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In-Human Robot-Assisted Retinal Vein Cannulation, A World First
Andy Gijbels1, Jonas Smits2, Laurent Schoevaerdts2
1Department of Mechanical Engineering, KU Leuven - University of Leuven, 3001, Heverlee, Belgium. andy.gijbels@kuleuven.be.
Abstract:
Retinal Vein Occlusion (RVO) is a blinding disease caused by one or more occluded retinal veins. Current treatment methods only focus on symptom mitigation rather than targeting a solution for the root cause of the disorder. Retinal vein cannulation is an experimental eye surgical procedure which could potentially cure RVO. Its goal is to dissolve the occlusion by injecting an anticoagulant directly into the blocked vein. Given the scale and the fragility of retinal veins on one end and surgeons' limited positioning precision on the other, performing this procedure manually is considered to be too risky. The authors have been developing robotic devices and instruments to assist surgeons in performing this therapy in a safe and successful manner. This work reports on the clinical translation of the technology, resulting in the world-first in-human robot-assisted retinal vein cannulation. Four RVO patients have been treated with the technology in the context of a phase I clinical trial. The results show that it is technically feasible to safely inject an anticoagulant into a [Formula: see text]-thick retinal vein of an RVO patient for a period of 10 min with the aid of the presented robotic technology and instrumentation.
Insights
Robot-assisted surgery offers a potential cure for Retinal Vein Occlusion (RVO), a blinding condition. This new technology enables safe, precise drug delivery directly to blocked retinal veins, marking a significant advancement in RVO treatment.
Area of Science:
- Ophthalmology
- Medical Robotics
- Vascular Surgery
Background:
- Retinal Vein Occlusion (RVO) is a leading cause of vision loss, characterized by blocked retinal veins.
- Current treatments for RVO primarily manage symptoms rather than addressing the underlying cause.
- Manual surgical intervention for RVO is highly complex and risky due to the delicate nature of retinal vasculature and limitations in surgical precision.
Purpose of the Study:
- To evaluate the clinical feasibility and safety of robot-assisted retinal vein cannulation for treating RVO.
- To introduce a novel robotic system designed to overcome the challenges of manual retinal vein cannulation.
- To assess the potential of direct anticoagulant delivery via robotic cannulation as a curative approach for RVO.
Main Methods:
- Development and implementation of a robotic system for precise instrument manipulation within the eye.
- Conducting a phase I clinical trial involving four patients diagnosed with RVO.
- Performing robot-assisted retinal vein cannulation to deliver anticoagulants directly into occluded veins.
Main Results:
- Successful clinical translation of the robotic technology for retinal vein cannulation.
- Demonstrated technical feasibility of safely injecting anticoagulants into a [Formula: see text]-thick retinal vein over a 10-minute period.
- No major adverse events reported during the procedure in the treated RVO patients.
Conclusions:
- Robot-assisted retinal vein cannulation is a safe and technically feasible procedure for RVO treatment.
- The developed robotic technology shows promise in enabling direct therapeutic intervention for RVO.
- This study represents the first in-human application of robot-assisted retinal vein cannulation, paving the way for future RVO therapies.
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