Scarless surgery with robotic hands

SINGAPORE, Jul 06, 2011 (The Straits Times - McClatchy-Tribune Information Services via COMTEX) -- Singapore scientists have come up with surgery without scars -- by getting to the site through the patient's mouth.

Using a pair of robotic hands, doctors have accessed cancerous tumours in the stomachs of three patients and excised the growths.

The patients went home the same day. Their operations lasted 17 minutes at most.

The designed-in-Singapore gadget is the Master -- short for Master And Slave Transluminal Endoscopic Robot.

The three who underwent the pioneering operation were patients at India's Asian Institute of Gastroenterology (AIG). The trial started there as AIG handles large numbers of stomach cancer cases.

The 6mm pair of robotic hands, developed by Associate Professor Louis Phee and his team at the Nanyang Technological University, essentially gives the doctor two 'hands' -- one to hold a polyp or lift up the tumour, and the other to snip or burn it off. The two hands, more flexible than current endoscopes, give the doctor more dexterity.

Existing endoscopes -- tubes used by doctors to access a patient's stomach through the mouth -- offer only one hand at the operation site.

The Master was built on a 10:1 scale, which means the doctor can use large movements; every 10cm of movement by the doctor produces a corresponding 1cm movement of the robotic hands within the confines of the body.

It requires two doctors to work it. One works the robotic hands, while the other controls the endoscope, or the tube carrying a light, camera and water spray, with which to look into the stomach or body cavity being examined.

Prof Phee started work on the robotic hands six years ago, to give Professor Ho Khek Yu of the National University Hospital (NUH) his dream machine. Prof Ho is a senior gastroenterologist who also heads the Department of Medicine at the National University of Singapore.

The pair say the operations on the Indians this month were the first instances of flexible endoscopy robotic surgery.

Master can replace some procedures now done by open surgery, Prof Ho said, and will mean no scars, less pain and much faster recovery for patients.

It is now undergoing trials elsewhere, and is likely to go into use next at the Prince of Wales Hospital in Hong Kong; the first patient in Singapore is likely to be treated in October at the NUH.

Prof Ho pointed out that Master can also be used in other surgical procedures, such as that to reduce the size of the stomach by sewing it up from the inside; a smaller stomach makes people feel full with less food.

Master can be also used to cut through the stomach to gain access to, for example, the liver or kidney to snip off pieces of tissue for biopsy.

It can also be inserted through the rectum, where it can excise polyps and flat lesions in the colon before they turn cancerous.

Prof Phee said he will next develop more tiny instruments, such as scissors, and fingers which can stitch up cuts. He also wants to make the parts plastic so that they are disposable and also cheaper.

AIG wants these hands produced at a faster clip, as it foresees Master bringing the cost of surgery down, possibly by as much as 90 per cent.

Prof Phee now needs to commercialise Master. He can work with an existing endoscope manufacturer or set up a company to produce and sell it.

To see more of the Asia News Network, go to http://www.asianewsnet.net/home/ Copyright (c) 2011, The Straits Times, Singapore / Asia News Network Distributed by McClatchy-Tribune Information Services. For more information about the content services offered by McClatchy-Tribune Information Services (MCT), visit www.mctinfoservices.com.

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