Medical robots (a frequent topic here) are popping up everywhere, whether they're being used in surgeries, assisting paralyzed people, or monitoring remote patients. The latest one helps cardiologists in a type of surgery called percutaneous coronary intervention (PCI), which uses stents and balloon catheters to restore blood flow to blocked arteries.
The FDA has approved Corindus Vascular Robotics' CorPath 200 for PCI surgery. Like other robotic assistants, the CorPath 200 gives surgeons very precise control over fine-tuned tasks, such as manipulating coronary guidewires and stents. It lets them move surgical devices and tools in increments as small as 1mm in blood vessels only 3mm or 4mm in diameter.
A robotic system helps cardiologists with PCI surgery, a procedure that restores blood flow to blocked arteries. (Source: Corindus Vascular Robotics)
The system also helps interventional cardiologists remain at a safe distance from the radiation produced by the X-ray guidance systems they use to perform these procedures. To protect themselves, cardiologists have worn restrictive lead aprons weighing up to 40 pounds, but the physical stress of wearing them can lead to back pain, fatigue, and orthopedic injuries. It's also not clear from the research that's been done whether this protection is adequate over a career that involves repeated exposures.
The CorPath 200 lets surgeons control placement of coronary guidewires, stents, and balloon catheters from a lead-lined cockpit. The surgeon is seated in front of monitors that show the angiography screen. This setup may reduce physical fatigue and head, neck, and back strain. (Watch a video demonstrating the robot here.)
As the basis for submitting its application to the FDA, Corindus conducted a multi-center study, the CorPath PRECISE Trial. The company says this study resulted in an overall procedure success rate of 97.6 percent. Also, in 98.8 percent of patients, PCI surgery could be completed without converting to manual PCI and without device-related complications. The study also found the system reduced radiation exposure by 95 percent.
Corindus says that it expects to use the system's open platform technology and intellectual property to address other types of vascular surgery, including peripheral, neuro, and structural heart applications.
Cool development, Ann. It does seem like you (and others) have been writing a ton about medical-related robotics technology lately. Have we turned the tide on some particular piece of technology or perhaps a cultural shift that signals this segment is more ready to embrace this kind of technology?
Impressive robot, Ann. Sounds like the robots movements are finer than a surgeon's hands. Is it still the surgeon who manipulates the robot? It would be interesting to see in coming year whether technicians will control medical robots, thus replacing surgeons -- a new version of the machine versus the human body.
Rob, in all so-called surgical robots, it's always the surgeons' hands that manipulate the tools. Technically, it should be called robotic-assisted surgery.
Do you see a time, Ann, when technical people -- who may understand the technology better than a surgeon -- are at the controls of this technology? Or, will we see a form of surgical practice that specializes on the use technology?
I'm not quite sure what you're asking. The robot surgical tools are the same ones surgeons use, but much smaller and more finely tuned, so they are more accurate. They can be smaller partly because the surgeons are controlling them through a robot intermediary. They are also accompanied by video cams that give the surgeons closeups of what they're working on. So they are really extensions of the surgeon.
Rob, I don't think surgeons are any different from the rest of us in this regard. Like typical end users, surgeons don't need to learn the technology behind the tools, just like most of us don't need to learn the tech behind driving a car or sending an email on a portable computing device.
Good point, Ann. So the surgeons need to know how to use the tool, but they don't need to know the technology behind the tool. The surgeons don't need to become robotics experts, and the engineers don't need to become surgeons.
Once again we see a story about engineers advancing medical science and saving lives. I'm not trying to detract from the important work that physicians and surgeons do, but it would be nice to see engineers get their due (as doctors do) when the subject turns to medicine in popular culture. Great story, Ann. There can never be too many of these!
Good point, Chuck. It could be that the biggest advance in medical care in recent years is the involvement of the engineer. Whether it's artificial limbs, surgery support, or remote care, the engineer is involved in wide range of medical advances.
