The MedLife Humanitas Hospital in Cluj currently has the world’s most modern technologies used in neurosurgical practice. The HotNews team witnessed surgery performed using the Brainlab Loop-X & Cirq robotic complex to see how the face of medicine is changing, and how a complex spine problem is being solved with equipment that looks like something out of a sci-fi movie. . The operation was difficult and lasted several hours, but the experience of the team of neurosurgeons at the MedLife Humanitas hospital, coordinated by Dr. Tiberiu Mayor, and the technology used are a guarantee that the intervention is carried out in conditions of maximum safety for the patient and has the best chance of success.

What can the world’s most advanced neurosurgical technology do in the operating room?

The Brainlab Loop-X & Cirq robot surgeon is used for extremely complex surgical interventions in the field of spine or brain pathologies and allows the use of surgical techniques that would be impossible in classical neurosurgery.

“This is a platform that opens up new horizons for us. The principles of spinal surgery have not changed. The goals, strategies, pathologies are the same, but the ease with which we approach complex cases with this new technology is much greater,” said Dr. Tiberiu Mayor, Chief Neurosurgeon of MedLife Humanitas Cluj.

The Brainlab equipment suite at the MedLife Humanitas Hospital in Cluj consists of the Loop-X intraoperative 3D imaging system, the Curve neuronavigation system and the Cirq robotic arm.

Dr. Major explained to us that the medical imaging system can take simple x-rays as well as high-quality tomography or three-dimensional x-rays. This system is used by doctors in the operating room to obtain quality images in real time. Later, these intraoperative images are combined with preoperative images (X-rays, MRI, CT, which the patient takes before the operation), thus forming a single entity that helps surgeons in highly precise planning of the operative steps.

“With the help of this technology, medical visualization is practically being rewritten. I will give an example: when patients come to us, they come with various types of research – X-ray, computer tomography, magnetic resonance tomography. These systems basically rewrite medical imaging by combining all these types of imaging studies. At the moment, we are working with three-dimensional reconstructions, where all the elements that interest us can be superimposed. We can have the entire bony architecture superimposed on the soft parts, to which we can add elements of angiography, tractography,” said Dr. Tiberiu Major.

In addition to a highly efficient imaging system, the robotic set integrates a neuronavigation system and a robotic arm, which together ensure the accuracy and precision of each surgical gesture. Here is a great advantage of the new technology available at the hospital in Cluj: the neuronavigation system helps the doctor not only to plan the surgical intervention in detail before entering the operating room, but also to accurately visualize the anatomical elements from deep in real time.

“The brain of the entire platform is the neuronavigation system. This system is actually our three-dimensional GPS of very high accuracy,” the neurosurgeon noted.

In addition, the robotic arm has a very precise positioning on a certain given trajectory and allows the safe insertion of different types of implants, thus increasing the safety of the surgical intervention.

“Last but not least, what is extraordinary and makes the Brainlab system unique is the virtual reality that helps us better understand the patient’s pathology and also helps us a lot during surgical procedures,” added Dr. Tiberiu Mayor.

“We are more confident than ever that we will not cause a neurological deficit in the patient”

The purpose of the intervention in the footage taken by the HotNews team was to reconstruct the spine in a new way. For this, doctors used reconstruction on a metal scaffold. This involves inserting screws into each vertebra, screws that are then connected with titanium rods. In this way, surgeons can rotate the spine along the spinal axis to bring it into a position as close as possible to normal anatomy.

“Because the vertebrae are so rotated relative to each other, it’s very difficult to calculate what the ideal trajectory of the screws is, given that you’re basically working near the spinal cord. This means that a few millimeters away from you, when you insert the screw in a weak or not ideal trajectory, you can cause a neurological deficit in the patient”, explained Dr. Gheorghe Ungurianu, a specialist neurosurgeon. “Practically, with the help of the new technology, we are more confident than ever that we will not cause a neurological deficit in the patient,” the neurosurgeon added.

Benefits for the patient

“The treatment of complex pathologies of the spine, such as deformities, requires great precision. That is why a system like the Brainlab robotic complex, which we have now installed in our hospital, allows us to perform this surgical intervention in conditions of maximum safety for the patient,” explained Dr. Ungurianu.

The most important advantages of the new technology for patients:

• This simplifies the surgical procedure
• This greatly increases accuracy
• This reduces the duration of the operation
• This significantly reduces surgical trauma for the patient
• Reduces the risk of intraoperative bleeding
• This reduces the risk of infections
• Reduces the risk of radiation
• Contributes to faster recovery
• This offers the patient the possibility of much faster socio-professional reintegration
• Reduces hospital stay
• Reduces hospitalization costs

Regarding the conditions that can be treated with the latest neurosurgical technology in the world, Dr. Major explained to us that this is not limited to spinal neurosurgery: “The neuronavigation system was developed specifically for cerebral neurosurgery, for cerebral pathology, but now there is an extension to orthopedics, for maxillofacial surgery, for oncology.”

Neurosurgery Department of Humanitas Hospital, Brainlab Help Center

Thanks to the integration of a mobile robotic imaging suite and robotic surgery, after an investment of approximately 2 million euros, the neurosurgery department of the MedLife Humanitas hospital has become part of the reference centers of the German company Brainlab.

“At the moment, there are 20 projects similar to ours at the European level. Thus, the Department of Neurosurgery of the Humanitas Hospital is included in the list of reference centers of the Brainlab company. We are about to be accredited as a training center and we will be able to organize courses, symposia, and training for surgeons coming from abroad. And perhaps the most important thing for us as doctors and for us as a hospital is to become a center for the development and improvement of the technologies of the future,” concluded Dr. Tiberiu Major.

Article supported by MedLife