One day a surgeon on Earth could use this robot to treat an astronaut on Mars.
NASA is funding a tiny surgical robot, known as MIRA (minitaturized in-vivo robotic assistant), for a 2024 test mission aboard the International Space Station.
The space agency recently awarded $100,000 to startup Virtual Incision, based at the University of Nebraska-Lincoln’s Nebraska Innovation Campus (NIC), where Shane Farritor has spent more than 15 years developing MIRA…
No matter how mentally and physically prepared they are, future astronauts bound for deep space can’t escape their mortal restrictions. At some point during their long and isolated journeys, these pioneers might need medical care. But that’s tough. In space, there are no hospitals.
Enter MIRA.
On Tuesday, scientists from the University of Nebraska-Lincoln said their invention of a small surgical robot — called the miniaturized in vivo robotic assistant, or MIRA — will board the International Space Station for zero-gravity testing in 2024. Ultimately, the team’s hope is for MIRA to accompany astronauts as they fly toward Mars and zoom through the untouched outer reaches of space…
In space, robots could someday make housecalls for doctors far from astronauts. Virtual Incision Corp. last week announced that it will test its MIRA surgical robot’s skills in a 2024 technology demonstration mission aboard the International Space Station, or ISS.
“The Virtual Incision MIRA platform was designed to deliver the power of a mainframe robotic-assisted surgery [RAS] device in a miniaturized size, with the goal of making RAS accessible in any operating room on the planet,” stated John Murphy, CEO of Virtual Incision. “Working with NASA aboard the space station will test how MIRA can make surgery accessible in even the most faraway places.”
Virtual Incision said it holds more than 200 patents and patent applications. It raised $43 million in Series C funding in November 2021. The Lincoln, Neb.-based company claimed that MIRA is the first RAS platform of its kind…
Recently, Virtual Incision CEO John Murphy was featured on the Medsider Podcast with Scott Nelson.
In this episode of Medsider, John outlines his best advice on fundraising, regulatory approvals, and the dual-track approach to exiting.
On June 29, 2021, The Annals of Internal Medicine published a systemic review of robot-assisted abdominopelvic surgery to “assess the quality of evidence and outcomes of robot-assisted surgery compared with laparoscopy and open surgery in adults.”
The conclusion of the review found “no clear advantage (in laparoscopy and open surgery in adults) with existing robotic platforms…”
However, the study also concludes that “with refinement, competition, and cost reduction, future versions (of robotic platforms) have the potential to improve clinical outcomes without the existing disadvantages.”
Many of the current robotic surgery technologies are cumbersome and immobile – oftentimes, consisting of larger structures that are permanently installed in private hospitals. The large size and structural permanence of such robotic platforms make them incapable of providing mobile surgical services, particularly to rural locations where such movable technology could be hugely beneficial to populations of patients that are far from readily-available medical and surgical access.
Additionally, robotic-assisted surgery continues to be an inordinately expensive technology. According to researchers from the University of Texas, the initial cost of the most prevalent robotic platform is $1.5 million, which does not account for costs of upkeep or personnel training. Furthermore, some private health insurance companies will not cover the additional cost of surgery involving a robotic apparatus, thus increasing the financial burden for patients.
Some research has also shown a myriad of “neutral” outcomes from robotic-assisted surgery when compared to traditional laparoscopic or open surgeries. From the recent Annals of Internal Medicine review: “The majority of studies showed no difference in intraoperative complications, conversion rates, and long-term outcomes.”
The MIRA platform is designed to usher in a new era of Minimally Invasive Surgery with a first-of-its-kind miniaturized surgical robotic support device, focusing first on colon resection and with other procedure specific designs to follow.
Straightaway, MIRA’s compact size, single-cable design, latency free video feedback, and lack of surgical draping should expand surgical access to rural settings. Weighing only two pounds, MIRA can be moved and set up easily, eliminating the need for dedicated hospital space or infrastructure. This mobile flexibility may also provide future advantages in military field hospitals and other difficult to access medical settings.
As an accessible option for laparoscopy, MIRA may also reduce the number of surgical incisions by up to 50%, which can make laparoscopic procedures more cost-effective to hospitals, insurance companies, and most importantly, to patients.
