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First in Human: Doctors Perform Remote-Controlled Cardiac Catheterization Procedure Kilometers Apart from Patient

Publication Date: 1/6/2019 | by: Rambam

An Israel-developed robotic heart catheterization system allows the operator to sit kilometers away from the patient lying in the catheterization laboratory. Professor Rafael Beyar, Director of Rambam Health Care Campus, the inventor of this novel robotic system, said: “In the future, we’ll be able to teach the robot how to perform catheterizations by itself.”

Professor Rafi Beyar (R) and a colleague during a procedure. Photo Credit: Pioter FliterProfessor Rafi Beyar (R) and a colleague during a procedure. Photo Credit: Pioter Fliter

It’s like a scene from a science fiction movie: The doctor was several kilometers away from the patient. Using a breakthrough technology developed in Israel, he was able to perform a heart catheterization procedure using a robot.

The procedure was recently carried out in India using a unique technology developed by Corindus, a company involved in cardiac navigation systems and remote-controlled heart catheterization technology. Five patients were catheterized at Apex Heart Institute in Ahmedabad, India, one after the other, while the interventionist sat in a monastery several kilometers away.

Up until now, the operator, using robotic technology, would have been found just a short distance away from the patient, sitting in a control room (referred to as the cockpit) in, or right outside of, the catheterization laboratory, guiding the medical procedure from a console.

The five catheterizations were performed by world-renowned cardiologist, Dr. Tejas Patel, the Director of the Interventional Cardiology Department at Apex Heart Institute, using a remote-controlled navigation system. Dr. Tejas sat facing computer screens placed in a monastery 32 kilometers away from the patients. His colleague, Dr. Senge Sha’a, stood beside the patients’ catheterization table in the hospital.

Impelling Motivation to Develop This New Technology: Prevent X-Ray Radiation Exposure to Interventional Cardiologists

Development of the CorPath robotic-assisted intervention system for heart catheterization was initiated in 2002 by the startup NaviCath (now Corindus), founded by senior cardiologist Professor Rafael Beyar, Director and CEO of Rambam Health Care Campus with his colleague, Tal Wendrov, a Technion – Israel Institute of Technology graduate, who was the company’s vice president for marketing and business development. NaviCath, established at the time as a Technion incubator in a joint project with Rambam Health Care Campus, has since moved to Massachusetts. Its technology is used in over 50 medical centers worldwide.

The robot, with third generation FDA clearance, was developed with the aim of enhancing the degree of precision and control from the safety of a radiation-protected interventional cockpit.

Staff members who performed the historic procedures opinioned that their success had paved the way for other, similar undertakings on a larger scale throughout the world. Based on the results of catheterizations performed in India, Corindus announced that it was planning to invest in commercial development of additional applications for the telerobotic system and to adjust the existing platforms for treatment of stroke.

“The system that came out of Israel 16 years ago is now making an historic contribution to cardiovascular medicine across the world,” averred Professor Beyar, “For the first time ever, this telerobotic technology is being utilized for heart catheterizations when the patient is tens of kilometers away from his physician. This is a gigantic leap forward. It enables us to send a physician’s treatment skills and capabilities over the Internet to the patient, instead of the patient having to come to the physician.”

Overcoming Geographical Distances

Cardiovascular disease (CVD), including stroke, is the leading cause of death worldwide. Annually, an estimated 18 million deaths are the result of CVDs. Many of these deaths result from patients having inadequate access to doctors, as well as socio-economic influences and the waning number of specialists in the field. Once symptoms start, treatment for cardiovascular emergencies such as stroke and heart attack must be given within a very narrow window of time—between 90 minutes to 24 hours—in order to prevent death or significant paralysis.

“The future is exciting,” concludes Professor Beyar, “it’s possible for a physician to treat a patient on the other side of the ocean and to consult and work jointly with doctors anywhere in the world. But more importantly, it enables the introduction of automatic elements to the catheterization procedure. Just like a self-driving car, it is possible to teach the robot to put the stent in place and thread it through the arteries until it reaches the right spot, to keep the stent there, and to then let go of it.”