Het Oogziekenhuis Rotterdam is the first hospital in the Netherlands to commission an operating robot for eye surgery. It involves the PRECEYES Surgical System from the Dutch company Preceyes. What do we know about this system?
Safe eye surgery requires a lot of training and precise motor skills. Globally, 6.5 million people are treated for vitreoretinal disorders, diseases of the vitreous and retina, on an annual basis. The PRECEYES Surgical System is an operating robot that helps surgeons perform such vitreoretinal operations more accurately and safely.
Preceyes
PRECEYES Surgical System is an operating robot from Preceyes. Preceyes is a Dutch company based in Brainport, a technology region with Eindhoven as its centre. The operating robot was developed based on research conducted by the University of Eindhoven and validated in in-vivo preclinical studies, in which animals were operated on using robot. The first clinical trial with the robot was conducted in 2016 in Oxford, UK. Preceyes expects to receive CE approval and introduce the robot to the market this year.
At Oogziekenhuis Rotterdam, the robot was used during the first clinical validation worldwide. Here, five patients were operated using the surgical robot. These operations were performed by surgeons from both Oogziekenhuis Rotterdam and the Italian Sacco
Hospital Eye Clinic. The clinical validation marks the start of a multi-year collaboration between Preceyes and Rotterdam Eye Hospital around the development of robotic surgery.
Enabling new treatments
Rotterdam Eye Hospital plans to use the robot for retinal surgery in the future. The hospital expects to be able to operate more precisely and safely by using the robot. In addition, the robot should enable new treatments for disorders of the retina for which no adequate treatments are currently available. The Rotterdam Eye Hospital is the first hospital in the Netherlands and the second hospital worldwide to use the robot.
The robot reduces the movements of a surgeon and filters vibrations of the hand from the movements. The surgical robot thus increases the stability and accuracy with which surgeons operate. It is also possible to put the robot in standby mode to freeze the position of the instruments, allowing the surgeon to take a break during an operation. All movements of the instruments during an operation are recorded by the system for post-operative evaluation and training purposes.
Distance sensor
The surgical robot that Oogziekenhuis Rotterdam has taken into use is equipped with a distance sensor, which measures the distance of the instrument on the robot from the retina and informs the surgeon of this using sound signals. Here, Preceyes draws the comparison with a parking sensor. The sensor allows surgeons to maintain a comfortable fixed distance from the retina, which reduces the risk of tissue damage and can improve eye surgery.
This sensor was developed by Preceyes and integrated into the robot in collaboration with Eindhoven University of Technology, the German Medizinisches Laserzentrum Lübeck and the Austrian Center for Medical Innovation as part of the European Horizon 2020 project EurEyeCase. Yanick Douven is working on the analysis of sensor data at Eindhoven University of Technology in his PhD.
Small and complex organ
"The eye is a small and complex organ. Eye surgery is therefore very difficult. In the future, the surgical robot will make it possible to perform treatments more precisely, allowing us to reduce complications and improve the outcome of surgery. We will also eventually even be able to perform new treatments that are currently very difficult or even impossible. Think, for example, of administering drugs into very small blood vessels at the back of the eye and other treatments that could, in the future, make people lose vision less quickly or not at all," Koorosh Faridpooya said.
"Using the robot definitely makes me a better surgeon. I felt safe while using it and all the surgeon's movements become very precise. Combined with the sensor, accidental trauma to the retina can be prevented. A robot with this sensor paves the way to new scenarios in eye surgery and new therapeutic approaches," said Matteo Cereda, eye surgeon at Sacco Hospital Eye Clinic.
Improving safety
"The validation of this sensor is an important milestone. With the support this sensor can provide, retinal surgery will be within the reach of surgeons with all levels of experience. The robotic sensor combination promises to improve the safety and outcomes of everyday surgical procedures," said Prof Marc de Smet, chief medical officer (CMO) at Preceyes. "In addition, during the use of the robot, a lot of data is collected. These data help us to be able to improve procedures and train surgeons again and again."
Author: Wouter Hoeffnagel
Source: Preceyes (pictured)
Source: Rotterdam Eye Hospital