MIRA is designed to be simple to implement and use, small to transport and prepare, and smart in functionality. It has been tailored to be fully autonomous while performing multi-quadrant surgery—providing a surgeon with 360-degree control of the positioning of the robot for the operation as well as providing complete control of the camera—all from the one console.
Ultimately, MIRA aims to be the future of robotic platforms that will provide the refinement, competition, and cost reduction needed to improve clinical outcomes of robotic-assisted surgery without the existing disadvantages.
Dr. Shane Farritor, a professor in the Department of Mechanical Engineering at University of Nebraska-Lincoln, studied at the Kennedy Space Center, the Jet Propulsion Laboratory (JPL), and Goddard Space Flight Center where he conducted satellite testing before receiving his M.S. and Ph.D. from Massachusetts Institute of Technology in 1994 and 1998, respectively.
During his time at MIT, Dr. Farritor helped lead research to support the Mars Exploration Rover. Along with his colleagues, Farritor built rovers, helped define the motion planning, and worked on the design of Mars rovers – specifically the use of sun sensors to detect a rover’s direction of travel. These efforts were eventually tested by Lockheed Martin and subsequently adopted by NASA’s Jet Propulsion Laboratory (JPL).
Dr. Farritor’s research and development work for the rovers captured the attention of the United States Army during the time of the second Iraq War. Their idea was to develop several types of surgical robots – conceptually similar to rovers – that could “drive” inside a patient—often in foreign environments dislocated from field hospitals—to provide surgical assistance.
“Like driving on Mars, it’s a very challenging environment to drive around inside the human body,” says Dr. Farritor. From the early 2000’s until present, Dr. Farritor and his colleagues have developed more than 40 iterations of surgical robots, continually testing and improving their clinical relevance, the quality of the robots’ video feedback during laparoscopic surgery, and their functional benefits.
Today, the decades of research and testing have culminated into the development of the MIRA Platform. MIRA is designed to enable minimally invasive surgery without the need for a dedicated space or infrastructure that is typically required for “mainframe” systems.
Dr. Farritor and the MIRA development team work to identify and solve practical problems that are commonly found within a surgical environment. MIRA provides an abundance of beneficial advantages including a single-cable design, which was also inspired by the development of the Mars Exploration Rover.
Well, good afternoon, everyone. John Murphy, CEO of Virtual Incision, and I’m here to share how we’re pioneering the use of mini-robots for general surgery, abdominal procedures.
The LSI app has a nice executive summary with key company highlights of ours, the most salient point being that our developed Mira platform is now FDA IDE approved, and we’re currently in a colectomy IDE clinical study in the United States. So that’s the first, in the United States, use of these devices.
Our initial indication is for colon resection. There’s approximately four-hundred thousand of these procedures in the United States every year, most of which are open procedures. And we feel like our approach to robotic MIS for colon will really be an enabler to grow this important market. We are also developing follow-on robots, mini robots, specialty by procedure to address procedures like hernia repair or gallbladder removal or adrenals or spleens or gastrectomy. So overall, this is a very large general surgery market.
Now the very impressive, intuitive surgical where their Da Vinci Systems have done a tremendous job pioneering in this area. And there’s a number of other mainframe robots that are coming to market and are in market. But instead of a 2000 pound robot, our approach is to have a two-pound robot, and we’ve worked diligently over the last ten years to make these things simple, small, and smart. And so, what I have with me today is one of these IDE-approved devices. This robot is real; it has hundreds of hours of operations on it. This robot is 15 times reusable. It has single-use end effector instruments, a bipolar grasper, and a monopolar scissors, as well as a visualization system which has the world’s first flex tip robotic camera scope. So, this has a robot in the handle. It has a light source in the handle, and it has your optics for about a five-millimeter, full HD, 1080p 60 scope that works in coordination with the robot here. I think it’s very exciting.
Our website shares a number of these things around simple, small and smart. The first is less invasive, fewer incisions. Equally important is our capability of full multi quadrant access with looking at a ten-second incision time, a ten-second quadrant change, a ten-second extraction. There’s no re-docking required here. There’s no draping required here. We thought this was a fun way to show that it’s a self-contained, sealed, and sterilize-able robot. If you want to try laparoscopic surgery in a fish tank, this is it. And it shows the advances in the seals and the devices and the design.
