Robotic Surgery at the George Washington University Hospital

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   Robotic surgery has been part of the medical scene for years, and is continuing to gain prominence as hospitals and surgeons explore its benefits to patients. At the George Washington University Hospital, robotic surgery has helped patients receive the care they need without enduring the side effects of surgery with such intensity.

   Surgeons at the GW Hospital Center for Robotic Surgery, which is the first in the DC area to have the da Vinci Surgical System, have performed almost 2,000 robotic procedures. The surgeries conducted with this technology now are less invasive, helping surgeons operate using a smaller incision than is required in traditional procedures. Pain and trauma experienced by the patient are reduced, as are infection risks, potential blood loss, hospital stays, and scarring.


   As the hospital has continued to expand its use of robots in surgery, surgeons have found that the robots enable them to maneuver in tighter areas of the body, such as the kidney, more easily. Traditional minimally invasive techniques still work, but in places like the chest, robots are proving superior for the right patients. “It is very hard to replicate open thoracic procedures using conventional minimally invasive techniques because of the anatomy of the chest and the complexity of many thoracic procedures," Farid Gharagozloo, MD, Clinical Chief of Cardiothoracic Surgery Services and Clinical Professor of Surgery, told GW Hospital Health News. “At GW Hospital, the robot is changing everything. Robotic cardiothoracic surgery is the newest frontier in surgery and only a limited number of surgeons have expertise in this field.”


   In another Health News article, Harold Frazier, MD, Director of Urologic Oncology and Clinical Professor of Urology, said, “Robotic surgery is so effective that it is evolving into the standard of care for prostate surgery.” Marc Margolis, MD, Associate Clinical Professor of Surgery, was quoted as saying, “We're seeing human anatomy and structures in ways we can't see with the naked eye or with less sophisticated imaging systems.”


   In 2008, the hospital obtained its second da Vinci Surgical System, which includes a TV screen and teleprompter surgeons use to teach their students more efficiently during operations. Physicians have actively sought out the tool to learn more about improving their skills. “It’s a difficult tool to master, but when mastered it’s a magnificent tool,” Jason D. Engel, MD, Vice Chairman of Urology and Director of Urologic Robotic Surgery at GW Hospital, noted in a news release. “It can make an experienced surgeon exceptional.”


References


http://www.gwumc.edu/medctr/news.cfm?view=news&d=7503

http://gwashington.uhspublications.com/spring2009/story3.html


http://media.www.gwhatchet.com/media/storage/paper332/news/2008/10/02/News/
Gw.Hospital.Acquires.Second.Robot.To.Perform.Surgeries-3465934.shtml


http://gwashington.uhspublications.com/winter2009/story2.html



https://www.gwhospital.com/Hospital-Services-O-Z/Robotic-Surgery

Self-Funded CYCOGS Robotics Manufacturer Applies for Second Patent,

Notwithstanding SBIR Grant Rejections

by John Otrompke

            Engineer and entrepreneur Wayland (Ty) Tobey, president of robotics manufacturer Cycogs LLC, has been so inconvenienced by the application process at the U.S. Small Business Administration’s Small Business Innovation Research (SBIR) grants program, that he didn’t even submit a third application as intended last December. The applications are usually about twenty pages long, and grant-fundign for phase I is around $100,000, according to Tobey.

And though he received a lukewarm reception at the hands of grants application reviewers, Tobey is nonetheless in the process of filing a second patent application for the company’s robotics drive.

            Tobey’s applications were rejected in April. “We received comments from the reviers such as , ‘over-ambitious’, ‘seems idealistic, unclear as to how to reach goals’, and  ‘no experience with mobility systems,’” said Tobey. “That last comment actually makes me mad. I presented at Robodev 2007 on mobility systems and I have a patent on a mobility system that is for sale now,” he said.

Other criticisms included that the company’s projects were too novel, that the proposals included too few benchmarks, and that the company has no funding track record, Tobey added.

CYCOGS, a privately held limited liability corporation formed in 2004, is located near Sauk City, Wisconsin. The company is self-funded, and initially planned to fund developmental robots including a  nurse's aide, a telemedicine robot and a physical therapy assistant, by selling components. Unfortunately, the recession of 2007 prevented the company from getting to market when it initially intended to, said Tobey.

Cycogs has succeeded in getting some products to market, though they have primarily been sold to hobbyists, Tobey said. “The modular components we are currently marketing are usable in general purpose robotics as well as other industries.  For example, our Wheel Assembly Module can be used for a robot, wheel chair or a powered cart,” he explained.

Other modules in development include the hybrid snake arm, and Cycogs’ sensor ring.  “That’s a rotatable ring of sensors that allows for ‘sensor amplification’ by rotating the sensors to cover a wider area than fixed sensors.  The hybrid snake arm is basically a snake arm robot connected to a rotary platform,” Tobey said.

                                    No Funding Sought for Snake-Armed Medical Robot

            For the SBIR grant, Tobey submitted two applications, including one for wheel modules, and another for co-robots. A third application, however, Tobey never submitted, which was for a hybrid snake-armed robot.

“For the whole complete robot, we have yet to find or create a name we like,” said Tobey. As for the combined robot, however,  “the combined equipment comprising the medium sized robot allows for the functionality to perform different tasks, which require a mobile robot with enough size, capacity and mass to move a good sized payload. The robot also has the ability to change its height, allowing the robot to tilt, which is needed for lifting heavy loads, and move on an inclined ramp or transverse doorways,” Tobey added.

The third application, never filed, was for the robot’s hybrid snake arms, which Tobey refers to as ‘Snarm.’

“These intelligent modular hybrid snake arms are each two meters ong and have a
very large donut shaped working envelope. “The arms can store themselves within the round robot body. The height adjusting ability along with the holonomic mobility allows our round robot to pick up a heavy object, rotate the robots body to place a wheel
under the load and lean the robot back.  This controls the overall center of gravity,” Tobey added. 

            Tobey said the company envisions a variety of medical functions for the device, including use as a nurse’s aide, a telemedicine robot and a physical therapy assistant.

            “One example of a telemedicine application is for a first responder, where the autonomous robot with human supervision and guidance performs basic assessment and first aid.  Besides sensor observations, the robot arms can perform some tasks and procedures, such as administering shots, collecting samples and physical patient manipulation,” Tobey said.

            The robot is 27 inches in diameter, 75 inches tall, and weighs around 600 pounds with batteries.

Accuray’s Purchase of Tomotherapy Increases Number of Company’s Installed Products

By John Otrompke

The purchase of radiation tool manufacturer Tomotherapy last month increases Accuray’s position as a radiation oncology provider, and may also provide result in new therapies being made available.

Accuray purchased Tomotherapy (located in Madison, Wisconsin) for about $277 million in cash and stock. Of shares outstanding, 79% voted in favor of the transaction, which offered shareholders a premium of approximately 30% of the stock price.

“Tomotherapy’s machine is similar to the Cyberknife, but slightly different, in that it is a gantry-based system,” meaning that the device uses a rotational ring around the patient, according to Rob Hill, vice president of engineering at Accuray.

The use of the gantry allows for 360 degree administration of radiation doses, while reducing radiation exposure to surrounding healthy tissue, according to the company.
 The acquisition will also more than double Accuray’s installed base, from 226 up to 550 machines in place in 32 countries. Of the two companies’, 30% of their 2010 income was generated from service contracts to installed machines.
 The company will maintain a presence in Madison, according to Accuray.

New edition of Medical Robotics Magazine forthcoming soon. Stay tuned!

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