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RONNA - Robotic NeuroNAvigation in neurosurgery project led by Bojan Jerbic in Croatia
Professor Bojan Jerbić, University of Zagreb, Ronna project leader
RONNA - the first robot-assisted neurosurgical operation
RONNA - RObotic NeuroNAvigation project in Croatia
RONNA - Robotic NeuroNAvigation is a project that deals with research into and the design of a new innovative and competitive robotic system for application in neurosurgery. The project was launched 7 years ago by the Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, with the Clinical hospital Dubrava and the Croatian Institute for Brain Research as partners in the project. Founders of the project are Professor Bojan Jerbić, PhD (project leader), Assistant Professor Darko Chudy, PhD and Professor Gojko Nikolić, PhD. The project received the first funding through the government program for technological development TEST and the Ministry of Science, Education and Sports. Further funding was received from the Unity Through Knowledge Fund, the Croatian Science Foundation and, recently, from the European Regional Development Fund (Strengthening capacities for research, development, and innovation - RC, 2 February 2008).
The main ideas of the project are:
Improve the traditional neurosurgical stereotactic procedure using the RONNA robotic system. Use a dual arm configuration (two robots), one as the main robot for precise spatial positioning and guidance of surgical tools and the other as the robotic assistant.
Use standard industrial robots in the unstructured medical environment.
Implement intelligent and intuitive control features for simple and intuitive use of the system. The RONNA system has been developed to the stage of commercial use as part of the project which was funded by the European Regional Development Fund. This project stage began in December 2014 and was divided into two main phases: industrial research and experimental development. In the first phase, new equipment was purchased and research involving continuous relative robot navigation was conducted. Exploration of possibilities and limitations of standard industrial robots for use in medical procedures and the development of protocols and equipment for human-robot interaction (HRI) were also part of this phase. According to the research carried out in the first phase, the robots KUKA KR6 Agilus and Universal Robot UR5 were chosen to be applied. In the second phase of the RONNA project, mobile platforms for the master and the assistant robot were developed following the rules of industrial design and satisfying special requirements related to medical equipment. They were then manufactured as first commercial prototypes. Concurrently, a prototype of an educational robot system was built for the training of medical stuff. All the research mentioned previously was conducted at the Faculty of Mechanical Engineering and Naval Architecture and the Clinical Hospital Dubrava. At the end of 2015, as part of the second phase of the project, clinical testing started as the preparation for the first robotized neurosurgical operation in Croatia. On the 10th of March 2016, the first stereotactic neurosurgical operation on a real patient was finally performed successfully. That was also the first neurosurgical operation of that kind in this part of Europe. Globally, there are only few robotic systems which are suitable for use in neurosurgical applications, mainly still in the experimental stage.
The conducted surgical procedure can be divided into two phases, preoperational and operational. In the preoperational phase, a marker was attached to the patient's skull, which acts as a coordinate reference system for the operation points in the CT scan of the patient. The surgeon determined the operation points (entry and target points) in the medical diagnostic software. The coordinates were then transformed into the coordinate system of the patientâs marker and immediately transferred (sent) to the robot. Thus, the preoperational phase was completed and the operational phase of the procedure could begin. Using a stereovision system, the robot localized the patient and its spatial position and orientation through the aforementioned marker. When the connection between the robot coordinate system and the patient was established, the invasive part of the procedure began. A sterile cover was put on the robot and the unsterile robot tools were replaced with adequate sterile tools. Then, the robot navigated to the previously planned trajectories and enabled precise drilling operations by guiding the surgical drill through its tool. Subsequently, the surgeon inserted a biopsy needle into the intracranial space of the patient under the precise guidance of the robot and performed the standard biopsy procedure together with the evacuation of the cystic part of tumour from the targeted brain region. Follow-up MR scans of the patient showed that the planned brain region was perfectly reached without any complications arising from the procedure.
The most important results which were produced by the RONNA project are:
Faster and more effective completion of a surgical operation.
Surgical operation procedure becomes less invasive.
