Precision In Health Treatment Through Robotics

Article by Sergio Arturo Dominguez - Head, Interventional Radiology & Cardiology Latin America for Siemens Healthineers

From manufacturing to medicine, from the interior of our planet to Mars, robotics has dramatically influenced the discovery, research, and improvement in procedures and treatments that have improved many aspects of our lives, sometimes imperceptible, which have returned a vital rank in the present and future of our humanity.

Invasive robots, considered worldwide within the surgical environment, represent more than 79%??of all robots considered in the medical setting, representing a market growth of around 18.9% as compound annual growth and to grow in this factor at least in the next five years according to the analysis carried out by Bloomberg?at the beginning of 2019.

This article focuses on three main clinical fields that have great relevance and importance within hospitals.

Surgical robotics for orthopedics and neurosurgery:

Here we can find equipment such as the Mazo X Steal from the company Medtronic? whose primary focus is assistance for spinal surgery and neurosurgery, which includes an integrated optical camera that allows the robot to acquire images in real-time and perform a volumetric evaluation of the field. Surgical device to auto-detect its location and avoid collisions with other system components.

Recent studies have confirmed the system's accuracy with a correct screw placement rate, without deviation, of 98.7%?This type of solution also minimizes the time of ionizing radiation, the complexity of the treatment, and the risk of infections by reducing intervention times due to its precision. Additionally, we find other equipment such as iBlock Surgical?, Robodoc?, Navio PFS Surgical System?, MAKO RIO?, Stanmore Sculptor Surgical? or Neuromate?, which have differentiated capacities and behaviors with a view to specialized treatment and assistance in this clinical field.

Laparoscopy surgery:

The central system known on the market is the Da Vinci Robot from the Intuitive company, which marked a milestone in the paradigm shift in assisted treatment for specialized surgeons and, with a large number of studies, has demonstrated its effectiveness in fewer complications, less loss of blood, reduction in hospitalization times and of course more remarkable recovery by minimizing the size of the incisions, through the patient cart, the surgeon's console and the imaging system, DaVinci offers a fast way to connect with the instruments, be precise in operations and be aware of the patient.

As an experience, I had the fortune to use this equipment during a worldwide surgery and imaging forum where I had the opportunity to experience this Robot, complex without a doubt, with the need for advanced knowledge in the clinic and the management of the equipment, it is very intuitive, and its use does not represent a great complexity. A study by the University of Korea showed greater effectiveness of using Da Vinci, presenting a mortality rate of 0.12% vs. 9% before the technology in 10,267 procedures. It is currently estimated that more than 5,500 systems are installed worldwide, of which more than 100 are in Latin America. Also, in this category, we can find models of medical equipment such as FreeHand Endoscope Holder System ?, Telelap ALF-X Surgical system?, or Broca?.

Percutaneous coronary intervention

One of the most important developments in recent years is the use of this type of equipment in diverse clinical markets, such as minimally invasive percutaneous coronary treatment through systems that act like the hands and eyes of the patient, such as the system Corindus’ CorePath GRX ? recently acquired by the company Siemens Healthineers, which consists of a robot with movements controlled remotely by the operator where the percutaneous access of catheters, ballooning, and placement of implantable devices, whether aortic valves or stents with millimetric precision, as well as a minimization of radiation in the medical staff as we can review in a study, carried out by the Hospital Israelita Albert Einstein in Sao Paolo Brazil where it was also shown that 100% of the cases that the effectiveness of the treatment was achieved.

1. Establish a business plan:?A hospital must establish its objectives regarding the purchase of a robot, anticipate the expenses and income that the equipment will have, and the benefits or complications for those patients who access the service and the institution itself. Here the market must be analyzed to understand the growth potential of the procedure, bearing in mind that, in addition to the benefits of surgical evolution, the concept of a robotic system is a commercial magnet, attracting the attention of more clients, whom they will prefer the institution for having advanced technology equipment.
2. Define the initial program:?Certainly, an implementation program must be established from the beginning, specifying the steps to be followed after purchasing the system, including the room or room that the hospital will allocate for the equipment, defining how they will train their employees for the correct use of the robot and how the implementation will be monitored.
3. Appoint staff in charge:?Every implementation system must have a committee that carries out detailed control of the program, including training new staff and coordinating business.
4. Purchase of the system:?The costs of a surgical assistance system correspond to the generation of the purchased robot, which varies with updates. At this point, the fixed and variable costs must be kept in mind. In the permanent ones, the maintenance of the system and the training are considered, in which the doctors with the most significant expertise can teach their colleagues some pathologies. Fixed costs include disposable surgical instrumentation, such as tweezers.
5. Training and implementation:?The committee must devote effort and time to the implementation program to become proficient in the procedures. Internally, they can create their training plans through a simulator or request advice from the selling company. From there, you need to set the standards and goals.
6. Dissemination of the advanced clinical program:?This step is carried out so that patients know that the medical plant has advanced technology. Educating in the short and long term through different channels, such as social networks, e-mail marketing, and/or a website, will increase the volume of potential patients in the institution, as they will know the benefits brought about by the assistance of a robot.
7. Program Monitoring:?Implementing a robotic surgery program requires constant monitoring. Collecting data on how the program was received and analyzing the results will be a fundamental step in continuing to operate the training of new surgeons successfully. The leader of this team works as a link between the doctors and the marketing areas, the website, and the patient. Likewise, he must focus on the growth of the program and collateral activities.

Conclusion

Robotics, in combination with artificial intelligence, big data, and nanotechnology, of which there is still much to talk about, are areas that are revolutionizing and will change the way we see medicine; therefore, more biomedical scientists must specialize in robotics to begin developing new ideas and improving patient management. Finally, the latest technologies created in Latin America must be affordable, simple, and efficient to support the economic situation of medical care in the continent and provide the best quality standards to improve patient treatment outcomes.

About the author

Contact Sergio: [email protected]

Professional Experience: Sergio has worked in a medical device company (Siemens Healthineers) since 2004, mainly as a business manager in different fields (Cardiology, Oncology, Neurology, and Surgery), and now, he is the head of Latin America for Cardiovascular and Interventional radiology solutions and as an ambassador of the Stroke clinical conditions.

He has done more than 150 presentations on medical devices, cardiovascular solutions, artificial intelligence, and robotics in medicine.

Sergio is the Vice-president of training in the Mexican pharmaceutical chamber in the medical device sector (CANIFARMA).

Education: Sergio holds a Robotic Engineering degree and an MBA.

He has several diplomas in marketing, medical devices, management, and economics and an ongoing Ph.D.

He speaks English, Portuguese and Spanish.

He has been awarded since he was a child more than 100 times in several fields like math, chemistry, physics, history, oratory, and business management, among others.

Sergio's hobbies are producing music, running, and scuba diving.