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TNO – Giving back the sense of touch to endoscopic surgeons

EARTO Innovation Awards 2016 – Impact Expected Category

Second Prize

           Since the end of the 20^th century, minimally invasive surgery has taken over a large part of open surgical interventions, increasing patients’ well-being. However, surgeons had to cope with the loss of their sense of touch. To recover it, a surgeon invented the concept of the OptiGrip and EARTO member TNO enabled its development. This innovative instrument feeds the actual force applied to patients’ tissues back to surgeons’ fingers in real time, for safer and faster surgeries.   The number of endoscopic interventions is still growing today, enabling shorter hospitalisation, smaller wounds and fewer infections. However, the mechanical nature of conventional instruments allow limited tissue feelings to surgeons, causing them to apply much higher forces than needed and leading to unintended damage. To compensate, surgeons guess the tissue forces by looking at camera images, but this feedback is poor and strongly dependent on each surgeon’s skills and experience. Besides, surgeons are hesitant to carry out certain operations with endoscopic instruments as they cannot feel the difference between cancerous and healthy tissues for instance.     Innovative sensing technology for safer tissue manipulation The OptiGrip overcomes this lack of tissue feeling: a fibre-optic sensor measures the tissue gripping force which is then fed back to the surgeon’s hand, enabling him to feel the tissue characteristics and even dynamic forces like pulsations in arteries. Due to the natural, feeling the force applied on tissue is reduced 3 to 4 times compared to standard instruments Moreover, if the surgeon mistakenly applies still too much force on the tissue, it will be automatically optimised, without the surgeon noticing, guaranteeing safety in all situations. Adding a sense of touch will also shorten the learning curve, typically quite long in endoscopic surgery.   Increasing control to improve patients’ well-being This technology also enables to set different sensitivity levels for the manipulation of delicate tissues or for microsurgical applications, offering surgeons a more controlled performance. Besides, while most conventional instruments use a scissor-like grip, the OptiGrip is equipped with an ergonomically designed pistol-shaped handgrip, allowing surgeons to operate with less strain. Moreover, two trigger sizes will enter the market to comply with different hand sizes. Such design secures an optimal fit creating unrivalled control for faster handling with greater precision.   Clinically validated instrument The OptiGrip has been clinically validated and is supported by medical publications. The Optigrip’s market share is estimated at 20.000 instruments/year by 2021. Despite 30% higher costs, a Health Technology Assessment study shows that the overall health costs will not increase thanks to lower complication rates and increased surgeon performance. Besides, the increased ergonomics will give surgeons greater confidence in carrying out endoscopic surgery for cancer or cardio-vascular interventions for instance. This technology can also be transferred for use in robotic micro-surgery systems in the fields of plastic surgery or eye surgery.