The Empowered Surgeon
Article written by?Anne Osdoit, CEO of Moon Surgical
To be a great fighter pilot takes a lot more than just the confidence depicted in the movies.
Fighter pilots must have situational awareness.
They must have an accurate mental picture of their position, velocity, and status in both time and space, and they need identical information on other aircraft. They must see and understand their surroundings while anticipating what they can’t see.
They also need to be in control, at all times. Skilled aviators have the fine control to have their aircraft engage a basketball-sized refueling basket while flying at 885 kph.
They have the precision control to land their plane on a 500 ft moving runway surrounded by the ocean. They must have the ability to precisely maneuver and adjust their aircraft; it is essential for their survival.
And their equipment matters.
They need to be confident not only in their abilities but also the capability and reliability of the aircraft they fly. They need to have equipment that helps them adapt to any situation that they might find themselves in.
In other words, it works well: everything depends on them, they are in full control, and yet they depend entirely on their aircraft which they trust. Full circle.
The surgeon, in many ways, used to be similar to the fighter pilot. If you’ve read my previous two articles, you’ll know that there have been significant tradeoffs as surgery has advanced to be more minimally invasive.
With laparoscopy, control and precision have been distributed to other team members within the operating environment. A scrub assistant controls what you see, and often the space within which you are operating.
It takes bandwidth to manage that person, creates anxiety, frustration, and can damage confidence. Imagine if a fighter pilot tried to land on an aircraft carrier if their wingman, who is often bored and distracted, controlled his vision, and managed the carrier’s bearing and speed—it’s not going to happen.
Tele-robotic systems like da Vinci by Intuitive Surgical, Inc. have largely been successful because they have returned the surgeon’s control of the instruments and vision. By gaining more control, surgeons gained more confidence.
For example, with a push on a foot pedal, surgeons can switch between the control of instruments to control of a laparoscope and even toggle to a 3rd instrument. This is a key power of da Vinci, but it came with new costs: adaptability and situational awareness.
You cannot remove the surgeon from the operating field, tuck them in a corner, and expect them to maintain situational awareness of the theatre.
They’re forced to delegate observation and management of the theatre to their team.
Adding fuel to the fire, tele-robotic systems also create much more demand in communication as they introduce complexities that need to be handled by the team: manipulations, orientations, and confirmations.
These cannot occur visually or haptically as they are out of the surgeon’s visual field and sense of touch.
Thus, to break through the adoption barriers in general surgery, a robotic system had to:
At Moon Surgical, we identified this trinity early on and knew those points could not be compromised.
We are building a solution that delivers total control of the operating theatre without compromise.
A solution that allows the surgeon to?perform surgery by herself if desired. That allows her to wield the techniques and instruments she was trained on while confidently approaching any setting and indication.
A solution that minimizes the communication challenges and conforms to existing workflows.
She has complete trust in the system and knows that she will have the best surgical team in every procedure.
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She will be aware, in control, and can adapt to any situation. She will be a Moon Surgeon.
To deliver this capability, one thing is clear: the surgeon must be scrubbed in, at the bedside, and in the center of the operating theatre.
From here, everything is within line of sight, and the essentials are within reach. This delivers situational awareness.
Today it takes 13 years to train a new general surgeon without any specializations.
In today’s healthcare environment, where demand surges and the supply of providers is limited, we need technology that enables us to do more with what we already know. We need the surgeon to have access to their preferred instruments to operate like they were trained.
Our device supports, follows, holds, and guides, but it is the surgeon that leads.
You can picture the surgeon as a conductor, the?Maestro, at the center of the stage, holding and moving two light sticks, controlling the surrounding activities.
Bringing the surgeon back to the forefront is not enough: we had to offer a solution that would be useful and usable in many, if not all, situations.
It had to address many clinical indications, many different anatomies, many surgeons’ preferences, etc. To deliver versatility, we focused on the one thing that has been our prism / magic bullet for solving that problem: adaptability, which our last article covered.
I’m excited to talk about how we’ve solved it.
What we’ve built is different. It is nothing like what has come before. It is compact, the size of a mini-fridge, and can be maneuvered by a single person with ease.
Upon setup, two unique and mechanically transparent arms expand towards the surgeon. These arms are engineered to be light as a feather and offer no resistance when the surgeon wants to move the instruments they are holding, and heavy as an anchor when the surgeon wants stability.
Any instrument can be attached to the system and enhanced in less than a second, allowing the surgeon to approach procedures with the instruments they love.
Engineered into the system are redundant degrees of freedom, intelligent algorithms, and ambient sensors, which all enable adaptability and setup automation.
Getting the system into use is fast; no calibration, no registration, you just go. It’s so fast that repositioning the robotic system within a procedure is no longer an issue.
It means that the holy grail of robotic surgery is finally viable: multi-quadrant surgery.
Getting the system into use is fast; no calibration, no registration, you just go.
The simplest interface possible - touch. The Moon Surgeon just grabs the instruments and moves them.
The Moon Surgeon is equipped with four arms and hands, all under direct control. There is no clutching, foot pedals, or voice control distractions.
And our surgeons also get to feel the surgery, the retraction, the cutting, the dissection.
The adaptability engineered into Maestro provides a versatile system that can be used in any room, by every surgeon, for every procedure and indication.
And it is always there. It is accessible, affordable, and will become an essential element of every OR.
Welcome to Moon Surgical, where the future is the empowered surgeon.
CEO at Moon Surgical | Partner at Sofinnova Partners - MD Start
2 年Well said ! At Moon Surgical, we think that better care can be delivered in the operating room. How ? By placing the surgeon in control, fully aware, with the patient and staff within reach. Read more.