Researchers achieve first remote-controlled magnetic endoscopy 5,778 miles away

According to the team, thanks to technology, better surgical care in remote locations may be possible in the future, particularly for operations for which there is no local experience.

Robotic telesurgery advance

Teleoperated robotic surgery is a rapidly expanding profession that offers long-distance expertise sharing and the ability to transcend geographic boundaries for a range of minimally invasive treatments.

Robotic magnetic navigation is a particularly promising technology for teleoperation. Unlike traditional surgical robots, a robotic magnetic navigation system creates external magnetic fields to guide soft magnetic devices inside the human body securely and deftly.

This allows a flexible, affordable, and easily accessible platform for telesurgery to be used for a range of treatments.

The newly tested technique, developed in partnership between CUHK and the ETH Zurich, was the first remotely controlled endoscopy, conducted on a living pig.

Surgeons from CUHK supported and observed the remote-controlled process in the operating room. The Multi-Scale Robotics Lab team at ETH and the surgeons from Hong Kong tested the probe in the operating room before a specialist took over its navigation in Zurich.

Additionally, the latter entered the pig’s stomach through its mouth and implanted the magnetic endoscope.

“Teleoperated endoscopy can be used not only for training surgeons, but also for providing diagnostic and surgical care in remote areas, especially in places where there’s a lack of local expertise. We could even provide trained nurses with instructions from a distance on how to carry out the procedures,” said Shannon Melissa Chan, Assistant Professor in the Faculty of Medicine at CUHK, in a statement.

Endoscope success

This breakthrough was enabled by two critical elements: a fast and secure internet connection to the operating room and a magnetic navigation system developed at ETH Zurich, which includes a magnetically controlled endoscope.

Bradley Nelson of ETH and his colleagues created a surgical navigation device called Navion. This device produces a magnetic field that controls the endoscope.

“Not only can the endoscope be bent in any direction thanks to its magnetic head; it’s also smaller and easier to maneuver than conventional devices,” said Alexandre Mesot, a doctoral student at the Multi-Scale Robotics Lab, who controlled the procedure.

Additionally, Mesot managed the teleoperated system using a control console, and a robotic agent in Hong Kong converted commands into actions

A computer communication protocol called WebSocket, which enables real-time data flow to and from a server computer, was used to establish the communication between the control console and the robotic system.

The operation bed was positioned next to the server computer. Additionally, it established cable connectivity with a robotic setup, a magnetic endoscope, and Navion, a portable magnetic navigation device.

The magnetic endoscope’s flexibility allowed Mesot to perform a retroflexion in the pig’s stomach, bending the device 180 degrees to inspect the stomach entrance with ease.

According to researchers, this demonstrates that magnetic endoscopes can be remotely controlled with at least the same dexterity as standard devices.

Additionally, the smaller endoscope can be inserted through the nose in humans, reducing the need for full sedation and making it suitable for use in children, where conventional probes may be too large.

“In the next step of our research, we hope to carry out a teleoperated endoscopy on a human stomach. There’s a lot of potential in this technology. Here I’m thinking of minimally invasive procedures in the gastrointestinal tract, such as cancer screening, said Nelson.