Technology Trends: Distance Learning
By Lauren Swisher
Radiology Today
Vol. 25 No. 6 P. 8
Virtual surgery could become a reality thanks to emerging technology.
A successful live telerobotic mechanical thrombectomy demo was completed at Abu Dhabi Global Healthcare Week on May 15. Vitor Mendes Pereira, MD, director of endovascular research and innovation at St Michael’s Hospital and a professor of surgery and medical imaging at the University of Toronto, performed the procedure from Seoul, South Korea, on a model patient 4,318 miles away in Abu Dhabi, United Arab Emirates. The telerobotic technology was developed by XCath in hopes of bringing a more accessible solution to neurointerventional care, particularly regarding strokes.
“In the US, there is about an average of 300 sites that can do this procedure. Less than 50% of Americans live within one hour of a mechanical thrombectomy site,” says Eduardo Fonseca, CEO of XCath. Fonseca has been at XCath since 2019 and is passionate about solving stroke intervention issues with nanorobotics technology. “We are just at the beginning of this journey, but the journey is one where we’re really looking to address what is the leading cause of death and disability,” Fonseca says.
According to XCath’s website, there are around 15 million annual stroke cases globally. Every three minutes and 14 seconds, someone dies of a stroke, and the cost of strokes by 2030 is estimated to be $1 trillion. A mechanical thrombectomy, Fonseca says, “Is one of the most effective medical treatments known to man. The real problem is very few people are actually provided care because it’s an incredibly time sensitive condition, and there are very few physicians that are able to do it.”
XCath, a dynamic startup founded in 2017, develops endovascular navigational tools, mainly robotics systems and smart steerable guidewires used to treat cerebrovascular disorders. They have two campuses, one in Houston that focuses on smart materials research and another in South Korea, focusing on robotic development. XCath’s mission is to make preventative stroke procedures safer and more precise.
Collaborative Effort
The remote thrombectomy device was developed in collaboration with several clinicians and academic institutions of research throughout the United States, South Korea, United Arab Emirates, Saudi Arabia, and Canada. “We elected to work with clinicians that have an engineering mindset. We want constructive criticism, and we welcome and encourage difficult feedback,” Fonseca says. The device works by navigating into the muscle through catheters to remove a blood clot. The robotic system is able to control four different devices independently and translates catheter movements and inputs. The system could potentially move catheters more accurately than what is usually expected with mechanical devices. Fonseca emphasizes that a physician will always be in the room and that this technology is intended to aid, not replace, physicians.
Fonseca says some of the biggest challenges in performing and developing a telerobotic procedure lie in safety parameters, innovation, and planning for future problems that may arise to ensure conditions are predictable, precise, and safe. Doing so allows physicians to deal with problems ahead of time. “I think the greatest hurdle we will face … will be the human problems. How do you create a procedure that ensures the physician is fully trained? How do you create procedures that account for any adverse events, and how do you improve it gradually and safely?” Fonseca says.
These issues can involve training with physicians and technicians, network settings, latency, and jitter. Latency is the difference between surgeon and device movements, and jitter is unexpected movement. XCath solves these movement challenges through AI. The machine uses AI to solve sophisticated networking problems, making the technology safer and easier to use.
The trial procedure at Abu Dhabi Global Healthcare Week proved that, from a technological perspective, this new technology is feasible. It also demonstrated the precision and networking capabilities of robotics technology. “Anything under 200 milliseconds is considered acceptable. For the test in Abu Dhabi, we averaged about 153 milliseconds,” Fonseca reports. Pereira also reported a reliable connection with low latency to the device in South Korea during the demonstration. In addition to XCath’s technology, the trial procedure utilized three devices from Stryker: the Trevo NXT, AXS Infinity LS, and the Trevo Trakb21.
Setting Standards
XCath’s current technology is not yet available to the public. They plan to get De Novo clearance for their surgical robotics technology. Their ultimate goal is telerobotics stroke care, but their immediate mission is to deliver a safe, precise, and cost-effective device to physicians. “Every surgical robot by design adds cost, complexity, and time to procedures. We have to deliver a device to physicians that is cost-effective and worth their time,” Fonseca explains.
— Lauren Swisher is an editorial intern and freelance writer at Great Valley Publishing.
