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Medicine Robotics

Tiny New Robots Perform Eye Surgery (technologyreview.com) 52

Posted by EditorDavid from the Eye,-Robot dept.
A tiny new Robotic Retinal Dissection Device -- nicknamed "R2D2" -- can crawl into an incision in the eye and lift a membrane no more than a hundredth of a millimeter. "The cables that enable the robot to navigate are each 110 microns across, a little over the diameter of a human hair," reports the MIT Technology Review. The robot is controlled by a joystick (while providing a live camera feed to the ophthalmologist). In September an Oxford professor used it to perform the first operation inside the human eye, and since then five more patients have undergone robot-assisted operations at an Oxford hospital. In one procedure, a gene-therapy virus that stops retinal degeneration "was planted on the retina itself, a procedure only made possible by R2D2's unprecedented precision."
Robotic surgery is already happening. The article points out that Da Vinci, an elephant-sized surgical robot that repairs heart valves, "has operated on more than three million patients around the world." But the Oxford professor believes these tiny eye robots "will open the door to new operations for which the human hand does not have the necessary control and precision."
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Tiny New Robots Perform Eye Surgery More

Tiny New Robots Perform Eye Surgery

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  • The "robot" is used for a lot more than heart valve surgery. I think it is currently the gold standard for radical prostatectomy.

    • It's only 'gold standard' if your standard is that you need more gold. Yes, it's becoming more common. Yes, it is quite a bit more expensive. No, it is not at all clear that it is any better. USA! USA! USA!

      It doesn't work as well as old fashioned [webmd.com] prostate surgery. (Yes, it's from 2009, hasn't changed that much [cancer.gov].)

  • R2D2? (Score:3)

    by Harold Halloway ( 1047486 ) on Sunday January 22, 2017 @02:49PM (#53716189)

    Personally I'd go with "I, Robot."

    • Isn't it more like a waldo? (Score:4, Insightful)

      by Rod.Dorman ( 458034 ) on Sunday January 22, 2017 @03:06PM (#53716261)

      From the description its more of a waldo (remote manipulator) than a robot. There's no mention of preprogrammed autonomous action.

      • Just like the Da Vinci. Everything it does is under the control of the surgeon.

        I am pretty unimpressed with the Da Vinci results vs standard laparoscopic surgery in most cases - it adds expense and time (setup/teardown), without really improving outcomes. These, at least, offer something you just couldn't get otherwise.

      • Re:Isn't it more like a waldo? (Score:4, Informative)

        by bargainsale ( 1038112 ) on Sunday January 22, 2017 @04:03PM (#53716503)
        Exactly so. Calling it a "robot" is a marketing ploy.

      • Autonomous actions (Score:4, Informative)

        by DrYak ( 748999 ) on Sunday January 22, 2017 @04:21PM (#53716601) Homepage

        I don't know about this specific type of robots.

        But other robots use in heart surgery can match the motions of the beating heart and thus perform surgery on a still beating heart.
        From the surgeon's perspective on the camera, it looks as if the heart was static.
        (The robot automatically compensating the heartbeat).

        It's not nearly fully autonomous at all (far from that): You won't be having the surgery completely done by a preprogrammed robot doing everything. Not even some part of the surgery.

        But you already have some robots that can do some automatic motions to help the surgeon.

        (Also, there was some research around train surgeon on a simulation done thanks to advanced 3D medical imaging, recording some interesting parts, and being able to recall the pre-recorded parts during the actual surgery. But as far as i know, its only still research, not put into production yet.)

    • The manufacturer refers to them as "Intercepters", but understandably doesn't publicize that in their marketing materials.

  • Don't follow the old links (Score:3)

    by slashkitty ( 21637 ) on Sunday January 22, 2017 @03:05PM (#53716253) Homepage
    / an elephant-sized surgical robot that repairs heart valves, / Goes to an article from 2002! With an unsafe website and broken links otherwise.

  • Unutterable bollocks (Score:5, Informative)

    by bargainsale ( 1038112 ) on Sunday January 22, 2017 @03:07PM (#53716271)
    "First operation inside the human eye" my arse. *Every* modern cataract operation is an operation inside the eye. The membrane-peeling described in the link is a standard vitrectomy operation. I have two colleagues who between them do several a week and have done for years. So far (not very) as this is anything new at all, it is automated assistance to a human surgeon.

    This is basically regurgitated publicity handout crap.
    • From TFA: "one in which a virus, used in gene therapy to halt the effects of retinal degeneration, was planted on the retina itself, a procedure only made possible by R2D2’s unprecedented precision."
      Also bollocks. Retinal gene therapy (which so far has really got no further than proof-of-concept) has been going of for a while. There was (among several examples) a very brief gene therapy study in Moorfields Eye Hospital in London for Leber's Amaurosis a few years back, It basically showed you can get

      • Re: (Score:1)

        by Anonymous Coward

        That's about as much surgery as getting a fucking Flu-shot.
        Injections != surgery.

        Injections are also horribly damaging to material directly in line of the target.
        Unlike multi-angled radiation machines we now have that limits the damage a single ray of radiation would cause, we simply cannot do that with needles.
        Robots are the only alternative that is considerably easier than trying to target the retina via chemical markers and HOPING it doesn't shit on some other part of the body. (which is all too common

      • Thank you. This points out the problem with PR releases (and Slashdot 'editors' and the entire 'journalism' echo chamber. TFA will get picked up by Reuters, Google, Yahoo (well, that was last year) and Bingo. It will filter to thousands of blog sites, get picked up by the search engines again and echo back and forth. Pretty soon somebody is going to actually believe it.

