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Tumor biopsy with Tijn's robotic arm

The robotic arm that is newly acquired by the Princess Maxima Center allows for a highly accurate brain tumor biopsy. Since June 2021, 14 children have been operated on using the robotic arm of ‘nail polish Tijn’. The first results are positive, according to research by neurosurgeon Kirsten van Baarsen.

In December 2020, the robotic arm was purchased. Stichting Semmy financed the robotic arm with the proceeds of the 'LAK. By Tijn’ nail polish campaign from 2017. The robotic arm supports pediatric neurosurgeons to safely obtain tumor tissue for diagnostics. With this, the course of brain (stem) cancer in children can be better mapped and monitored.

Navigation in the brain

Tijn's robotic arm is a manually adjustable electronic arm with a robotic navigation module that allows a pediatric neurosurgeon to automatically and accurately align surgical instruments according to a pre-planned route. Kirsten van Baarsen, pediatric neurosurgeon, about the study on initial experiences and results with the robotic arm: ‘We compared the results of 14 children that were operated with the new robotic arm with a previous series of 23 children operated with the non-robotic biopsy equipment. In all cases, a complete diagnosis was made from the biopsy. Because the alignment of instruments with the robot is computer-controlled, it is less prone to human error. This, of course, is essential when it comes to surgery in deeper tumors of the brain.’

Fewer complications

The robot was more accurate than the non-robotic system with respect to biopsy location, and there were fewer complications. Kirsten: ‘What we can already say is that biopsies with the robotic system are feasible, safe and at least as accurate. But the numbers are still small so far. We need larger numbers to show all the benefits of robotic arm surgery for children with brain tumors. As pediatric neurosurgeons, we are very pleased that the robotic arm is working out so well in practice.’

Increasing accuracy

Eelco Hoving, Clinical Director neuro-oncology: 'The robotic arm is part of all the equipment in the brain tumor operating room, where the intra-operative MRI is also located. We expect that in the near future the robotic arm will not only be used for biopsies, but also to perform navigation-guided endoscopic surgery in the brain. Eventually, the robotic arm may even be used as the neurosurgeon's ‘third hand’. Hopefully, in the future, the robotic system can support administering medication directly into deep seated tumors, for more effective treatment with fewer side effects.'