Robotic surgery set to transform medical care in the Gulf

The Gulf region, and particularly Saudi Arabia, has become a world leader in the application of medical robotics. (Shutterstock)
Updated 10 July 2019
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Robotic surgery set to transform medical care in the Gulf

  • Technological advancements helping surgeons perform complex procedures using minimally invasive techniques
  • In robot-assisted surgery, the surgeon sits at a console and views the patient's target anatomy in HD 3D image

DUBAI: When it comes to man versus machine, many industries, including medical science, are at a critical juncture. 

Advancements in technology are creating a world where robots are performing tasks with speed and efficiency unmatched by their human counterparts.

Increasingly, robots are becoming a familiar presence in operating theaters, especially in the Gulf. Experts predict that the region could become the leader in the field of robotic surgery.

In June, Johns Hopkins Aramco Healthcare (JHAH) — the result of a joint venture between Saudi Aramco and Johns Hopkins Medicine — became the first hospital in the Kingdom to perform a robot-assisted hysterectomy.

“The new trend in hospitals that provide the most up-to-date medical services to their patients is to do surgical procedures using minimally invasive techniques,” Dr. Tareq Al-Tartir, a urologic oncologist and head of JHAH’s robotics program, told Arab News.

“Robotic surgery has revolutionized the way surgery is being conducted, and now many hospitals in Saudi Arabia have adopted this technique.”

Saudi surgeons are conducting increasingly complex procedures using the Da Vinci surgical system, said Al-Tartir.

The device features a set of three or four robotic arms remotely controlled by a human surgeon. 

IN NUMBERS

  • 2002 - The year robotic surgery was introduced. 2003 - The year a surgical robot was first brought to Saudi Arabia.
  • 44 - Da Vinci surgical systems installed in the Middle East.
  • 19 - Da Vinci surgical systems (pictured below) installed in Saudi Arabia.
  • 930 - Documented robot-assisted procedures performed in Saudi Arabia in 2004-2010.
  • 60% - Jump in robot-assisted procedures in 2011-2017.

Using the Da Vinci system, operations can be done with just a few incisions and the utmost precision, with less bleeding, faster healing and reduced risks of infection.

“At the beginning, robotic surgery was installed in a few institutes in the Middle East. The expertise needed to perform the procedures using the robotic machine developed with time. Currently, more institutes and more procedures are using the machine,” said Al-Tartir.

“The JHAH robotic surgery program is considered among the leading ones in the Middle East using this high-tech machine.” 

In the JHAH case last month, Al-Tartir said, the “hands” of the Da Vinci surgical system used to perform the hysterectomy allowed a high degree of dexterity. 

Thus surgeons had the ability to operate in very tight spaces, for example the pelvis, which would otherwise only be accessible through open surgery with long incisions.

During such surgery, the surgeon sits at a console and views the patient via high-definition 3D imagery, and manipulates the robotic arms through their own hands and wrists.

The system can be used on a range of minimally invasive surgeries, such as cardiac, urologic (including prostate, bladder and kidney cancers) and thoracic surgery.

JHAH has also carried out the first robot-assisted operations in the Kingdom to remove cancerous tumors. 

Its doctors, based in Saudi Arabia’s Eastern Province, were also the first to perform bariatric surgery and treat gastroesophageal reflux using similar techniques.

Al-Tartir said thanks to the JHAH’s program and the willingness of the Saudi government to invest in medical care as part of its Vision 2030 reforms, the Kingdom is capable of putting the Gulf region on the map of robotic-assisted surgery.

“The ability of young surgeons to digest this new technology is a well-known fact, and the world trend now is to move into digital transformation. Medicine in general, and surgery in particular, is part of that trend,” he added.

“In the coming few years, robotic surgery will be the new gold standard in doing surgical procedures, and countries like Saudi Arabia, which invests a significant part of its income on the health of its citizens, can become a leader in this field.”

According to a study titled “The Development of Robotic Surgery in the Middle East,” led by King Saud University, robotic surgery started gaining a foothold in the region in 2003, about three years after Da Vinci became the first robotic surgery system approved by the US Food and Drug Administration for general laparoscopic surgery. Saudi Arabia was the earliest adopter of the technology in the Middle East.

The Kingdom already has 14 Da Vinci surgical systems, each coming with a price tag of more than $2 million, Al-Tartir said. 