Faster patient recovery (due to a shorter duration of the surgical operation).
More effective use of hospital resources.
Introduction of new technologies into medical practice.
Technological and scientific contribution of the project:
Development of new control models for the intuitive use of robots in the operating room.
Development of an original method for patient localization.
Design of specific robot tools and instruments suitable for use in the medical environment.
Knowledge of new possibilities for the application of robotic technologies in the neurosurgical practice.
The total value of the RONNA (Robotic NeuroNAvigation) project funded by the European Regional Development Fund is 3,698,461 kunas. The 16-month project was completed successfully on the 1st of April 2016. The research team from the Department of Robotics and Production System Automation at the Faculty of Mechanical Engineering and Naval Architecture in Zagreb together with the Neurosurgical team from the Clinical Hospital Dubrava will continue their work on the development and improvement of the system. The eventual aim is to make the system suitable for use in hospitals and clinical centres around the world.
More information about the project can be found on the projects official website: www.ronna-eu.fsb.hr
Robotic innovation gives Croatian neurological surgeons a helping hand
An innovative and commercially competitive robotic system for neurosurgery applications has been developed through an EU-funded project based in Zagreb, Croatia. The new system is composed of a master robot for pre-planned navigation and an assistant robot for handling complex medical instruments, enabling it to perform specific and complex actions that require incredible precision and accuracy.
"A spin off company is planned in order to further develop the commercial robotic platform. Given the amount of interest shown, we are confident about ensuring a stable and sustainable support base for all clinical users."
Bojan Jerbic, Department of Robotics and Automation of Manufacturing Systems, University of Zagreb
The RONNA robot is capable of performing precise bone drilling operations that the project team says will improve patient safety and reduce the potential trauma that can be caused by manual drilling procedures.
The new system also features advanced control mechanisms that allow an intuitive and natural interaction between medical staff and the robot itself. The project team, which consisted of academic and medical staff, is now working on registering patents for some of these innovations.
Safer neurosurgical procedures
The project built upon previous robotic work done by members of the team and other research and sought to complete the transition from an experimental prototype robotic platform toward a more technologically advanced system capable of performing clinical neurosurgery procedures. These operations can present a highly complex challenge to even the most skilled and experienced neurosurgeons.
The RONNA system was developed to assist surgeons during these procedures, and even improve on them. The master robot is essentially an intelligent navigation instrument that follows preoperative planning conducted by neurosurgeons, while the assistant robot is able to perform invasive surgeries such as sensitive bone drilling, external drainage catheter insertion and biopsy probe insertion.
A mobile platform for robots
Activities within the RONNA project were split into two main phases. During the first phase, the project acquired equipment and conducted preliminary tests. The team developed and demonstrated planning and control models for the robotic platform. The second phase involved the development of mobile platforms for the master and assistant robots in line with specific medical requirements. The robots were then manufactured as a first commercial prototype.
The team conducted successful clinical trials of the platform and made an oral presentation of these trials at the clinical hospital Dubrava. Furthermore, 18 medical personnel at Dubrava were given first-hand experience of operating the RONNA system, introducing them to cutting edge technologies that could one day revolutionise clinical care.. A spin off company from the project's commercial partners plans to continue R&D activities, which will help bring the RONNA system closer to commercialisation. Total investment and EU funding
Total investment for the project "RONNA - Robotic Neuronavigation" is EUR 486 638, with the EU's European Regional Development Fund contributing EUR 342 729 through the "Regional Competitiveness" Operational Programme for the 2007-2013 programming period.
RONNA G4 proclaimed as innovation of the year for 2018 in the field of medical robotics
An international conference Hamlyn Symposium, dedicated to the newest trends and achievements in the field of medical robotics, has been organized by the Imperial College in London. The latest robotic instruments have been shown and described by specialists from Canada, South Korea, Germany, Switzerland, Italy, and Croatia.
The Croatian RONNA G4 was elected by the international committee as the scientific and technological innovation of the year. Congratulations to our team!
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