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The Senhance system is designed to work with 5 and 3-mm instruments. | Source: Asensus Robotics
Last year, a significant milestone was achieved in pediatric surgery when Rev, a 16-year-old from Aurora, Colorado, became the first patient to undergo a gallbladder removal procedure using the remotely controlled Senhance robotic system at the Rocky Mountain Hospital for Children. Remarkably, Rev was discharged the same day and was dancing at his prom just two days later.
Traditionally, surgeries like gallbladder removals often required overnight hospitalization and extensive recovery time. However, innovations from Asensus Surgical, including the Senhance system, are transforming this landscape, promising quicker, less invasive, and safer procedures. This advancement is particularly important in pediatrics, a challenging domain for surgical interventions.
Dr. Steve Rothenberg, the surgeon responsible for Rev’s operation, noted the diverse range of patients he encounters, ranging from those weighing less than a pound to over 250 pounds. “There’s a huge range of patients that I have to deal with,” he stated, emphasizing his focus on minimally invasive surgery for infants and children throughout his career.
The surgical procedure utilized Senhance’s reusable 3 mm instruments, specifically developed for pediatric patients with smaller anatomies. The robot was enhanced with a 5 mm camera, haptic feedback capabilities, and sophisticated clinical intelligence, enabling the surgeon to operate from a nearby control center.
“[The Senhance system] is a soft-tissue, abdominal, multi-port surgical system,” explained Anthony Fernando, president and CEO of Asensus. He highlighted the system’s unique features, such as haptic feedback and the ability to employ three-millimeter instruments, making it a standout option in the market.
Asensus targets pediatric surgeries
With over two decades of experience in surgical robotics, Rothenberg expressed the difficulties he faced in finding an appropriate system that catered to pediatric needs until discovering the Senhance system.
“I was intrigued by the fact that they could use smaller instrumentation,” he remarked. Additionally, he appreciated the system’s open platform design, which allows surgeons to both operate the console and maintain visual contact with the patient, a significant advantage over other robotic systems that obscure the surgeon’s view.
He also pointed out that the Senhance system allows for enhanced maneuverability during surgery, facilitating better access to smaller patients. “As opposed to having this giant, sort of octopus that comes over and makes it difficult to access our smaller patients, these robotic arms come in separately,” Rothenberg added.
Starting with larger patients and simpler procedures, Rothenberg plans to expand his use of the robot to include younger patients and more complex surgeries as he gains experience.
“It’s exciting to have a company that’s focused on pediatric surgery that has listened to what we feel our issues and needs are, and is willing to work towards those,” he concluded.
Tackling the ‘learning curve’ of surgical robots
The Senhance system includes advanced features, such as the ability to track the surgeon’s line of sight to direct the camera accordingly. Rothenberg noted the efficiency this brings to surgical procedures. “Normally when I do standard laparoscopic surgery, I have to have an assistant who runs the laparoscopic camera for me,” he explained. With the Senhance system, he can utilize his gaze to control the camera movements while maintaining focus on the instruments he is using.
“I look where I want the telescope to look, and it goes right there,” he said, reflecting on how this technology enhances precision during operations. This functionality allows surgeons to refine their focus and perform multiple tasks more seamlessly, although it does introduce a learning curve for new users.
“The learning curve is how do we use all the additional features in the best and most efficient way,” Fernando acknowledged, highlighting the importance of practice.
Rothenberg further detailed the need for surgeons to adapt to the system’s setup and operation, stating that “sometimes we use angled scopes in the robot, but we’re tending to use more straight scopes,” illustrating the adaptability required in leveraging new technology.
Asensus plans for second-generation system
According to Fernando, the Senhance system represents Asensus’s first-generation technology. He noted that it was developed with the intent of gathering real-world feedback from surgeons to enhance future iterations. Asensus aims to avoid treating this system as merely a research project but as a viable tool in clinical settings, especially within pediatric surgery.
“This is a few years out, but all of these experiences and feedback have gone into creating the second-generation platform,” Fernando stated, emphasizing the drive for innovation in instrumentation.
Asensus continues to gather insights from medical professionals during the development of its next-generation system, boasting data derived from over 90% of the 15,000 cases facilitated by Senhance to date.
Rothenberg expressed his appreciation for a company that actively engages with clinicians in the design process, which he believes significantly improves the development of medical technology. He anticipates that systems like Senhance could one day function similarly to advanced driver-assistance systems (ADAS) in vehicles, providing safeguards during surgeries.
“Surgeons today are not getting as much broad experience as I did during my training, for a lot of reasons,” Rothenberg said. His hope is that advancements in robotics will support surgeons in expanding their competencies and improving patient outcomes.
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