When even the most trained surgeons perform procedures in the retina, one of the smallest and most delicate parts of the human body, bets are high. Surgeons should account for breathing, snoring and the eye movements of patients, along with their own involuntary hand tremors, while working in a layer of cells less than a millimeter thick.
That is why researchers from the John A. Moran Center of the University of Utah and the John and Marcia Price College of Engineering have collaborated to create a new robotic surgery device that aims to give the “superhuman” hands “surgeons” .
The robot itself is extremely precise, executing movements as small as 1 micrometer (smaller than a single human cell). It is mounted directly to the patient’s head using a helmet, so that the subtle movements (already not so subtle) of the patient’s head are compensated, keeping the eye quite still from the perspective of the robot. The robot also scale the surgeon movements, measured using a portable robotic device known as haptic interface, to the much smaller surgical site inside the eye, compensating the tremors of the hands on the road.
While it is still in the test stages, the device aims to improve the results for patients and support cutting -edge procedures, including the delivery of gene therapies for inherited retinal diseases.
The researchers successfully tested the robot using enucleated pork eyes, publishing their results this week in the magazine Robotics of science. The study was led by Jake Abbott, a professor in the U -Engineering Department of the U, and the Moran Center Retina Specialist Paul S. Bernstein.
The retina is home to the cells of the bar and the cone sensitive to the light that form the basis of the vision. Several inherited disorders make these cells incorrectly form, which leads to the deterioration of the vision of variable gravity, but the new gene therapy techniques could reverse these conditions.
“Treatments for vision disorders advance rapidly,” said Abbott. “We need to give surgeons a better capacity to keep up.”
The first gene therapy approved by the Food and Medicines Administration of the United States for a hereditary retinal disease, for example, requires an injection into the space between the retina and another layer of cells known as the retinal pigment epithelium. In addition to the complications presented by the ocular movement and the tremors of the hand, this survey objective is very small; The surgeon must introduce the drug between two submilimetric cellular layers.
Because the device is not yet approved to operate in human subjects, the tests required a human volunteer equipped with special glasses that allowed an animal eye to be in front of their natural eye. This allowed researchers to prove the robot’s ability to compensate for the movement of the head and correct the tremors of the hands, all while operating with animal tissue, without risk for the volunteer.
In the experiments described in the study, surgeons achieved higher success rates while using the surgical robot device to perform subbinian injections while avoiding ophthalmic complications.
These results show that the robot has the potential to improve patient care, according to co -author Eileen Hwang, a retinal surgeon of Moran Eye Center.
“The unique feature of this robot, the assembly of the head, can make it possible for patients to have under -terminal injections under intravenous sedation (IV), instead of general anesthesia,” said Hwang. “Sedation IV allows faster recovery and is safer in some patients. Robots can also allow a more precise supply of gene therapy medications compared to manual injections for more reproducible and safe treatments.”
As the robot makes its way from the laboratory to the operating room, its trip will be reinforced by the type of interdisciplinary collaborations that made it life for the first time.
“These collaborations are wonderful at the University of Utah,” Bernstein said. “When I have ideas, engineers, chemicals, physics, are just a few blocks away.”
The co -authors include the members of Abbott Lab Nicholas Posselli and Zachary Olson and Aaron Nagiel of the Keck Medical School of the University of Southern California. The research was supported by the National Institute of Eye of the National Health Institutes; Research to prevent blindness; the endowment of godmothers in experimental therapy for ophthalmology; and an endowment of gentlemen of the Templar Foundation.