S. Duke Herrell, MD, Chief Medical Officer , Virtuoso Surgical
The proverbial ‘two hands are better than one’ philosophy has found its place in rigid endoscopic surgery. Virtuoso Surgical’s endoscopic system offers two robotically controlled, needle-sized manipulators instead of the traditional singular manipulator. “Our technology acts like two miniscule, dextrous hands at the end of the rigid endoscope, allowing surgeons to grasp, manipulate, and cut tissue with great ease and flexibility,” says S. Duke Herrell, MD, Chief Medical Officer, Virtuoso. The key to Virtuoso’s system, combining two dextrous instruments at this scale, is in the nitinol manipulators that were co-invented by Robert Webster PhD, President and CTO of VSI, during his time at Johns Hopkins University. The manipulators have unique super-elastic and metal-memory properties, which enable their small size, dexterity, precision, and force.
The manipulators in Virtuoso’s system are designed in the form of concentric nitinol tubes sliding and rotating inside each other like a tv antenna. Complex computer algorithms built into the system allow the surgeon to easily maneuver the tips of the manipulators with high precision and control, through simple surgeon controls.
But, what do all these features add up to? Complex treatment procedures, such as tissue enucleation for benign prostatic hyperplasia (“BPH”), that have historically only been carried out by a specialized group of surgeons, can now be done by any trained surgeon, almost intuitively (no pun intended), without disrupting the operating room workflow.
Take, for instance, the case of bladder cancer. The standard endoscopy tools of today make sampling the correct muscle tissue, in order to stage the cancer, challenging in many cases.
Similarly, some brain lesions, lung cancers, and uterine fibroids demand new technology where surgeons can better control the endoscopic system and manipulate tissue during difficult procedures. While initially targeting urology and gynecology, preliminary work with pulmonary specialists and neurosurgeons has also found that Virtuoso’s system, with its overall manoeverability and yet controlled rigidity, is extremely exciting. These specialists anticipate more complex, safer, and more successful minimally invasive procedures, such as rigid bronchoscopic tumor treatment, pituitary surgery, and ventricular neural endoscopy.
The manipulators operate at a scale that was not possible before. To put things into perspective, Virtuoso’s manipulators are 1.4mm in diameter, whereas the standard da Vinci™ surgical system is 8 mm. “To you give you a real-world analogy, if the da Vinci surgical system and other robotic solutions available in the market work need at least a football sized space to work, Virtuoso’s system can work within a golf ball and can get there through a single cigar-sized opening,” says Herrell. The benefit: Virtuoso’s system can be introduced into the body through natural openings, such as the urethra, vagina, nose, or throat, without causing trauma or damage to the patient. What’s more, the solution’s manipulators have the strength to retract tissues with a firm force while completing delicate surgical procedures using the system’s surgical toolset. Impressed with the performance of Virtuoso’s system, three of the busiest and most recognized prostate enucleation surgeons in the US have joined the company’s medical advisory group. These experts expect their practices (endoscopy procedures) to be much more streamlined once the Virtuoso technology hits the market. “Built on the US and European clinical evidence guidelines, BPH enucleation procedures have been tested to be durable, safe, and cost-efficient, and are now the gold standard where available,” says Herrell.
Apart from its cutting-edge technology, Virtuoso’s strength and value is the company’s leadership team that includes Herrell, Richard Hendrick, COO, and Dr. Webster. The trio have been working together on this system over the last ten years. With their joint patented technologies incorporated into the Virtuoso system, they envision greater ease and a wide range of benefits to both patients and surgeons for many years to come. Furthermore, the company’s strong relationship with Vanderbilt University and the Vanderbilt University Medical Center supports its commitment to healthcare innovation, connecting the company to a wide variety of clinical and operational expertise.
Virtuoso plans to seek CE Marking and FDA approval in the next 18-24 months.