        Thank His (Her?) Noodliness we have Slashdot!

    • Re: (Score:2)

      by SirSlud ( 67381 )

      Man I'm glad there are smart people like you around, who know some smart people.

    • Re: (Score:3)

      by dwywit ( 1109409 )

      Is it going to be able to navigate to the floater that sits just to the right of the focal point in my left eye? Will it then at least move it away, or extract it? It's annoying to have this little bit of fuzz jump left and right as I'm trying to read.

    • Re: (Score:2)

      by tsqr ( 808554 )

      I'm glad you brought this up. I've undergone two DMEK procedures in the past year to treat Fuch's Dystrophy. No robots involved; just a highly skilled surgeon.

  • It has been used already. (Score:1)

    by Anonymous Coward

    It created blurred vision in Washington and was implanted in the new press secretary so that the crowds he saw at the inauguration would look much bigger. The results are called "alternative vision" [theguardian.com].

  • Where does the idea that Da Vinci is "elephant sized" come from? The link is to another Slashdot summary, and most of the links are dead.

    It's not exactly sleek, but from what I've seen is hardly elephant-sized. Unless you mean a baby elephant.

  • I was in the room for the first surgery with R2D2 (Score:5, Informative)

    by Mark Hillen ( 4846803 ) on Sunday January 22, 2017 @03:33PM (#53716383)
    Why is this a big deal? It is the first robot to be used to perform surgery inside the human eye. The first procedure was a fairly vanilla case, yes, a vitrectomy (not with the robot) and an ILM peel (with the robot). It was a proof of concept. Robert MacLaren has the robot to do some far cooler stuff - creating a bleb under the retina, and adding in some of NightstaRx's viral vectors for gene therapy. To do that involves slowly pushing in fluids from what's basically a syringe, into a tiny hold that you've created. Your hand has to stay still with virtually no tremor to avoid causing damage. And the application takes minutes. It really is the surgeons with the steadiest hands in the world that can do this. The robot eliminates the tremor. And if you have to go back to the same hole and apply some more... hard. Beyond eliminating tremor (and extending the practical working life of some of the most experienced and talented surgeons by many years and enabling surgeons to work with really friable tissue), it can work in concert with advanced imaging technology, automate the drudgery of things like vitrectomy, and frankly, speed surgery while making it safer. This is huge - as there's a tsunami of baby boomers with age-related eye disease who need treating - and robotic assistants like R2D2 will be essential to deal with these people needing surgery. I covered it here: https://theophthalmologist.com... [theophthalmologist.com] and the Preceyes Robot here: https://theophthalmologist.com... [theophthalmologist.com] Check out Marc de Smet - he's the surgeon's that led the development of the robot.

    • Re:I was in the room for the first surgery with R2 (Score:4, Informative)

      by Hotawa Hawk-eye ( 976755 ) on Sunday January 22, 2017 @04:05PM (#53716517)
      The device filters out the movement caused by the surgeon's own heartbeat, among other benefits [mathworks.com].

    • Fine and good. Now, let's look at outcomes before we get all wound up about it. The DaVinci experience should lead one to perhaps hit the pause button. Hundreds of these nice, expensive machines were sold. At least in the US, Medicare allows an additional payment for robotic surgery (wonder why?). Yes, DaVinci is supposed to be tracking outcomes and costs but it has been very, very slow at publishing them. The earlier studies didn't show much of an improvement.

      There are lots of shiny new tech invention

      • Re:I was in the room for the first surgery with R2 (Score:4, Interesting)

        by Mark Hillen ( 4846803 ) on Monday January 23, 2017 @08:44AM (#53719911)
        I don't want to speak for the Preceyes team, but from my conversations with them, they know what they're doing, and they've learned from Da Vinci. The use cases are very different. R2D2 isn't huuuuge and multipurpose. It's small, designed to operate only in the eye, and it's able to augment what the surgeon can do. The outcomes will come with time, but with cost, these robots might cut them. OK, it's an investment to buy/ lease the robot, and it costs to operate. But you need a sterile area to operate in. If the robot's doing the operating (on low-risk, routine procedures) and you're controlling it elsewhere, and the person's under a laminar flow hood, blowing sterile air, then you don't need an operating room (which costs lots of money to run, takes up lots of space, etc.) -- you need a laminar flow hood.

  • They can't fool me, I know exactly how this procedure turns out. [youtube.com]

  • Dear Editors: (Score:4, Informative)

    by fahrbot-bot ( 874524 ) on Sunday January 22, 2017 @04:24PM (#53716625)

    ... can crawl into an incision in the eye and lift a membrane no more than a hundredth of a millimeter.

    Is that the incision width, the lift distance limit, or the membrane thickness? A few extra words and comas -- actually in TFA -- would help:

    Using a joystick and a camera feed, MacLaren guided the arm of the Robotic Retinal Dissection Device, or R2D2 for short, through a tiny incision in the eye, before lifting the wrinkled membrane, no more than a hundredth of a millimeter thick, from the retina, and reversing Beaver’s vision problems.

  • Sure it starts with this device naming itself after the movie robot, but the name is so cool that everyone will be doing it. R2D2 is the new 'Smurf'.

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