Innovation
The installation of Africa’s first vascular suite with robotic capability at Mediclinic’s Wits University Donald Gordon Medical Centre
opens a world of possibilities to surgeons, with dramatic implications for patient outcomes.
“Right now, we’re at the very inception of artificial intelligence (AI),” says Professor Jay Pillai, Head of Vascular Surgery at Mediclinic’s Wits University Donald Gordon Medical Centre. “But as we experiment with the Corindus CorPath machine, we’ll learn more about the nuances of AI, what it can do and what it can’t – and that sets the stage for greater use going forward. With this machine, we’re poised to see the use of AI in surgery emerge from its infancy.”
This suite, manufactured by Siemens Dubai, is one of only two such models in the world (the other is in use in Dijon, France). What makes it exceptional is that the surgeon “operates” while seated in a cockpit fitted with joysticks. These may be manipulated to give instructions to a robotic arm attached to the operating table. “This means the surgeon, or interventionalist, doesn’t have direct contact with the patient,” Professor Pillai explains.
The use of robotics in vascular surgery is not new, he adds. For several years, operators have been able to perform open operations using a robotic arm; a process that has been shown to deliver better surgical outcomes. This may be because robotic arms are more dexterous than the human hand. Also, because images of the body are amplified on a screen, interventionalists have a better visual of the condition.
Professor Pillai says machine-driven operations are also used extensively for endovascular therapy and procedures like angiograms, inserting stents, or placing balloons inside blood vessels to dilate them.
Great potential
The difference with the Corindus CorPath is that the surgeon no longer inserts those wires or balloons; now, these actions are completed via the robot. “This makes it appropriate for cardiological as well as endovascular interventions,” Professor Pillai explains.
He adds that the machine has great potential in the African context, where patients, especially those living in rural areas, often lack access to the sophisticated resources required to treat their conditions. Because it’s possible for interventionalists to control the robotic arm even when the cockpit is located as far as 20km away, the suite holds important implications for remote treatment.
There are benefits for practitioners, too: typically, the machinery used during an endovascular procedure emits significant radiation as it transmits visuals onto the screen, placing surgeons at risk of developing conditions like cataracts and some cancers. This machine greatly reduces this risk, because the interventionalist is shielded by the cockpit, which itself is situated some distance from the robotic arm.
Developing scientific protocols
All of this makes the introduction of this equipment very exciting – but, Professor Pillai says, his team is aware of the responsibility they assumed when the installation took place a year ago. “Our job now is to support the international interventionalist community by testing the technical competencies of the robotic system, and finding unique uses for it in Africa,” he explains. “We’re essentially developing a blueprint, finding out which wires and devices are the most efficient in certain situations, and how best to deploy them. Once we’ve done that, we need to take a closer look at the clinical benefits of the machine – we need to show that this isn’t just technology for its own sake. Based on our findings, we’ll develop rigorous scientific protocols to ensure best practice.”
To date, the team has asserted that some of these benefits include greater control, more precision and more stamina, and they’re now ready to create phantom models to prove their theories.
From there? Only time will tell – but, as Professor Pillai says, the potential is tremendous.