROSA is a multi-application robot that assists during neurosurgery, offering
Precise planning, surgeon-oriented ergonomics, precise instrument handling and guidance, haptic collaborations with surgeons. The ROSA has cutting edge technology ranging from free hand navigation, complex instrument handling and manipulation to the innovative markerless automatic registration.
1. The ROSA is a surgeon assisting robot which performs minimally invasive surgeries on the Brain for epilepsy and other neurological conditions as well as surgeries on the spine in a safer way. ROSA performs as an assistant to the surgeons in the operating room and helps map and navigate the brain. The ROSA is suitable for any kind of cranial and spinal procedures which need surgical planning and accurate handling of surgical instruments. It is useful for the treatment of epilepsy as it uses implanted electrodes to monitor epilepsy. The ROSA functions through the usage of images to guide and gives a stereotactic device to hold surgical tools and makes image guidance procedures to be done robotically. Before surgery, patients will usually have multiple thin cut CT scans, the ROSA properly stacks and joins together these scans to create a 3D model of the patient’s head. When this is completed, the surface of the patient’s face is scanned by the ROSA, creating an accurate contour of their head. This information allows the trajectories for the procedure to be created. The robotic arm of the ROSA then helps surgeons by holding surgical tools still and precisely during the procedure.
2. This device, the ROSA, is a significant advancement not only in the field of medical biotechnology but in the field of medicine as well. Before the ROSA, brain surgeries took long as doctors had to navigate their way through the brain to find the location of the tumor and in doing so caused damage to the normal part of the brain tissue in order to reach the tumor. With the aid of the ROSA, surgical time is considerably reduced as the ROSA cuts to precisely where the tumor is located, therefore reducing surgical time, invasiveness and damage to the healthy parts of the brain, in so doing the patient is less exposed to anaesthetic drugs and their side effects. With the ROSA there is less risk of significant blood loss, less need for blood transfusion and less risk of complications associated with blood transfusions.
3. The ROSA is used in everyday brain and spine neurological procedures as after patients are co-registered, entry points and a target are chosen. These two points define the trajectory and once they are entered into the software along with the patient’s scan, the ROSA is ready and knows exactly where they are and will take surgeons along that trajectory. This helps surgeons prepare for surgery, by being able to plan and find the exact location and approach in the operating room. Some of the important life- saving neurosurgical procedures in which ROSA has found its value are operations such as spine discectomy, brain space occupying legions such as brain cysts, brain tumors, small intracerebral bleeds. Before the advent of ROSA, the surgical dissection to remove a small brain cyst would take much more time and cause much more damage to the normal brain tissue with all the consequences on the patients’ health.
4. ROSA is performing critical procedures on human beings and cannot be held responsible for any mishap, so someone has to be responsible for the use of this biomedical technology. The company which provides the tool is liable for its proper functioning but will not be responsible for any misdiagnosis. This implies a multidisciplinary approach. This involves the neurosurgeon, the radiologist, the biotechnician, as well as the institution where the ROSA will be used and the intervention will be performed.
The basic use of the ROSA depends on a proper neurosurgical diagnosis, reliable investigations, such as CT brain (computed tomographic images of the brain tissue) and MRI brain (Magnetic Resonance Imaging of the brain tissue) and adequate programming of the ROSA based on the above investigative tools. In the unlikely event of a surgical mishap, the ROSA per se cannot be held legally responsible.
5. With regard to potential negative implications with the use of this device, the ROSA is after all an electronic devise which is prone to human error as well as electronic malfunctioning and virus invasion. Therefor regular servicing and maintenance are mandatory. Safety checks and daily software updates should be part of the basic requirements in each institution which uses the ROSA as a tool on each human being. A dedicated member of staff or team has to be responsible for this. In the event that the above measures are not adhered to the consequences on human health can be catastrophic. The brain tissue cannot be regenerated or transplanted. Any mishap with the ROSA cannot be corrected and the patient’s life will be endangered if not lost.
Despite all the progress made in neurosurgery with the help of ROSA, one still needs to consider the cost involved in the manufacturing and maintenance of this biomedical device. Major centres of expertise around the world are still not able to meet this financial demand. The benefits of the use of the ROSA in neurosurgery are accompanied with a high financial implication for the patient too. Nevertheless, the risk benefit ratio of this device is more in favour of the benefit. Considering the mobility and mortality associated with most neurological conditions, most population will benefit from the use of ROSA and see an increase in life expectancy, therefor making this device one of the greatest breakthroughs in biomedical technology in the last 40 years.
Brighamandwomens.org. (2018). The ROSA™ Robotic Surgical Assistant – Brigham and Women’s Hospital. online Available at: https://www.brighamandwomens.org/neurosurgery/rosa-neurosurgical-technology Accessed 20 Apr. 2018.
Medtech.fr. (2018). Surgeons | medtech. online Available at: http://www.medtech.fr/en/surgeons Accessed 20 Apr. 2018.