“Surgeons across all regions in Saudi Arabia are putting all their efforts into using this technique,” he added.

“The benefits include better magnification with better visualization, low risk of blood loss, lessened need for blood transfusions, less pain and scarring because of the use of small incisions to perform complex surgical procedures, reduced hospital stays and speedier recovery.”

While Da Vinci surgery, developed by the US company Intuitive Surgical, is considered a medical leader, many big tech companies are developing their own autonomous systems.

CMR Surgical, a British medical device company, is rolling out its offering “Versius” which, like other surgical robots, performs laparoscopic surgeries.

Surgical robotics are “a key enabler for increasing access to minimal access surgery and keyhole surgery,” Dr. Mark Slack, chief medical officer at CMR Surgical, told Arab News.

But despite its numerous proven benefits over open surgery, this technique is utilized in less than half of all procedures worldwide.

“This means many thousands of people each year are more likely to be subjected to the disadvantages of open surgery, including increased pain, surgical site infections and a range of surgical complications. This also creates a burden of long stays in hospital and significantly longer recovery times,” Slack said.

The scope for countries willing to invest in the robotic medical field is endless. But though the march of technology may be relentless, surgeons need not worry about robots taking their jobs. 

“Surgical robotics, including Versius, have been designed to be a tool to be used by surgeons, and therefore the relationship between surgeon and patient doesn’t change,” Slack added.

Dr. Rakesh Suri, CEO of the Cleveland Clinic Abu Dhabi (CCAD) and head of its robotic cardiac surgery program, said a common misconception is that robotic surgery does not involve the surgeon.

“In fact, the robot acts as an extension of the surgeon, enabling us to perform operations in a way that simply wouldn’t be possible with human hands. The robot allows us to manipulate surgical tools with unparalleled precision,” he told Arab News.

“Robotic surgery is of most benefit in densely packed and awkward areas of the body that present significant risks through traditional approaches,” he said.

“Because it’s minimally invasive and the robotic arms are so precise, we can access specific sites with minimal damage to the surrounding area,” he added.

“This helps patients recover significantly faster with fewer complications, improving outcomes and costs for health systems as a whole.”

Currently, robotically assisted procedures are most commonly used in urological procedures, said Slack. 

But forecasts predict strong expansion across gynaecology, general surgery and upper gastrointestinal surgery, meaning many now-common surgical procedures could soon become obsolete.

Suri said robotics play a key role in dealing with some of the leading health care challenges in the Middle East.

“As we deal with rising rates of cardiovascular disease, obesity and cancer, robotic surgery will only become more important in offering patients the best possible outcomes, and eliminate the need for patients to travel abroad for treatment,” he added.

“To meet that challenge head on, it’s vital that the Middle East is able to build on its potential to become a leader in the field of robotic surgery globally.”

 


Saudi ‘smart glove’ inventor thrives in the age of innovation

Updated 21 July 2019
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Saudi ‘smart glove’ inventor thrives in the age of innovation

  • Hadeel Ayoub is the founder of BrightSign, a London-based company specializing in assistive technology
  • BrightSign's signature product is a smart glove that can facilitate communication by individuals with speech disability

LONDON: Saudi inventor and tech innovator Hadeel Ayoub is giving people who can’t speak new hope — and a new voice.

The founder of London-based tech company BrightSign is the driving force behind a smart glove that allows individuals who are unable to speak to communicate by translating sign language into text and speech.

After more than four years’ work, Ayoub, a designer, programmer and researcher in human computer interaction, plans to launch the device later this year.

Some of the biggest beneficiaries will be families with children who have speech disabilities and want to be better connected through technology. The BrightSign glove will enable these children to become better signers and communicators, but can also be hooked up with a web app to provide instant translation in most languages.

The architecture of a BrightSign glove is relatively straightforward: Multiple sensors, embedded under an outer glove, track finger positions, hand orientation and dynamic movements. The hardware is contained inside a slender wristband.

Hand gestures are translated into text that appears on a screen embedded in the glove, and speech is made audible via a mini-speaker. The user can select the voice and speech language.


