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First operations for brain stem cancer carried out with robotic arm

The robot arm of 'nail polish' Tijn, purchased thanks to the Semmy Foundation, has been brought into use in the Princess Máxima Center. The first operations on children with brain stem cancer using the robotic arm were successfully performed in June. The significance of this robotic arm was celebrated with a memorable and festive gathering in the Máxima today.

The form of brain stem cancer for which the robotic arm is now used, DIPG, grows diffusely in the brain tissue so that it cannot be removed surgically. The new robotic arm helps surgeons to safely take a biopsy to obtain tumor tissue for diagnostics. In the near future, the robot arm will be able to assist in placing a small tube for administering medication directly into the tumor.

In 2017, the nail polish campaign of the then six-year-old Tijn Kolsteren raised almost €1.2 million for the Semmy Foundation with the aim of improving the treatment of children with brain stem cancer. With this support, the Princess Máxima Center was able to purchase the robot arm at the end of last year. Recently, the first operations with the robotic arm in children with brain stem cancer were successfully performed.

Precise navigation

In children with brain stem cancer, the tumor is situated very deep inside the brain. That makes it very important to precisely map out the navigation to the tumor before doing a biopsy or placing a catheter. The robot arm helps with this.

Pediatric neurosurgeon Kirsten van Baarsen carried out the first operations with the robot arm. ‘It really is a fantastic device to work with,’ she says. ‘The robot arm has many 'joints' to steer as precisely as possible, causing it to feel like a third arm in the operating room.’

Before the operation, the neurosurgeon determines exactly the route through the brain that the needle should take. The robot arm then helps the neurosurgeon to navigate the needle exactly to the tumor. The part of the tumor that is needed to make the correct diagnosis is still obtained manually by the neurosurgeon themselves.


Everyone who was involved in the robot arm came together during a presentation of the robotic arm, including Máxima neurosurgeons and oncologists. Van Baarsen shared her first experiences with the robot arm. In addition, pediatric oncologists Dannis van Vuurden and Jasper van der Lugt spoke about innovative therapies that could be made possible with the robot arm. For example, direct administration of medication, virus therapy and immunotherapy.

Tijn’s mother and brother, and the parents of Semmy, the deceased son of the founders of the Semmy Foundation, were also present. They were surprised with a painting of the two protagonists, Semmy and Tijn, portrayed as superheroes by illustrator Arne van Ree. The painting has been given a prominent place in the Máxima center.

Valuable addition

Prof. dr. Eelco Hoving is a neurosurgeon and clinical director of neuro-oncology. He sees the robot arm as a very valuable addition to the operating room of the future. Hoving: ‘We have now started using the robotic arm for controlled operations in brain stem cancer. We would like to investigate whether this could help direct administration of medicines for this tumor. And we will likely also be able to use this robot arm for other brain operations in the future.’