Surgery steps away from the cutting edge
Monash University systems engineer Professor Sunita Chauhan, a specialist in medical robotics, says ultrasound is already used for diagnostic imaging and therapeutic purposes, but the potential of high-intensity focused ultrasound (HIFU) as a surgical technique is only just beginning to be realised.
HIFU techniques make surgery without a scalpel possible, reducing the potential for complications inherent in any procedure that cuts into the body. However, most HIFU treatments are still considered experimental.
“It is usually offered to patients who have no alternatives,” Professor Chauhan said. “Some people do not want to have surgery and others are poor candidates for various reasons…. Some people might require multiple surgeries and you can’t operate on the same place over and over again because of the scar tissue. Or they might be offered this technique when other treatments, such as radiotherapy, have failed.”
HIFU, which uses precisely targeted soundwaves oscillating at up to 4000 kilohertz, has gradually gained acceptance in procedures to remove benign tumours in the uterus (uterine fibroids), and for tumours associated with prostate cancer.
In her research, The Monash Engineering professor is particularly interested in developing neurosurgery that does not involve cutting into the brain, or even opening the skull.
The most common sufferers of brain tumours are children and the elderly—both also high-risk candidates for conventional neurosurgery. Moreover, parts of the brain carry an extremely high risk for surgery in terms of the potential for damage to cognitive and motor functions—but these areas can be precisely targeted with robotically assisted HIFU.
Fundamental research is continuing into the mechanisms of ultrasound transmission through multi-layered brain structures, and imaging techniques to ensure the most accurate and safest targeting of lesions in the brain.
“But we’ve still a long way to go,” Professor Chauhan says. “We are still working to prove our techniques in non-critical surgeries, before we advance to the brain—our ultimate goal.”