Researchers ready super-tiny, micro-laparoscopy robotic surgical system for the clinic

Needle-based surgical robot with a wrist--Screenshot courtesy of Vanderbilt University

Academics at Vanderbilt University's Medical Engineering and Discovery Laboratory have added a wrist to a needle-based surgical robot that's already been 6 years in development. Now, the researchers are ready to put the system to the test in head and neck surgeries, with transnasal surgeries to remove tumors from the pituitary gland likely up first in the clinic.

That kind of surgery typically involved surgeons cutting large openings in the skull and/or face of the patient. Surgical robots remain somewhat controversial. In fact, the FDA has called a committee meeting for early next week to address "the current challenges and opportunities related to robotically-assisted surgical medical devices."

The agency reportedly has received 144 reports of deaths associated with robotic surgery, which could be a result of improper usage of, or lack of training on, the devices. In fact, the FDA found that the death rate for robotic head, neck, and cardiothoracic surgery is almost 10 times higher than for other kinds of robotic surgery.

Still, the Vanderbilt researchers are optimistic that their needlescopic surgical robot could help enable endoscopic surgery via the nasal cavity--a procedure that is so difficult that only a few surgeons have perfected it. Earlier this week, the FDA cleared a somewhat similar, wristed transoral robotic surgical system for procedures in the mouth and throat from startup Medrobotics.

"The smaller you can make surgical instruments the better … as long as you can maintain an adequate degree of dexterity," said Professor of Urological Surgery Duke Herrell, who is consulting on the project, in a statement. "In my experience, the smaller the instruments, the less post-operative pain patients experience and the faster they recover."

The researchers noted that robotic surgery player Intuitive Surgical's ($ISRG) da Vinci Surgical System, designed for minimally invasive surgery, requires incisions of 1/3 of an inch (8 mm) to 3/16th of an inch (5 mm) long, while their own can use incisions that are less than 1/16th of an inch (2 mm).

The researchers hope to have the control software and interface for the system completed by the end of this summer; they are actively looking for a commercial partner to help advance the system through FDA approval.

"It should be useful for a number of other operations as well," said Associate Professor of Mechanical Engineering Robert Webster, who heads the project, in a statement. "We think once we give this tool to surgeons they will find all kinds of applications we haven't thought of."

"Our best case scenario is that the system could be available to surgeons in four to five years," Webster said.

- here's the statement