Less Invasive Podcast’s Post

A spine robot for epiduroscopy surgery. Meet 𝗕𝗜𝗦𝗛𝗘𝗣, the Robotron Technologies robotic-assisted platform for endoscopic spinal decompression, designed to be a tissue-preserving alternative to spinal laminectomy (300,000 cases a year in the US). 𝗘𝗽𝗶𝗱𝘂𝗿𝗼𝘀𝗰𝗼𝗽𝘆 involves the placement of a small flexible steerable endoscope through the sacral hiatus into the epidural space. This minimally invasive technique using a camera and laser fibers avoids open surgery and allows direct access of the disc fragment. There are though multiple limitations making the adoption rate of this approach very low: it's technically challenging with a steep learning curve, there is limited control of the endoscope and instruments, the result is dependent on surgeon dexterity, it's difficult to understand where you are in relationship with the anatomy, etc. Robotron has designed a robotic and semi-autonomous platform to facilitate this approach. BISHEP is a small device with 𝘁𝘄𝗼 𝗽𝗼𝗿𝘁𝗮𝗹𝘀 integrating camera, light, laser & irrigation, suction, and instruments. The tip of the system embeds an electromagnetic tracking sensor for navigation. With this system, the surgeon gets to 𝘀𝗶𝘁 𝗼𝗻 𝗮 𝗰𝗼𝗻𝘀𝗼𝗹𝗲 away from the operative field, which should lead to improved ergonomics and reduced radiation exposure. The robot is controlled with a 6 degree-of-freedom joystick. The system can stabilize the movement of the robot, make it rigid when needed, prevent it from rapidly moving towards a neural structure, and allows for debris removal. The team also developed a first generation of 𝗮𝗿𝘁𝗶𝗳𝗶𝗰𝗶𝗮𝗹 𝗶𝗻𝘁𝗲𝗹𝗹𝗶𝗴𝗲𝗻𝗰𝗲 algorithms that leverage the high resolution camera and the powerful light source to provide tissue labeling and recognition - labeling for instance the nerve, disc, ligamentum, bone and fat tissue. Robotron has built a team of medical professionals that label the relevent anatomy in endoscopy images to train the algorithm so that it can recognize live video streams. This multi-class tissue segmentation feature could flatten the learning curve and reduce the stress factor for the operator. The 10+ people team is led by Kris Siemionow, CEO, and Cristian Luciano, CTO, who previously founded HoloSurgical, an augmented reality & AI spine surgery startup that was acquired in 2020. The company plans to do the first cadaver lab later this year and be CE mark ready by the end of 2025. #medtech #roboticsurgery #spinesurgery