A low-cost mechanical device for minimally invasive surgery

February 21, 2017, National Science Foundation
The innovation could provide more surgeons with access to a robot-like laparoscopic instrument, resulting in less trauma for patients and shorter, less painful recovery times. Credit: Austin Thomason, Michigan Photography

Surgeons can now use a new type of mechanical instrument to perform complex, minimally invasive procedures, also known as laparoscopic surgery, thanks to researchers and small business entrepreneurs funded by the National Science Foundation (NSF). The technology could lead to less trauma for patients and shorter recovery times after surgery.

According to its creators, the handheld instrument provides the same sorts of benefits as robot-assisted surgery, such as greater precision and functionality, but at a lower cost compared to existing robotic surgical systems. That lower cost could result in new capabilities for rural hospitals and other medical centers that can't afford more expensive systems. The technology is based on NSF-funded engineering research and is being commercialized by FlexDex Surgical, which has received seed money from NSF's Small Business Innovation Research (SBIR) program.

The technology gives surgeons a higher degree of dexterity and intuitive control than traditional laparoscopic instruments, according to Shorya Awtar, a University of Michigan (U-M) engineering professor who co-founded FlexDex with his U-M colleague and surgery professor, James Geiger, and entrepreneur Greg Bowles. Traditional laparoscopic instruments typically require significant training for surgeons and can be difficult and tiresome to use, leading to longer surgeries and increased healthcare costs.

"For decades, surgeons and hospital staff assumed there was a tradeoff for minimally invasive instruments. If you want affordability, you get traditional hand-held instruments. If you want functionality, you need to pay a higher price for a robotic surgery system," Awtar said. "I was convinced there was a better solution."

FlexDex Surgical received two NSF SBIR awards to develop its first product -- a needle-like instrument for laparoscopic sewing. Credit: Austin Thomason, Michigan Photography

In 2007, Awtar and Geiger began a crucial step toward finding a solution: fundamental research in engineering.

"Dozens of companies have tried this and they have failed, because their solutions were not based in scientific discovery," Geiger said.

Supported by an NSF early career development award, Awtar looked at how different components in a mechanical system move in relation to one another, and how multiple chains of motion influence the performance of a system overall. This field, known as parallel kinematics, could address a number of mechanical engineering challenges, from and micro-devices to manufacturing and metrology machines.

Awtar and his team gained further insight into the design of these types of systems through additional NSF research awards. Inspired by nature, they incorporated jointless structures that enable simplicity in design while providing smooth and precise motion.

The handheld instrument is based on fundamental engineering research and provides robot-like functionality at a lower cost compared to existing robotic surgery systems. Credit: Austin Thomason, Michigan Photography

The researchers then set out to create an instrument that feels and operates like an extension of a person's own body.

Awtar created an abstract representation, known as a constraint map, of a person's arm movement—from the shoulder to the elbow to the forearm to the wrist to the fingers—with each joint represented. He then mapped the motions of each joint and extended them beyond the hand to the motions of corresponding joints in the instrument, eventually developing a streamlined mechanical instrument with precision pinchers.

In 2013, Awtar and Geiger participated in the University of Michigan Innovation Corps (I-Corps) program, an NSF program that immerses scientists and engineers in entrepreneurial training that teaches them to look beyond the lab and consider the commercial potential or broader impact of their research. I-Corps participants interview prospective customers and identify market needs for federally funded innovations. From the program, Awtar and his team determined that medical facilities that could not afford expensive robotic systems needed access to less expensive, simpler instruments.

The following year, Bowles and serial entrepreneur Tom Davison, both of whom have experience in the medical device industry, joined Awter's team to launch FlexDex Surgical, which received two NSF SBIR awards to develop its first product—a needle-like instrument for laparoscopic sewing.

"At the NSF SBIR program, we support early-stage engineering solutions to address old and expensive healthcare problems," said Jesus Soriano, NSF program director for the SBIR Smart Health and Biomedical Technologies program. "NSF enables basic research in science and engineering, and also the commercialization of many of these fundamental discoveries into useful products and services. It is an effective use of taxpayer dollars."

Surgeons in Michigan began using the new instrument in January, according to the team. Since then, the company has shipped the product nationwide.

"We have been an NSF-funded discovery and innovation from beginning to end," Awtar said. "This technology demonstrates that basic research is needed to create breakthroughs."

Explore further: Computer vision techniques for laparoscopic surgery training

Related Stories

Computer vision techniques for laparoscopic surgery training

January 12, 2016
A team of European researchers, including an UPM group, is currently working on the development of training technologies and surgical evaluation based on laparoscopic videos assessments.

Robotic surgery technique for lung cancer provides more precision, shorter recovery

August 25, 2016
Sitting at a console that looks like a video game, Gary Chmielewski, MD, is performing complex lung surgery.

Johns Hopkins surgeons among the first in the country to perform a robotic single-site hysterectomy

May 30, 2013
Two Johns Hopkins gynecologic surgeons are among the first in the nation to perform a robotic hysterectomy using a single, small incision.

With the surgical robot, similar outcomes at a higher cost

December 18, 2013
In a study of national data on colon surgery, Johns Hopkins researchers found that while patients who undergo either minimally invasive laparoscopic surgery or the high-tech robotic approach have similar outcomes, robotic ...

Robotic surgery: More complications, higher expense for some conditions

October 8, 2014
For benign gynecologic conditions, robot-assisted surgery involves more complications during surgery and may be significantly more expensive than conventional laparoscopic surgery, according to a study by researchers at Columbia ...

Surgeons offer procedures through belly button

September 23, 2012
There's a novel way to remove a gallbladder: Use a surgical robot to take it out through the navel.

Recommended for you

Antibodies may predict transplant rejection risk

June 19, 2018
The presence of certain antibodies in patients may suggest a higher risk of transplant rejection across multiple organ types, including the kidney, liver, heart and lungs, according to a new study published in PLOS Medicine.

Surgical blood transfusions tied to clot risk

June 13, 2018
(HealthDay)—Blood transfusions around the time of surgery may raise your risk for dangerous blood clots, researchers say.

Tonsil and adenoid removal associated with respiratory, allergic and infectious disease

June 7, 2018
Tonsil and adenoid removal associated with long-term risks of respiratory, allergic and infectious diseases Removing tonsils and adenoids in childhood increases the long-term risk of respiratory, allergic and infectious diseases, ...

Clues found to early lung transplant failure

May 21, 2018
Among organ transplant patients, those receiving new lungs face a higher rate of organ failure and death compared with people undergoing heart, kidney and liver transplants. One of the culprits is inflammation that damages ...

In breakthrough, surgeon builds windpipes from arteries

May 20, 2018
Where others failed, sometimes spectacularly, French surgeon Emmanuel Martinod has helped people whose windpipes have been ravaged by cancer and other diseases to live and breathe normally again.

Blood type O patients may have higher risk of death from severe trauma

May 1, 2018
Blood type O is associated with high death rates in severe trauma patients, according to a study published in the open access journal Critical Care that involved 901 Japanese emergency care patients.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.