Surgery in surgeons

Minimally invasive surgery often sees robots acting as a surgeon’s hands inside the patient’s body. Such robots are large and cost several million dollars, and although smaller handheld instruments are out there, their straight-stick design means they’re not as dexterous as a skilled surgeon’s own hands. A new “needle driver” from a University of Michigan startup, FlexDex Surgical, is designed to precisely mimic the motions of a surgeon’s wrist and translate it to a tiny flexible claw, with no electronic or computerized components.

Anchored just above the surgeon’s wrist, the FlexDex has a gyroscopic handle that can be rotated, twisted, and angled in three dimensions, while the rest of the device stays still. Those motions are translated through a cable down the length of a metal shaft to the tip, where a two-pronged clamp closely follows those instructions like a tiny robotic replica of the surgeon’s own hand.

The pinchable claw and precise rotation lets the FlexDex specialize in internal suturing. For existing devices, a task that fiddly usually requires big, awkward movements on the surgeon’s side, but the FlexDex’s center of rotation is in the same spot as the human wrist. According to the team, that means its movements aren’t inverted like other instruments.

“If I move my hand up, the device tip goes up,” says Jim Geiger, co-inventor of the Flexdex. “Wherever I move my hand, the tip of this instrument follows.”

The long-used Da Vinci line of surgical robots may be more versatile and provide finer control, but they also come with multi-million-dollar price tags that can keep them out of reach of small or remote hospitals. For a much more reasonable US$500, the FlexDex can help these facilities provide minimally invasive surgery, which is less traumatic and painful than being cut right open, and takes far less recovery time.

“I was amazed by the sophistication of the (Da Vinci) technology,” says Shorya Awtar, co-inventor of the FlexDex device. “At the same time, I had a strong instinct that this functionality can be achieved much more simply and cost-effectively. At its price point, this technology would not reach patients across the globe.”

So far, the device has been tested in a few different procedures for examining abdominal organs and inside the lungs, but in future FlexDex plans to put it to work treating hernias, and in hysterectomies and prostate cancer removal.