Remote robotic-assisted interventions in endovascular therapy
Legeza Péter Tamás
Cardiovascular Medicine and Research Division
Dr. Merkely Béla
SE Ér- és Szívsebészeti Klinika előadóterme
2024-10-21 09:00:00
Dr. Sótonyi Péter
Dr. Ghimessy Áron
Dr. Fazekas Gábor
Dr. Rényi-Vámos Ferenc
Dr. Jermendy Ádám Levente
Dr. Ménesi Rudolf
These two studies are important in outlining the requirements of robotic-assisted remote interventions and significant first steps towards this interventional modality becoming a reality.
Network connection speed and stability are vital factors for remote interventions. Good audiovisual communication is also crucial since the operator is not present in the angiography suite, and the interventional steps are based on their decision.
Our first study aimed to assess the threshold of acceptable network latency. A porcine model was utilized to perform coronary arterial, femoral arterial, and external carotid arterial navigation with robotic assistance. Network latencies from 0-1000 ms were artificially added to the intrinsic (minimal) network lag. Guidewire navigation times, perceived latency, and procedural impact scores were registered. Results highlighted that network latency should be kept below 400 ms during remote robotic-assisted endovascular procedures to be imperceptible for the operator.
In the second study, long-distance tele-PVI was performed. The operator navigated the robot from a distance of 40 miles and completed ten successful robotic-assisted superficial femoral arterial interventions. The network connection was found to be stable throughout the study, with a network latency imperceptible for the operator. A communication protocol was established before the study. Communication between the interventionalist and the bedside technician was rated on a 1 to 5 scale after each intervention, and results varied between 4 and 5 ("good", "ideal").
Currently, endovascular robotic surgery is not widely spread, and the advancement of the technology is expected in the future. Modern telepresence systems, high-speed wireless networks, and more sophisticated robotic systems will serve this interventional modality to become a reality in the everyday clinical routine in the future.
