A robotics laboratory is working to enable earlier diagnosis, wider screening and more effective treatment of life-threatening diseases such as cancer.
STORM lab, based at the University of Leeds in the UK, is creating affordable and intelligent robotic solutions that could improve access to endoscopy and laparoscopic surgery in settings with limited access to healthcare infrastructures.
Health Tech World spoke STORM Lab director Pietro Valdastri.
HTW: What is your team working on at the moment?
PV: “Our activity is very much focused on robotic surgery and rheumatic endoscopy. Recently, we specialised in the diagnosis of cancer and personalised treatment of cancer.
“We have strong activity in colorectal cancer and are developing a platform for the screening and early detection of colorectal cancer.
“I have been working on the robotic colonoscopy project for 15 years and we are on the final step.
“We have received support to do first in human trials and are in discussion with a large company for licencing to use it with patients in three to five years.
“We’re also doing a lot of research into AI. AI alone is just software so there’s a limit to what it can do, but if you mix AI with intelligent robots it’s much more powerful. And there aren’t many groups in the world doing that.”
HTW: How will your robots increase accessibility to screening and diagnosis?
PV: “So a colonoscopy is a very effective procedure to look inside the last part of the gastrointestinal tract, where colorectal cancer develops.
“In the UK, screening is recommended to people over the age of 50 or 60 years of age, by faecal blood test. If that comes positive, then they are recommended for a colonoscopy.
“In the US, the first step of screening is the colonoscopy So they don’t do the faecal blood test.
“Colonoscopies are very difficult to perform because the instrument was designed in the 60s and hasn’t changed since then. It’s a long stiff tube and it’s very difficult to manipulate and move inside the patient.
“And so, the doctor doing the colonoscopy needs a lot of training and the outcomes are very related to the skills of the doctor.
“At the moment, worldwide, there is a bottleneck in the capacity of gastroenterology. So there are not enough gastroenterologists to meet the demand for screening and diagnostic colonoscopies.
“So we are trying to replace the instrument used for colonoscopy with the robotic version that we have developed.
“It has the same functionalities as a flexible endoscope, but it has three very important advantages.
“Number one, it’s an intelligent robot. So basically the doctor manoeuvres it inside the patient using the equivalent of a PlayStation controller. So the doctor won’t have to work with an unintuitive instrument anymore.
“The doctor watches the image coming from the camera and then moves the joystick forward, backward left and right. So with this, we hope to reduce the length of training required and uniform the outcome.
“The second advantage is that it may be less painful because we have completely redesigned the instrument so it relies on magnetic fields.
“So, there is a magnet inside the scope And then on the outside there is a permanent magnet on a robotic arm. So we basically move it by magnetic fields, while the current version is pushed like a garden hose.
“The magnetic field allows us to drive it from the front and so we don’t need the body to transmit power by mechanical force. And so our hypothesis is that it will be painless for the patient, compared with the current procedure which often requires sedation.
“The third advantage is the cost. So there are no really complicated or precise components inside the scope. While there are many precise components inside a conventional endoscope.
“The conventional scope costs about £60,000 and needs to be reused because it’s so expensive so it needs to be cleaned. The facility to clean an endoscope is very specialised and is only available in large hospitals and health centres.
“Our system is disposable. Of course, the robotic arm with a magnet will be reused but it doesn’t need to be cleaned.
“The part that goes inside the body can be made at a low price because the components are cheap.
“This should lead to an increase in access to colonoscopy beyond hospitals or large health centres.”
HTW: What role does AI play?
PV: “In a colonoscopy, If we combine AI with our robot we can use it for image analysis and to spot lesions.
“This will empower the gastroenterologist and basically level up the quality of a colonoscopy because they won’t need a high level of skill to spot potential cancer because you have an AI system that helps.
“The AI image processing can also recognise the centre of the colon so it will automatically know where it needs to go.
“The doctor won’t need to direct the scope, because the system will be able to decide where to go, like autonomous driving.
“So if we have autonomous driving and autonomous lesion detection it can increase capacity to the point where there could be one gastroenterologist overseeing eight or 10 different procedures at the same time.
HTW: What will that mean for patient outcomes?
PV: “It will bring down waiting times because there will be one doctor overseeing nine robots that will be doing all the diagnoses.
“It’s crucial that we bring down the waiting times because if you treat colorectal cancer early, you can basically get rid of it. So it has the potential to save lives.”
HTW: What will you be working on next?
PV: “We have been also working on gastroesophageal cancer with an aim to create an ultra-low-cost device for screening.
“More recently, we are working on developing a platform for lung cancer biopsy, so basically an advanced bronchoscope.
“The current bronchoscopes are four millimetres in diameter. Our robot is two millimetres so we can reach much deeper inside the lungs so that would allow us to get closer to potential lung cancer and get biopsies and also treat them more effectively.
“We also have an active grant to develop a technology for the personalised treatment of pancreatic cancer.”
