Hani Marcus - CMIC/WEISS joint seminar series

Speaker: Hani Marcus

Title: Technological advances to keyhole transcranial endoscopic microsurgery

Abstract:

The pituitary is a tiny gland, the size of a pea, which lies deep within the base of the brain. Tumours within the pituitary are usually treated with surgery, and this is typically done through the nose using the so-called “endonasal” approach. The endoscopic endonasal approach is one of the best examples of keyhole surgery in the brain and results in fewer complications and more rapid recovery than conventional open surgery through the skull. Over the past decade, some surgeons have described the use of an expanded endoscopic endonasal approach for other tumours around the base of the brain. Although there are theoretical benefits to patients undergoing such surgery, most surgeons still find operating in this way very difficult. In a recent study of members of the Society of British Neurological Surgeons, we asked surgeons the reasons for this and the majority reported that they struggled with lack of 3D vision, and found using existing instruments akin to “operating using chopsticks”.

We aim to address these barriers by adapting existing devices, and developing new devices, tailored to the particular requirements of the endoscopic endonasal approach. The objectives of this work are threefold: first, to combine augmented reality and 3D cameras to enhance the surgeon’s vision; second, to introduce robotic instruments that allow for wristlike dexterity, and limit the forces exerted, to enhance the surgeon’s touch; and third, to use artificial intelligence developed using videos of existing experts to enhance the surgeon’s judgement. 

Bio:

Mr Marcus is an academic consultant neurosurgeon, and was among the first cohort of trainees to be selected for a Walport Integrated Academic Training Pathway, with rotations at the University of Cambridge, Imperial College London, and University College London.   

His clinical interest is in “keyhole” endoscopic neurosurgical approaches. To this end, he completed fellowships in endoscopy and anterior skull base surgery (including pituitary surgery) at the Klinik Hirslanden, Zurich and the National Hospital for Neurology and Neurosurgery. His research interest, and the subject of his doctoral thesis under Prof Lord Darzi, is the development and evaluation of new devices that makes these keyhole approaches more safe and effective, including augmented reality, robotics, and artificial intelligence. 

His work has received over £1.5 million in research funding, has resulted in over 100 peer-reviewed publications, and has frequently featured in the national press. In recognition of these achievements he was commissioned by Springer to act as Editor on their first book dedicated to Neurosurgical Robotics, serves as a Member of the Advisory Group on Robotic Surgery in the United Kingdom, and has been awarded several prizes, including the prestigious Hunterian Professorship by the Royal College of Surgeons of England in 2019.  

Chair: Matt Clarkson