As sophisticated as modern medicine has become, the best method available to doctors to insert a catheter is still to use their own two hands, a needle and some wire. Hugo Guterman, an engineer at Ben-Gurion University in Israel, wants to remove the first requirement. His lab is currently developing the Human-Assisted Needle Delivery System, HANDS, a somewhat ironic backronym for a process that inserts surgical catheters robotically.
Most people know of catheters from their role in aiding urination for patients with bladder control problems. But doctors may also opt to use a catheter during heart surgeries, either to inject a dye into the heart to have a better look at what’s awry or to send radio-frequency energy to suspicious tissue, so they can destroy it and restore a normal heartbeat. Missing a vein during blood draws is an annoying problem, but missing these major vessels, either through the groin, arm or throat, en route to the chambers of a patient’s heart can be catastrophic.
In many surgeries, ultrasound is used to help locate artery blockages; HANDS simply wants to solve the second problem of finding a way to reach them. In its current form, the device comes in two main parts: a thick joystick reminiscent of old-school flight simulators and a hidden needle that plunges into the skin once the user finds the target on a nearby screen.
HANDS can pinpoint blood vessels from as shallow as half a centimeter to as deep as 30, Guterman says. “Any place that we can enter in the body, we think we will be able to enter much faster and with more accuracy.” HANDS is patented and currently in clinical trials. It hasn’t yet received U.S. Food and Drug Administration approval, but already Guterman’s lab has visions of applying the technology to improving the accuracy of biopsies, with a focus on breast cancer. The lab is also currently working with Cincinnati Children’s Hospital in testing to see if HANDS can help reduce nurse and doctor error when operating on children, who have smaller vessels that require more precise catheterization.
Ideally, says Guterman, HANDS will follow in the fully autonomous footsteps of current robotics, such as Intuitive’s line of da Vinci surgical robots. With only the press of a start button, the device will be able to locate the ideal site to enter a vein or collect samples of cancerous tissue and do it successfully the first time, every time.
But first surgeons must accept it, Guterman says. His greatest hurdle isn’t developing the technology but getting it into the operating room, as not all physicians may be keen on making room for robots. Dr. Ranjan Sudan, vice chair of education for the Duke University Department of Surgery, says the acceptance barrier is only a temporary one, apt to follow the normal curve of innovation. “There are a lot of [early] adopters of the technology,” he says. “And the adopters are actually increasing in numbers exponentially.” As time passes, the new technology will eventually become the mainstream.