Computer-programmed drill slices surgery time from hours to minutes

Drilling into the skull can require years of surgical practice and training. But an automated robotic drill may take the challenge out of surgeons' hands. Researchers from the University of Utah published a study in Neurosurgical Focus that examined a computer-programmed drill's ability to reduce surgery time, cost, infection rates and human error.

Currently, surgeons attempting cranial surgeries use hand drills that can take hours for a single procedure. With the automated drill, researchers hope to cut surgery time significantly while reducing the risk of human error. The team, led by William Couldwell, MD, PhD, a neurosurgeon at University of Utah Health, constructed the medical drill based on conventional varieties used in mechanical work.

"We knew the technology was already available in the machine world, but no one ever applied it to medical applications," said Couldwell. "My expertise is dealing with the removal of metal quickly, so a neurosurgical drill was a new concept for me. I was interested in developing a low-cost drill that could do a lot of the grunt work to reduce surgeon fatigue."

Surgeons began a procedure by taking CT scans of the patient, identifying bone data and sensitive structures like nerves and veins, and programming the drill's path accordingly. The drill has an automated emergency shut-off switch in case of emergencies but can also be programmed within a millimeter of sensitive structures.

"The software lets the surgeon choose the optimum path from point A to point B, like Google Maps," said A. K. Balaji, PhD, associate professor in mechanical engineering at the University of Utah. "Think of the barriers like a construction zone, you slow down to navigate it safety."

Researchers tested the dill on the translabyrinthine opening, a complex section of the skull near the ear commonly used for removal of auditory tumors, which usually requires a highly skilled surgeon to perform safely. Results showed the dill was able to perform the procedure in 2.5 minutes, an impressive decrease from the usual two hours needed with a hand drill.