SURGEONS from the UK and the US have performed what is thought to be the world’s first remote-controlled stroke surgery.
Operating from Dundee, , Dr Iris Grunwald performed a remote thrombectomy – the removal of a blood clot from a blocked artery or vein to restore blood flow – on a human cadaver.
Prof Iris Grunwald demonstrates the technology which she says now shows that a specialist doesn’t need to be in the same hospital, or even in the same country, to help youCredit: SWNS
The specialist machine was developed by Lithuanian MedTech company SentanteCredit: SWNS
The professor was at Ninewells Hospital in Dundee operating a specialist machine developed by Lithuanian MedTech company Sentante, while the body she performed the surgery on was across the city at the university.
Meanwhile in , Dr Ricardo Hanel used the robotic device to operate on the body from across the Atlantic Ocean, more than 4,000 miles away from Dundee.
Thrombectomy dramatically improves a patient’s life, but specialists able to perform the surgery are lacking in the UK.
Professor Grunwald said: “By the time patients reach a specialist centre, there’s often no brain left to save.
“Every six minute delay in receiving treatment equates to 1 per cent lesser chance of a good outcome.
“For example, here in Dundee we’re covering the north of Scotland – so a patient coming from , or one of the islands, would have a long distance to travel.
“The answer lies in expanding expertise locally through cross-speciality training, or by using robotic technology, such as Sentande, that lets experts operate remotely.”
Ischaemic strokes are medical emergencies, and according to the World Stroke Organisation they kill an estimated 3.3 million people annually.
Sentante said in Scotland, just 212 patients underwent a thrombectomy last year, representing 2.2 per cent of people who had an ischaemic stroke.
To carry out the surgery, Sentante’s robot is connected to catheters and wires, a surgeon recreates the procedure using joysticks and the machine performs the same movements in real time.
Edvardas Satkauskas, Sentante’s chief executive, said: “For an iscahemic stroke, the difference between walking out of hospital and a lifetime of disability can be just two to three hours.
“Today, patients are often transported long distances to reach one of a limited number of thrombectomy centres.
“With Sentante, the specialist comes to the patient over a secure network and performs the entire procedure remotely – with the same tactile feel and control they have at the bedside.”
Remote thrombectomies have previously been conducted on a silicon model – a 3D printed replica – and on an animal.
Following this first procedure on a human body, the research team now hope to take part in clinical human trials next year.
Professor Grunwald said: “This is undoubtedly one of the most exciting innovations in stroke intervention in the last decade.
A thrombectomy removes blood clots from a patient’s brain following a stroke and can greatly improve a patient’s quality of life – but specialists able to perform the surgery are lacking in the UKCredit: SWNS
Professor Grunwald said: “This is undoubtedly one of the most exciting innovations in stroke intervention in the last decade.”Credit: SWNS
“What amazed me most was how tactile the experience was. My hands felt exactly as they usually would if I had been doing a conventional thrombectomy.
“Remote robotics has the power to decouple expertise from geography.
“Our demonstration shows that a specialist can perform a technically demanding neurovascular intervention from thousands of miles away, perhaps even from their home.
“It was an honour to perform the first remote thrombectomy in a human body and to then be part of the team that delivered the first transatlantic thrombectomy.”
Dr Hanel added: “Tele neurointervention will allow us to decrease the gap and further our reach to provide one of the most impactful procedures in humankind—the thrombectomy—to more people.
“To operate from the US to Scotland with a 120 millisecond (blink of an eye) lag is truly remarkable.”
What is thrombectomy?
Thrombectomy is a treatment for ischaemic stroke that removes a blood clot from a blocked blood vessel in the brain using a special device.
A wire is carefully inserted into a blood vessel in your groin and moves up to your brain to pull the clot out.
This allows doctors to reach and remove clots that are too large to be broken down by clot-busting medication in thrombolysis.
Thrombectomy should be carried out as soon as possible after a stroke.
It is most effective when performed within the first few hours of symptoms starting, but can be done up to 24 hours after the stroke if doctors think it will benefit you.
Thrombectomy is performed in specialist stroke centres, usually in large hospitals with dedicated teams and equipment.
Some hospitals offer thrombectomy 24 hours a day, but not all areas in the UK have round-the-clock access yet.
If your nearest hospital doesn’t provide thrombectomy, you may be transferred to a specialist centre.
There aren’t enough trained specialists yet for a 24/7 service across the UK, and specialist equipment is also needed.
More hospitals are working to provide this treatment.
Source: Stroke Association
