American surgeons have set an incredible precedent for innovation in medical technology. With it, they carried out the world’s first remote thrombectomy with robotics – successfully. Led by Professor Iris Grunwald of Dundee, Scotland, the first such procedure used a machine created by the Lithuanian start-up Sentante. This cutting-edge surgery was the first of its kind on a human cadaver donated to medical science. It presented an inspiring example of the promise of remote stroke care over such great distances.
The experiment also had to be held in Dundee, where Prof Grunwald was able to visit, and run the Sentante machine. Meanwhile, from a remote location in Florida, neurosurgeon Ricardo Hanel conducted a complementary procedure. With advanced robotic technology, both surgeons expertly synchronized to the same catheters. What they did was magic with wires you usually only find in the world’s best traditional surgical theatre.
Additionally, the cadaver used in the procedure must have been embalmed and deceased within the last three years. This arrangement allowed Prof Grunwald and Hanel to see real-time X-rays of the human body. In response, they were able to keep track of their achievements, successes, and failures in real-time. Prof. Grunwald had the Sentante machine down within 20 minutes of instruction. This extraordinary achievement is a testament to the intuitive simplicity of this groundbreaking technology.
“This technology would now provide a new way where you’re not depending on where you live – saving the valuable minutes where your brain is otherwise dying,” said Prof Grunwald. She emphasized that the ability to perform such procedures remotely could significantly mitigate the inequities currently faced in stroke treatment across the UK.
In Scotland, people needing access to thrombectomy procedures have the least options, with only three major hospitals—Dundee, Glasgow, and Edinburgh—providing this life-saving treatment. Nationally, that percentage is still only 3.9% of all stroke patients who received a thrombectomy as of one year prior to March 2024. Of those patients, just 212—or 2.2%—received the procedure. In stark contrast, only a tenth as many chose medication to dissolve clots.
Prof Grunwald highlighted the urgency of timely intervention for stroke patients, stating, “Every six minutes delay, you have a 1% less chance of having a good outcome.” This trend highlights the urgent need to provide immediate access to thrombectomy procedures to stroke victims.
Robotics have the potential to change the way we deliver care to those who live in remote and rural areas. These communities are not being serviced with crucial thrombectomies. Juliet Bouverie, Chief Executive of the Stroke Association, remarked on this issue: “For too long, people living in remote and rural areas have been deprived of access to thrombectomy.”
The consequences of this robotic technology reach far outside the operating room. Further, it opens up the opportunity for physicians to perform life-saving procedures from far-away locations—perhaps even from their homes. This means patients can stay in hospital operating rooms while surgeons control the surgery from miles away.
Despite these caveats, Prof Grunwald and her team remain hopeful about their involvement in upcoming clinical trials planned for next year. This first experiment has established a good precedent to build upon for future endeavors. Now we can explore remote surgery capabilities and their successful use in treating strokes.
It’s easy to see why Prof Grunwald has been awarded such praise for her exemplary work, including a Distinguished Fellow Award from Innovate UK. She is vice president of the World Federation for Interventional Stroke Treatment.