MMI Winter 2015 Newsletter
MMI Team Snapshot
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We are letting Surgeon opinion guide our platform design. In the context of a feasibility study carried out for a Horizon2020 grant we won in December 2014, we developed an online survey with few key questions pertinent to guiding our product development. The survey was distributed by us via an email invitation to surgeons we met at the conferences listed above, and by our clinical advisor, Dr. Marco Innocenti inviting select expert microsurgeons and key opinion leaders. These include the presidents of the World Society for Reconstructive Microsurgery, the Italian Society for Microsurgery, the French Society of Microsurgery, the Secretary General of the European Federation of Societies for Microsurgery and the founder of the European School of Microsurgery. Using these two channels we gathered 49 responses. Cumulatively we have responses from a group representing over 4000 annual microsurgeries, while most surgeons participating perform fewer than 100 microsurgeries per year. One goal of our product is to lend dexterity to surgeons who perform small volumes, permitting them to maintain a high, uniform level of quality without practicing microsurgery on a daily basis.
We asked surgeons which techniques are the most challenging or where they foresee a robot as an aid. Surgeons envision a wristed robotic instrument to be most useful in the performance of ergonomically difficult anastomoses that are deep within the tissue (deep/far anastomosis), with anastomoses of small vessels of 0.5mm diameter or below and in lymph duct surgery, the new frontier in treating lymphedema, which requires anastomosis of very small diameters. We envision deep/far anastomosis and anastomosis of small diameter vessels or lymph ducts as the primary areas, which will be facilitated by a robot:
· Being mounted on long shafts, the depth of the anastomosis will no longer be a factor for the surgeon, who will work with the master, designed to be similar to classical instruments surgeons are used to operating with.
· The surgeons movement will be scaled by the robot, permitting smaller interventions to be performed more easily. Hence a 0.5mm anastomosis, currently beyond the capabilities of most microsurgeons, will be performed with the same ease as a 1mm or above anastomosis.
Furthermore, we found that the prevalent opinion among surgeons(65%) is that microsurgery has not yet found all its applications, but will grow in its implementation. We expect a robotic platform to permit surgeons who would otherwise not have the confidence or expertise to perform microsurgery to integrate microsurgery into their practice after training on the robot. Our prediction is that this would improve outcomes of many interventions in neurosurgery, transplant surgery, cardiovascular surgery and other as yet unexplored specialties. Finally, 75% of surgeons declare a strong interest in emerging technologies such as robotics and imaging, indicating a consensus that the future of surgery will be driven by technologies yet to be developed. Our collaboration with surgeons will result in a product tailored to their needs.
Mitsuishi M. et al., 2013 Jun;9(2):180-9. doi: 10.1002/rcs.1434. Epub 2012 May 16.
Ahmet Gudeloglu, et al., Semin Plast Surg. 2014 Feb; 28(1): 11–19.
Sanjay Saraf. Medical Robotics, Vanja Bozovic(Ed.), 2008. ISBN: 978-3-902613-18-9, InTech, DOI: 10.5772/5261.
Livernaux PA, Berner SH, Bednar MS, Parekattil SJ, Ruggiero GM and Selber JC. Springer, 2013. ISBN: 2817803906.