A miniature robot designed to help surgeons operate more precisely and successfully on the spine is expected to enter the market sometime near the end of this year, researchers told United Press International.

SpineAssist, as the soda-can-sized machine is called, attaches directly to the patient's body. Surgeons insert surgical instruments such as drills or needles through the arm of the robot, and the device helps position the surgeon's hand. The hope is to minimize the risk of nerve damage, blood loss and infection.

Another advantage of the robot is that it helps make such surgery minimally invasive, Moshe Shoham, creator of the device and director of the robotics lab at Technion-Israel Institute of Technology in Haifa, Israel, told UPI. You don't have to perform an operation along the entire back. With the robot guiding a surgeon, you can just perform through a keyhole lesion.

Robot-assisted surgery is a steadily growing field, with a few dozen surgical robot prototypes developed since the early 1990s. The most prominent is ROBODOC, from Integrated Surgical Systems in Davis, Calif., as well as Da Vinci and Zeus, from Intuitive Surgical in Sunnyvale, Calif.

The whole concept of using robotics in medicine is to provide minimally invasive approaches that are less traumatic for the patient, are less time consuming and speed the patient's recovery, Jan Wald, a healthcare securities analyst at A.G. Edwards & Sons Inc., a St. Louis brokerage firm, told UPI from Minneapolis.

Despite the advantages of higher surgical accuracy and reduced operating room staff that robots help deliver, the number of surgical robots worldwide remains less than 1,000, Shoham said.

The reason: Robot surgical technology is very expensive, with the Zeus system costing between $800,000 and $1 million, for instance. In addition, annual service contracts for these systems can compose roughly 10 percent of the initial sales price, according to analyst firm Frost & Sullivan in Palo Alto, Calif.

The systems also are often huge and can take up half the space of an operating room, Shoham explained.

The new robot is about 100 times smaller than other surgical robots, Shoham said. It also will be about 10 times cheaper. Mazor Spinal Technologies in Israel, which Shoham founded, will manufacture and market SpineAssist for an estimated cost of $100,000 per unit.

This should help hospitals to do surgery with the robot, Shoham said.

This kind of system is what you'd want to see and what you'd expect to see become part of a spinal operating theater, Wald said.

Shoham added that his team's smaller robot, developed over the past three years, should prove more accurate than larger robots.

You have patients move during surgery, because of breathing, for instance. That can limit accuracy. You have to somehow hold the patient down or do something else. When the robot is small, you can actually mount it on the patient so it moves with the patient. You can get accuracy down to 1 millimeter, Shoham said. Because they're smaller, you don't have to evacuate half the operating room to use them.

The learning curve for robot-assisted surgery often is slow, dissuading many surgeons from using these systems, Frost & Sullivan industry analyst Dhiraj Ajmani reported in 2003.

Extensive training is required as the surgeon is more familiar with using his hands inside the human body than sitting in a console to guide the surgical instruments, Ajmani wrote.

The researchers purposefully designed the robot merely to guide a surgeon's hands, instead of actually performing the surgical operation.

Surgeons want to be in control of an operation at all times, so this will hopefully help surgeons accept it in the operating room, Shoham said. It always takes time for the medical community to accept a new technology.

The researchers focused on surgeries that require only small operating spaces, such as those on the spine or head.

More than 500,000 spine surgeries are performed annually in the United States alone, a number currently growing by 8 percent per year. According to analysts' reports, Shoham said, the spinal industry is expected to triple its growth over the next eight years, reaching annual sales of $7 billion.

With the spine, you don't need a big, general-purpose robot, Wald said. By making a robot for a specific task, you can provide a very focused set of functionality for that robot. That's a good thing.

Mazor already has installed the first systems at the Cleveland Clinic Foundation in Ohio and Sheba Medical Center in Tel Hashomer, Israel. The company expects to install more of the robots later this year at other spine centers in Europe and the United States.

What the robot will do is make the gap between expert and novice doctor smaller, Shoham said. It will give novice doctors tools to do surgery with much higher accuracy than they can do today with just a free hand.

SpineAssist technology also could be applied to brain and knee surgeries, Shoham said. Once doctors know there is such a device, I'm sure they will be room for more new applications.

Shoham added his team is working on a surgical robot only 3 millimeters or 4 millimeters across, small enough to fit inside a patient's spinal cord.

This is more on the science fiction side, he said.

Charles Choi covers research for UPI Science News. E-mail [email protected]