From Scratch Paper to the OR: New Robot Debuts in 2017

Since 1990, Dennis Fowler, MD, MPH, has been performing and developing new techniques around minimally invasive surgery (MIS), including laparoscopic colon surgery.

For 10 years before that, he was performing various endoscopic procedures. “Laparoscopy was a very challenging way to do surgery, even though it allowed us to do minimally invasive surgery and allows us the opportunity to improve surgery for patients, but it puts numerous constraints on the surgeon,” he said.

While he was working at Columbia University, he and two of his engineering colleagues were talking about this and decided there had to be a better way to use technology to make MIS easier to learn and easier for patients to recover from. “We started with a clean sheet of paper and asked what’s the most efficient, least invasive, most ergonomic way for a surgeon to do an operation in the abdomen. This is what we came up with,” he said.

This being the prototype for Titan Medical Inc.’s SPORT Surgical System. While it’s most likely going to be released in Europe in the second half of 2016 and will make its debut in the United States in early 2017, Fowler said it’s already been an exciting journey.

He and his colleagues at Columbia came up with a design and received a three year, National Institutes of Health (NIH) grant to take it from concept to prototype. With a couple more professionals and a handful of PhD-graduate students who were pursing engineering degrees, they did it. Titan Medical took notice, and purchased a licensing agreement of the intellectual property from Columbia University in 2012.

For the past couple years, Titan has been refining the prototype, adding to it and putting the finishing touches on the robotic surgical system. Fowler joined Titan Medical’s team so he could watch what started as a conversation take robotic form and is now the vice president for clinical and regulatory affairs. “I think the most exciting part of it is that it’s designed to meet the needs of patients, surgeons and healthcare providers,” he said. Titan’s CEO and Chairman of Board John Hargrove added, “Our SPORT Surgical System will bring quality, performance and value to the healthcare continuum while answering the need for a return on investment clinically, financially and operationally.”

Features

From the very beginning, the Titan team and Fowler planned for SPORT Surgical System to offer:

Better ergonomics: Comfortable sitting position with a user-friendly display and high resolution, 3D imaging

Increased connection between surgeon and machine: Software designed to accurately match movement by the surgeon’s hands to machine movement

Less invasive alternative: “We deliver the equivalent of two eyes and two hands through a single, small incision. Anything prior to this has required three or four incisions for two eyes and two hands,” Fowler explained.

Another goal was to be cost competitive, he said. “By creating design specifications around cost from the beginning of the design and development, we have identified certain cost targets for the cost of goods, from development to manufacturing,” Fowler said. “Because it was a design specification, it has to be high quality, durable and affordable.”

Fowler added these are only a few of the features that will make this option stand out, including its smaller, mobile platform.

This is hardly the end though, Fowler stated. After SPORT Surgical System is released, he said Titan Medical’s team will continue to find new ways to deliver the best care to patients and the best value to the healthcare providers. “All of the other advances are going to be software related,” he explained. “They will focus on automation and navigation to enable the computer assisted surgical device to help surgeons do better operations. All of that will be available through software upgrades on the platform. That’s how we anticipate that it will be improved over time.”

Learning the System

Like with any new system, there is training involved before surgeons can start operating on patients. In early May, Titan Medical announced James and Sylvia Earl Simulation to Advance Innovation and Learning (SAIL) center at Anne Arundel Medical Center (AAMC) would be helping it develop a training curriculum.

“We believe training is a key success factor to successful use of the SPORT Surgical System and the safety of our patients,” Fowler said - that’s why it will be extensive and consume a few days, in addition to team practice. The training currently under development will include training for surgeons and their teams’ psychomotor skills, team communication and choreography of events during an operation. SAIL also offers a simulation element to the training, he added.