A small robotic system with miniature, humanoid-shaped arms that mimic the movement of the surgeons is revolutionizing certain internal surgical procedures.
The Anovo Surgical System features unique robotic instrument arms that mimic the movement of the human shoulder, elbow and wrist, offering high dexterity, multi-planar flexibility and unprecedented articulation.
Dr. Michael Conditt, PhD, SVP Strategic Marketing and Clinical Development at Momentis Surgical, the Tel Aviv-based medical device company behind the system, said:
“The ability to articulate the arms enables less invasive access, without the need for multiple abdominal incisions, for a number of procedures. Anovo also requires a much smaller footprint and costs significantly less than conventional robotic systems, making it possible for more hospitals and ambulatory surgery centers to acquire the system.”
Internal Manoeuvrability
Momentis was founded in 2013 when co-founders Chief Executive Officer Dvir Cohen and Professor Nir Shvalb, PhD, began exploring the idea of creating a surgical robotic system with articulated fingers.
Mr. Cohen conducted extensive market research and found the clinical need was not for articulation of the instrument’s grasper, but for the ability to better manoeuvre instruments within the body. According to Dr. Conditt,
“He understood that if that articulation happened internally, it would reduce the number of instrument portals needed, revolutionizing how procedures were performed and further reducing the invasiveness of already minimally invasive surgeries.”
It was decided that robotic-assisted vaginal surgery would be the Anovo’s initial application.
This was because, despite recommendations from the American College of Obstetricians and Gynecologists that there should be a vaginal approach to benign hysterectomy whenever feasible, this only happened in about 16% of procedures due to challenges with anatomy, accessibility and visualization.
“It was clear early on that the unique articulation and reach of the Anovo system could enable procedures to be performed less invasively and less traumatically by transforming robotic surgery from straight instruments through multiple incisions to multiple flexible instruments through a single incision,” he explained.
Small and Portable
The second generation Anovo platform is now bringing a suite of upgrades to enhance surgeon experience and ease of use.
It is now believed to be the first FDA-cleared robotic system (single-port or multi-port) capable of operating in both retroflexion and anteflexion.
“Surgeons can now also experience enhanced ergonomics with integrated haptic feedback, creating more intuitive control of the robotic arms during surgical procedures. Furthermore, a new annotation-enabled video overlay enhances in-room communication and supports teaching and collaboration among medical teams,” Dr. Conditt said.
He says they have seen significant positive clinical outcomes, such as less postoperative pain, often requiring no prescription pain medications, and quick return to work, related to the less invasive access enabled by the technology.
“The ergonomic design of the second-generation console makes the system easy to use for the surgeon as well as facilitating open visualization and communication access to the operating room team during use. The small size and portability of the system provide surgical times on par with manual techniques with documented docking and draping times of less than two minutes, compared to published docking times of greater than 20 minutes for other conventional robotic systems.”
[Docking involves positioning the robot onto the patient and draping is covering it with sterile material before attachment.]
Wider Surgical Applications
The Anovo is currently approved for seven benign gynecological indications, including hysterectomy, salpingectomy, oophorectomy and cyst removal.
“A recent approval in general surgery for ventral hernia repair will allow an even broader utilization as the system is now truly a complete robotics platform,” Dr. Conditt added. “The new features of the second-generation system will enable us to pursue further indication expansions into bariatric, colorectal and ear, nose and throat surgeries.”
