Pretty much any time a patient is placed under a general anesthetic, a plastic endotracheal tube is inserted down their throat, in order to keep their airway open. The procedure is known as intubation, and has so far always been performed by hand. In this age of robotic surgery, however, it's perhaps not surprising to hear that surgeons at Montreal's McGill University Health Centre are now trying out a remote-control intubation system on human subjects.
The robotic system is called the Kepler Intubation System (KIS), and was developed by McGill Professor of Anesthesia Dr. Thomas M. Hemmerling and his team.
Intubation is a tricky process, and even experienced medical personnel can reportedly sometimes find it challenging. "Difficulties arise because of patient characteristics but there is no doubt that there are also differences in individual airway management skills that can influence the performance of safe airway management," said Hemmerling. "These influences may be greatly reduced when the KIS is used."
The system incorporates a joystick-controlled video-laryngoscope, which lets the user see inside the patient's trachea. They can then safely and precisely insert the endotracheal tube, steering it along the path of least resistance.
After a period of practicing on medical simulation mannequins, field testing of KIS on human patients has now begun.
"We think that The Kepler Intubation System can assist the anesthesiologist's arms and hands to perform manual tasks with less force, higher precision and safety," said Hemmerling. "One day, it might actually be the standard practice of airway management."
Hemmerling's lab was also responsible for the creation of the world's first anesthesia robot, nicknamed McSleepy, in 2008.
Robots are very helpful, but are cumbersome to set up and use. For instance, a hernia repair might take only 30 to 45 minutes in skilled hands but setup and use of a Davinci robot for the same procedure triples the time for the same surgery. The only advantage is that the facility gets to charge a lot more money for the procedure due to the use of the robot.
A typical heart bypass requires a the sternum to be split and rib cage opened up to allow access to the heart. This causes lots of pain after the surgery and extends healing time. The same surgery performed with a da Vinci robot can be done without cutting the sternum but through several small incisions between the ribs.
Less recovery time and less infections help offset the high cost ($1M) of the robot however it isn't cost effective for all surgies.