Sutherland, Dr. Garnette

2007 Alberta Technology, Recipient

NeuroArm. The name alone conjures images of robots and brains and science fiction. And that’s apt, given the University of Calgary project effectively allows a neurosurgeon to sit at a console and guide a robotic arm through the complex minutiae of brain surgery while the patient is in the bore of an MRI machine. Cool! We know that’s not a technical term and that ASTech is an organisation that recognises technical achievement. But really. a robot doing brain surgery? Awesome! The project is the subject of articles appearing in vastly different publications, including IEEE Journal (published by the renowned Institute of Electrical and Electronics Engineers) and Neurosurgery (presented by the Congress of Neurological Surgeons). What this means is the U of C team that developed this technological marvel is not just brilliant; it’s remarkably diverse, requiring a vast range of skills and expertise.

The neuroArm project is the brainchild of Dr. Garnette Sutherland, born in Edmonton, raised in Calgary, France, and Nova Scotia, and educated in Winnipeg at the University of Manitoba. Though he was always better in science than anything else in high school, it wasn’t until he was doing his undergraduate studies that Garnette was truly bitten by the science/medicine bug. He was working with a very futuristic research chemist, Ernie Bock, who showed him a picture of the very first MRI—it was the image of a finger taken by the English research team led by eventual Nobel Laureate Sir Peter Mansfield. He began to realise that researchers such as Mansfield and his fellow Nobel Prize Recipient, American Paul Lauterbur, invent things whose use is then determined by specific fields. He felt that if he obtained a medical degree, he could apply research to improve medicine. And so a career was launched.

During his third year of medicine at the U of M, Dr. Sutherland took the opportunity to spend some time at the Montreal Neurological Institute, where he met Theodore Rasmussen, a great neurosurgeon who demonstrated that because of its direct, hands-on contact with disease, neurosurgery was an attractive field. He was further pointed in this direction upon returning to Winnipeg where he worked with the exceptional Dwight Parkinson. Upon completing his degree, Garnette moved to London to take up his residency at the University of Western Ontario. It was there he came under the influence of legendary Charles Drake, at the time arguably the world’s finest neurosurgeon. It was he who taught Dr. Sutherland the one major lesson that has guided much of his career. “Never mind your successes. You have to examine your failures, and by understanding them, develop strategies for not repeating your mistakes.”  He explains further. “At the end of the day, Dr. Drake would ignore his myriad successes. He’d take his residents to the x-ray viewing area and look at the instances where he’d been unable to completely obliterate the aneurysm or excise the whole tumour. I took that approach with me when I returned to Manitoba to join the Department of Surgery and Pharmacology.”

That refusal to accept failure led him eventually to start coordinating his surgeries with intraoperative MRIs so that he would be able to look at the images of missed tissue before closing the wound and thereby improving patient outcomes. He has never forgotten one particular case—a young girl who required two surgeries, rather than one, to remove multiple tumours. While the child survived, she suffered additional trauma of the kind neuroArm can minimise. The robotic arm can work inside the bore of an MRI machine, allowing a physician to watch the procedure in real time on a screen while manipulating the arm as it handles specially-designed surgical tools. The robot has to be able to perform like a neurosurgeon and must be able to work in very confined spaces. But the surgeon can be surer of getting the job done the first time because s/he is being fed a real-time image of the environment.

If this all sounds incredibly complex and, well, brilliant, that’s because it is. Consider the challenges. Because the robot has to be compatible with a high magnetic field, it requires extremely specialised materials and motors that won’t be affected by the magnet. In fact, this international project features components manufactured around the world and requires the use of high-grade titanium, a compound known as polyetheretherketone, or PEEK, and ceramic (or piezoelectric) motors. Interestingly, when it came time for the U of C team to find someone to build the actual robotic arm, the normal suspects—French, German, and American firms—couldn’t deliver a product that could perform with the delicacy of a neurosurgeon in such a difficult space. But BC-based MacDonald, Dettwiler and Associates (MDA), responsible for the legendary CanadArm™ technology, were up to the task, experienced as they were in building a robot that could succeed in a harsh environment.

It has taken six years of collaboration between Dr. Sutherland and his colleagues, MDA, and companies in Israel, the US, and Japan, but patents are in place and interest in the technology is being expressed from as far away as China. And the benefits appear to go far beyond the ability to augment brain surgery. In fact, neuroArm will be usable for all kinds of surgery that can benefit from MRI guidance. And then there are ancillary, perhaps even unexpected, benefits that have significant impact on the healthcare system and all of us who rely on it. Consider that the robotic arm is designed to detect and eliminate hand tremors. Such unintended minute motion can have dire consequences, particularly for neurosurgery patients. And the older a surgeon becomes, the more these tremors are likely to manifest. This means a device that can eliminate these unintentional movements can effectively extend the career of valuable medical practitioners. And it also levels the playing field, meaning good surgeons may not achieve the levels of their truly great colleagues—the grand masters—now have a tool that leverages their basic skill and improves outcome. And finally, because every element of neuroArm’s surgical procedure is recorded and fed into a computer, Garnette Sutherland and his team have developed an extraordinary training tool. All in all, we can be forgiven for calling the robot cool!

Since 1993, Garnette and his wife of 28 years, Helen, and their three kids, Christina, Catherine, and Andrew (all U of C students in various fields), have called Calgary home. They like it here and know coming here was the right move, particularly when they when they enjoy all the benefits Calgary offers.  But there’s not much downtime for an innovator who constantly travels to discuss his technology and its application, impacting the world one patient at a time and making us grateful that we can call Garnette Sutherland one of our own.