A research team led by Prof Fijs van Leeuwen of Leiden University Medical Centre (LUMC) receives a NWO grant of 1,328,429 euros for the development of a robot that can "feel" whether tissue is healthy or diseased during prostate cancer surgery. The team will use the company to develop robotic instruments that can detect the molecular composition of prostate cancer. This should make interventions more precise in the future.
Robotic-assisted prostate cancer surgery has long been a standard form of urological care. In practice, however, surgeons face the challenge of distinguishing diseased from healthy tissue. In this regard, sight is currently the only sense the surgeon can rely on. "During robotic surgery, sight is now the only sense a surgeon can rely on. But only large and superficial tumours are easily visible," Van Leeuwen explains.
Better understanding of tissue composition
Van Leeuwen's research team is working on modified versions of robotic- and laparoscopic instruments used by urologists during operations. These give a specific signal if they grasp tumour tissue. With this, the instruments give the urologist a better understanding of tissue composition during surgery. This helps distinguish between healthy and diseased tissue.
"As humans, we use multiple senses simultaneously to accurately assess our surroundings. We therefore want to allow the robot and thus the surgeons to 'feel' in addition to seeing," Van Leeuwen explains. "This will also make deeper lying and smaller tumours recognisable to the surgeon. This will reduce the risk of disease recurrence (and side effects) after surgery." The research is called 'Steerable robotic and laparoscopic instruments that can 'sense' the molecular signature of prostate cancer tissue' (SurgiSense).
Evaluating prototypes
For the technical development of the robotic instruments, the research team is collaborating with Design & Prototyping, part of the Department of Medical Technology at LUMC. "The way we are going to evaluate prototypes is very similar to the way improvements are made in elite sports like Formula 1. We are going to map out exactly how the design affects the surgeon's actions. Based on this, we will further refine the designs so that technological advances translate directly into performance improvements in the surgeon. We also call this way of working intelligent design."
The project involves several partners. They include Antoni van Leeuwenhoek Hospital, Delft University of Technology, Amsterdam UMC, Leiden Instrumentmakers School (LiS), Prostate Cancer Network Netherlands, Technische Universität München, European association of urology, Orsi Academy, DEAM, Demcon, SurgicEye Gmbh, Crystal Photonics and Intuitive Inc.
KIC call 'Key technologies for minimally invasive interventions in healthcare'
The grant made available for the research comes from the KIC call: 'Key technologies for minimally invasive interventions in healthcare'. Within this call, five other research projects contributing to the development of smart medical technology for minimally invasive interventions have been allocated in addition to SurgiSense:
- AdLap Systems: a versatile modular advanced laparoscopic robotic platform with reusable wireless instruments with an alternative drive mechanism. The system is fully modular and easily cleanable. This is in contrast to many current surgical robots, which use disposable instruments that can cost up to €14,000 per procedure. The researchers also point out the environmental impact of disposable instruments. The applicants are Amsterdam UMC, LUMC and TU Delft.
- AIM@EPILEPSY: An AI-assisted 4D cortical assessment for minimally invasive treatment of epilepsy. The technology can accurately determine where the regions are in the brain that cause epilepsy. This enables minimally invasive treatment with coagulation or radiotherapy. The applicants are Maastricht UMC+, Maastricht University and TU Delft.
- Bringing Tractography into Daily Neurosurgical Practice: Diffusion MRI makes it possible to image the motility of water molecules in the brain. This motility is influenced by the underlying structures. This allows indirect insight into brain pathways through a technique called tractography. Within this project, scientists and clinical specialists want to make tractography suitable for daily use in the clinic. The applicants are Erasmus MC and TU Eindhoven.
- INTelligent computeR-Aided Surgical gUidance for Robot-assisted surGEry: Oncological surgeries are complex procedures, involving long learning curves and postoperative complications. For instance, vital anatomical structures are located in the narrow surgical field in oesophageal resection. This makes surgical orientation challenging. The project revolves around improving surgeons' orientation and anatomy recognition during operations using machine learning algorithms for phase and anatomy recognition. The applicants are Eindhoven University of Technology and UMC Utrecht.
- Non-invasive analysis of wrist kinematics by four-dimensional CT scanning to improve both diagnosis and treatment of wrists: Wrist injuries can lead to an unstable wrist joint. If left untreated, this can lead to joint wear and tear. However, an unstable wrist joint is something that is often missed on radiographs. This is because instability is only visible if the wrist moves. Four-dimensional CT imaging (4DCT) can help. In 4DCT, a series of 3D images is taken of both moving wrists in just a few seconds. Within this project, the parties involved aim to introduce 4DCT in the clinic to replace keyhole surgery. This should improve diagnosis and treatment, while reducing collateral damage to patients and healthcare costs. The applicants are Amsterdam UMC, Radboudumc, UMCG and University of Twente.
A total of 9 million euros is available for the awarded projects. NWO is funding 6.3 million euros of this, while the remaining 2.7 million euros comes from partners.
Author: Wouter Hoeffnagel
Photo: fernando zhiminaicela via Pixabay
