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Robotic retinal surgery could mitigate human limitations
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SAN FRANCISCO — Robotic-assisted or fully robotic retinal surgery could improve patient outcomes by mitigating human limitations, according to a speaker here.
“Compared to traditional surgery, robotic surgery provides some super-human dexterity and improved visual feedback,” Jean-Pierre Hubschman, MD, said at Retina Subspecialty Day at the American Academy of Ophthalmology annual meeting. “As we all know the human body presents some limited performances and during traditional eye surgery we still rely on limited feedback, limited spatial resolution and depth perception.”
Hand tremors and dexterity are also limitations of the human body that could be corrected with the assistance of robotic technology.
There are currently three types of robotic surgery being developed for ophthalmic use, he said: handheld smart tools, co-manipulation programs where the surgeon and a simulated system work together to control the tools, and fully-automated systems in which the robot controls all of the surgical tools with an overseeing surgeon.
Robotic tools that can correct for hand tremors is an example of the first type of technology.
In Belgium a co-manipulation system has been successfully tested for retinal vein cannulation, while the Preceyes Surgical System, based on the telemanipulation design, has been C-marked and approved in Europe for membrane peeling and subretinal injection, he said.
At UCLA, a fully automated system for cataract surgery has been successfully tested in animals.
“For retinal surgery we are envisioning a system with semiautomated capability where the surgeon will be seated at the surgical cockpit and immersed with augmented sensory feedback, visual feedback with real-time image processing, and tactile feedback through the robotic controllers,” Hubschman said. “Robotic surgery is still in its infancy in ophthalmic surgery, but we believe it will provide super-human capabilities and improve our surgical outcomes, and potentially open the door for new tissue manipulation.” – by Rebecca L. Forand
Reference: Hubschman JP. Toward robotic vitreoretinal surgery. Presented at: American Academy of Ophthalmology annual meeting; Oct. 11-15, 2019; San Francisco.
Disclosure: Hubschman reports he holds patents on robotic technology through UCLA and receives grant support from NIH and NEI, the Hess Foundation, the Earl and Doris Peterson Fund and Research to Prevent Blindness. He is a consultant for Alcon, Bausch + Lomb and receives lecture fees from Allergan and Novartis.