Intelligent Machines

For Hospitals That Can’t Afford a Surgical Robot, This $500 Device Could Fit the Bill

A tool that mounts to a surgeon’s arm could help with precise medical procedures at small or remote hospitals.

Surgeons try out an inexpensive handheld instrument with the same functionality as a surgical robot.

A new $500 device developed by researchers at the University of Michigan improves upon existing tools used for minimally invasive surgery and could help surgeons in small and remote hospitals do certain precise medical procedures that are currently performed by a $2 million robotic system at large medical centers.

The device, which is being commercialized by FlexDex Surgical, is a handheld instrument for making small incisions and stitching in the body. It mounts to a surgeon's arm and locates the device’s center of rotation at the same point as the surgeon’s wrist, so that it operates like an extension of the arm. The device has been used for the first time for an abdominal surgery at the University of Michigan Health System, and its inventors say it could be used for a range of other procedures like hernia repairs, hysterectomies, and prostate removal surgeries.

University of Michigan professors Jim Geiger, a pediatric surgeon, and Shorya Awtar, a mechanical engineer, developed the robot-like device, which functions without a motor or computer chip. They say the tool can do many of the same tasks as the Da Vinci robot, made by Intuitive Surgical.

Robotic surgery is an advanced form of minimally invasive surgery, known as laparoscopy, which uses smaller incisions than traditional surgery. Smaller incisions mean patients often heal faster with less pain. Traditional handheld laparoscopic tools give surgeons a limited range of motion though. They're also difficult to use because they move in the opposite direction to the surgeon's hands. The Da Vinci system was developed to overcome those problems. Like the Da Vinci, the tip of the FlexDex instrument moves in the same direction as the surgeon's arm, giving the surgeon more precision and dexterity.

The Da Vinci is the only robotic surgical system approved by the U.S. Food and Drug Administration, but its $2 million price tag puts it out of reach for smaller hospitals or those in developing countries. Intuitive Surgical has so far installed 3,803 Da Vinci robots worldwide, including 2,501 in the U.S. and 644 in Europe, according to its website.

Peter Janu, a surgeon with Affinity Health System in rural Wisconsin, says he plans to use the FlexDex device. Janu splits his time between a larger community hospital with a Da Vinci robot and a small 25-bed medical center without a robot. He says he’ll use the handheld device at the smaller hospital for certain procedures he used to do with conventional laparoscopy tools.

Awtar and Geiger don’t expect their device to replace existing Da Vinci systems in hospitals and health-care systems that already have them, but they say it will help bring minimally invasive surgery to parts of the world where many procedures are still being done with traditional surgery, “I don’t think robotic surgery is going to go away. But for many operations, you just don’t need all of what the robot brings,” Geiger says.

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