BIO

• Founder and Chief Technology Officer, BrightSign

• Experienced lecturer, researcher and entrepreneur with experience in the higher education industry

• Skilled in innovation, creative coding, programming and design research

• Ph.D. in human-computer interaction and gesture recognition from Goldsmiths, University of London


Ayoub has been featured in Forbes magazine, tech programs on the BBC and Discovery channels, and has spoken at discussions organized by Britain’s Financial Times and Guardian newspapers. She has also taken part in a number of exhibitions with innovation and assistive technology as their themes.

Recalling the inspiration for the smart glove, the Saudi inventor said she was originally designing a device for an air-draw program — the air was the canvas, and the hands and fingers were the drawing tools. Her aim was to replace the mouse and keyboard with trackable wearable technology.

On the basis of her design, Ayoub was selected to represent her university at an IBM global hackathon in artificial intelligence for social care. She reprogrammed the glove to translate sign language and won the competition.

When news of the smart glove was circulated in the media, Ayoub’s inbox was flooded with inquiriesttt from parents wanting the glove for their children, from speech therapists for their patients, and from teachers for their students.

The tech innovator quickly realized there was a need for this kind of technology and decided to make it the focus of her Ph.D. research.

Hadeel Ayoub’s BrightSign smart glove allows people with speech disabilities to translate sign language into text and voice. (Reuters)

“I want to break the current barriers facing those who wish to broaden their experience with sign language beyond the current traditional method,” Ayoub said.

She believes that at least three improvements are urgently needed: Integrating children with disabilities into mainstream classrooms; equipping adults who have disabilities with technologies that will help them perform tasks as well as their peers manage; and making smart-glove devices available in public locations such as airports, shopping malls, government offices and hospitals to offer a smoother service to visitors with disabilities.

A global award winner for her technological innovation, Ayoub regularly tests and improves the BrightSign glove, which she describes as a work in progress.

“The glove has gone through multiple rounds of prototyping and testing. I have implanted the users’ feedback to develop hardware, software and design,” she said.

“It is now being used in six schools to help non-verbal children overcome their communication challenges in the classroom.”

Ayoub said that further studies would help her develop the final product. “I am now taking glove pre-orders on the BrightSign website,” she said.

The Saudi inventor said that she has always been “a progressive thinker and a dreamer of possibilities,” and described a childhood spent immersed in books rather than playing with dolls.

She remembers her family library with fondness and reminisces on quiet evenings spend reading.

As well as being an innovator, Ayoub is a mother who talks lovingly about her children.

“They are very much involved in the development phases of BrightSign,” she said. “I consider their opinions on the products designed for children. I always encourage them to do what they love since that would mean that they will excel in it.

“They get excited every time they see someone using BrightSign and they can see how it helps people live better.

“They also understand the concept of tech for good and aspire to work one day on technologies with a social impact.”

Ayoub sees herself as problem solver with an eye for technical detail, a kind of instinctive trouble-shooter. “When I attempt to solve a problem, I go through cycles of trial and error until I achieve a breakthrough,” she said.

“I encountered a number of problems that were unprecedented, so I wasn’t able to turn to a source or a reference. I guess this is what prompted me to get creative and think outside the box, which eventually put me on the innovation route.

“I find dead ends challenging. When someone tells me that something has never been done, it does not mean that it is not doable. On the contrary, it motivates me to keep going until I find a solution.”

As for the current model of innovation, Ayoub admires the global interconnectedness.

“The mindset now is collaborative rather than competitive,” Ayoub said.

“I am part of inventors’ groups in Saudi Arabia, the Gulf region and the Middle East. Most of us got business training at some point in order to secure investment and go into production.”

I find dead ends challenging. It motivates me to keep going to find a solution.

Hadeel Ayoub

Being a innovator has been far from a walk in the park for Ayoub. She believes what really pushed her in her chosen field was her desire to learn something new in every degree she pursued, starting with design, then programming and, finally, technology.

“More often than not I find myself the only woman speaking at a tech conference or giving a tech talk at an event,” she said. “I am proud to represent my country in global exhibitions and am even prouder when I walk away with awards at competitions.

“I hope that I can inspire young girls to experiment with technology and use it to enhance their respective practices.

“I have created a ‘women in tech’ group where we have regular meetings to share our challenges and extend our support each other.”

Based on her experiences, Ayoub has a message for young Saudis: “This is the age of innovation and entrepreneurship. If what you are passionate about doesn’t exist as a field of knowledge, create it.

“Learn how to code. It will be useful in any career you pursue and will enable you to integrate technology into your practice.”