Chuck, one thing I really like about robot-assisted surgical systems is that fact that they were clearly designed in close partnership between engineers and surgeons. Such insanely tight tolerances make that a necessity.
Don't be too sure about cooperation. A friend of mine works for a hospital that does heart surgery. Two of the surgeons refuse to discuss the statistics of their surgeries with anyone without MD after their name. An arrogance that stifles any kind of improvement.
Beth, I think the answer is yes. Meaning, a combination of several factors. For one thing, the story I wrote on the open source Raven II surgical robot http://www.designnews.com/document.asp?doc_id=239419 and NASA's use of the daVinci surgical robot http://www.designnews.com/document.asp?doc_id=237609 made it clear that surgical robotics technology is being applied to a variety of applications. Next, the open source Robotic Operating System (ROS), which Raven II is based on, and open source robotics in general, are taking off, broadening the types of surgery robotic assistance is being aimed at. And patients, as well as surgeons, are also becoming more accustomed to the idea and the practice.
Robots are truly amazing machines and everyday engineers are finding another practical use for them. The Artifical Lab of MIT has a wealth of medical robot's research. They're investigating robots for In Vio Biopsy and Laparoscopic surgeries. Here's the link of their research.
Thanks for that link, mrdon, there's a lot going on in that lab. MIT is doing a lot of robotics research in several different labs. We've covered some of their robots n various labs under CSAIL http://www.designnews.com/author.asp?section_id=1386&doc_id=243258 and robots from their Interactive Robotics Group http://www.designnews.com/author.asp?section_id=1386&doc_id=246646
Quite welcome Ann. You are correct in terms of engineers and doctors working together to create new medical techologies. Gyrus have trainng courses where engineers observe doctors performing surgeries on patiences to under how they use their heart monitoring products.
Hi Ann, Carol Reiley is a young surgical roboticist who runs a website called TinkerBelle Labs. Here's an excellent paper on using robots to train surgeons of tomorrow she co-authored.
http:m.spectrum.ieee.
org/automaton/robotics/medical-robots/using robots-to-train-the-surgeons-of-tomorrow
Thanks, mrdon. BTW, there's a typo in that link. It should be
http:spectrum.ieee. org/automation/robotics/medical-robots/using robots-to-train-the-surgeons-of-tomorrow
I love the idea--surgeons originally helped engineers devise surgical robotic tools. Now those robots, in turn, help train surgeons.
Hi Ann, Thanks for correcting the link. I agree: the synergy between doctors and engineers to create surgical tools, especially using robotics, is a winning combination for all including the patient.
Ann, Excellent story. It makes sense that robotics would be a great addition for very precise control over fine-tuned tasks that a surgeon must perform. It's also amazing that the interfaces have become so visual. I like to tease a young man I've know for years, who just graduated from medical school, that all his years at video games are coming in handy for his new life as a cardiologist. Thanks.
So right you are. The video gaming generation finally has use for those skills. There is still skill and judgment involved, but I'll bet eventually the engineers will even take that out of the equation. Then it will all be done automatically!
Interesting comments about video games. I don't play them (anymore), but like lots of us I do conduct many very fast web searches, several times a day. That requires very quickly seeing what's on a web page and whether it's the data/links you need. My point is, I suspect that this is the baseline for the visual interfaces we have come to expect. After all, many of the surgeons using this and other robotic-assisted surgical tools are in the older generations.
I agree, apresher, that the precise control is extremely valuable. It also takes some of the fear away that a super-star surgeon could lose his job over a relatively minor (for the rest of us) injury to the hands.
Funny you should mention video gaming, I used to work with large mobile industrial equipment. About 5-8 years ago there was a suggestion that they could be controlled with off-the-shelf gaming controllers. I imagine that they would have lasted about one day in that environment, though.
Jack, You can see why it is called Robot Assist. It makes for more precise motion and consistent movements than a human surgeon can create on their own. The gaming part is interesting because it shows how important user interfaces are becoming -- a layer of software that is removing the complexities for the user. Good stuff.
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