Brain Surgery Robot Is No Bigger Than A Pen

By Ariel Grossman, NoCamels March 07, 2023 5 minutes

Tamar Robotics has developed the world’s smallest and most accurate robotic endoscopic system for minimally invasive brain surgery. Courtesy

A tiny robot developed in Israel is no bigger than a pen, yet it has all the tools a brain surgeon needs to operate on a patient.

Tamar Robotics has developed the world’s smallest and most accurate robotic system for minimally invasive brain surgery, with a diameter of just 10mm (0.4in).

It’s equipped with a camera, two steerable and bendable robotic arms that can hold classic surgical tools, and an extendable scaffolding that makes it easier to see and maneuver the tools within the target workspace.

The world’s smallest and most accurate robotic endoscopic system for minimally invasive brain surgery. Courtesy

The company is based near Haifa and was founded by Prof. Moshe Shoham, who is considered to be one of the pioneers of medical robotics. He hopes the system will be approved for use in American hospitals in 2026.

Every millimeter counts when operating on the brain. Neurosurgeons normally have about one to two inches (25-50mm) of workspace, and often need to drill large openings in the skull to fit cameras, microscopes, and other tools, to ensure maximum accuracy when operating.

The deeper they need to dig into the patient’s brain, the more complex the approach to the target tumor, and the higher the risk of damage to healthy brain tissue, which can result in a range of complications such as memory problems, loss of speech or movement, seizures, and even death.

Neurosurgeons normally need to drill multiple openings in the skull to fit the many tools they use to operate on the brain. Deposit Photos

But with Tamar Robotics’ system, they only need to create a single, small incision in the skull and corridor, reducing the risk and recovery time for the patient.

“Everything is so delicate and so cramped in the brain that if you move in the wrong direction, you may be able to take out the tumor, but the patient won’t be able to speak or walk for the rest of his life,” says Aaron Feldman, VP of Business Development.

“That’s why if you can reduce the corridor through the brain tissue in order to access the tumor, that’s a major difference.”

An animation showing how the Tamar Robotics system looks when used to remove a pituitary tumor through the nose. The circled image is the view the surgeon has on the monitor. Courtesy

Space is at a premium with neurosurgery. With the Tamar Robotics system, all the tools the physician requires extend from the same spot, so there’s no risk of them crashing into each other during the procedure.

Today, surgeons insert their tools into the same large incision, or several incisions, to perform the surgery. If they want to have enough mobility and good vision, they need to dig a wider corridor in the brain tissue, which increases the risk of injury.

On the other hand, if they want to preserve healthy brain tissue and dig into a smaller area of the organ, they will be unable to remove the entire tumor in many cases, and patients will likely need follow-up surgery.

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Brain scans showing the progression of a cancerous tumor over a 10-week period. Neurosurgeons are often unable to remove the entire tumor if they want to preserve healthy brain tissue, resulting in patients needing follow-up surgery. Courtesy Wikimedia Commons

“In both cases, surgeons will run into the same issue,” explains Feldman. “Tools are knocking into the camera, which means they need to make a larger corridor so that there’s enough room for both the camera and the tools.

“With our system, you have the camera and the tools right up front. That means you don’t have to make such a big corridor, and you have full free movement of your tools and excellent visualization. So we’re getting the best of both worlds.”

An illustration of the robotic endoscopic system, and its two robotic arms. Courtesy

The company is first focusing on brain operations, but is also developing technology for spinal surgery to remove tumors, and for head and neck surgeries which address thyroid and laryngeal cancer.

In the future, it will be able to target other surgeries including those aimed at lung, bladder, and prostate cancers.

The company will start testing its robot on cadavers by the end of this year, and then begin its first human studies.

brain — The company will start testing its robot on cadavers by the end of this year, and then begin its first human studies. Courtesy Robina Weermeijer / Unsplash

Eventually, it wants to reduce the size of the robot to just 6mm in diameter.

Robots first performed single-port surgery, or surgery through a single incision, in 2018. Today, it is used in many medical centers for procedures including the ear, nose, and throat.

Several other companies are developing robots for single-port brain surgery, but none are as small as Tamar Robotics’. The closest rival is still 50 percent bigger, at 15mm.

Co-founders of Tamar Robotics Prof. Moshe Shoham and Hadas Ziso (CTO). Courtesy

Moshe Shoham, professor of mechanical engineering at the Technion Institute of Technology, in Haifa, previously founded a company called Mazor Robotics, a manufacturer of robotic navigations systems for spine surgery, which was bought by multinational medical device company Medtronic for $1.65 billion in 2018.