Our engineers also thought it would be fun to show how strong this robot is. It can lift two pounds in any and all axes. And, of course, it can do press-ups with a four-pound weight on his back. You need strength to do the bulk work in colon surgery, of course. The other elements of this, we see ourselves, absolutely as complementary to the mainframe system. You’ll have one or two of these mainframes in a room, but we’re addressing the other 80% of ORs where robotics is almost table stakes now in whether you’re at the community hospital, the rural setting, or the ASC.
Beyond the robot and the scope, we’ve got a console that sit-stand, it’s mobile, you can move it from OR to OR. And quite impressively, this is our mock OR in our beautiful headquarters in Lincoln, Nebraska, and Jerry, our clinical specialist here, is showing how you can set up a blank room, a completely empty room into a robotic MIS room in about six minutes. So, this is the full element of this system on show here. So very much driving OR efficiency with this approach.
Now on the smart sides, well, obviously a great AI platform. This robot is spitting out a hundred thousand data items per second. We use deep learning on the surgery video, we use simulation data, and we have, you know, AI algorithms to auto edit down four-hour surgeries into two-minute clips and things like this depending on which events. And and we’re currently using about a dozen of these algorithms today. So that’s very important.
I’d be remiss if I didn’t say we were easy to use. Meaning surgery at practice and training is to proficiency is much quicker. Exponentially less cases than manual lap and considerably fewer than robotic cases. We’ve driven a very hard challenge for ourselves is to be cost parity with manual laparoscopic surgery. So, we’ve got a world-class supply chain. We have got a reuse strategy on the robot side that really drives very compelling economics.
Now also as part of this series C financing, our reason to be here, to get us into commercial launch; we’ve got a comprehensive set of R&D pipelines. Initially, we just move the robot and position the robot with a physician’s assistant, but you’re seeing here a prototype of, what we call, our port bot system, which is an autoclavable robotic support arm. So now you’re talking about fully autonomous, multi quadrant surgery, 360-degree control of the positioning of the robot, of the robot itself for the operation, and for the camera use all from the one console. I told you about a family of devices; we’re changing the geometries, the degrees of freedom, and the instruments to be able to tailor each of these mini robots for a specific procedure, but you use the same camera, and you use the same console and the same workflows in general. We’re advancing these as part of the series C as well.
I mentioned we’re in a colectomy clinical study now, we’re recruiting patients in Lincoln, Nebraska, near our headquarters, and we’re expanding to Pennsylvania and to Florida for three site clinical study for the rest of this year and look to clear a De Novo approval next year and move into a limited market release in the United States.
I’ve got a great team. This technology, it emanates from the University of Nebraska. UNMC in Omaha got DaVinci serial number eight, and Dmitry Oleynikov, a real luminary robotics and MIS surgeon was recruited to start the robotics program at UNMC. He always felt that little robots on the inside made a lot more sense in some cases than a huge robots reaching in from the outside. So, he teamed with my CTO and co-founder Shane Farritor, he’s MIT Ph.D., Mars Rover guy, three NASA sites, and together they started the company in 2006, and I joined about ten years ago. We’ve also got a tremendous functional team in Mukund, Rick, and Eric with decades of technology and med device experience. The use of proceeds of our approximately 35 million round is to get through De Novo approval, get into a market launch, do the key hires in some sales and clinical specialists and the engineering we’re talking about and advance these R&D elements.
The most important thing to conclude with is Mira, its Miniaturized In vivo Robot Assistant. We’re an FDA IDE-approved device. We’re in the clinic now in the United States, and it’s a general surgery, abdominal, you know addressable market for us.
Thank you for your time and your interest in Virtual Incision.
Below is an excerpt from an article originally posted by the University of Nebraska
More than 400,000 Americans need colon resection procedures each year to treat lower gastrointestinal diseases such as diverticulitis, colon polyps, pre-cancerous and cancerous colon lesions and inflammatory bowel disease. Read more
Below is an excerpt for the featured article in General Surgery News
We’ve glimpsed a possible future of robotic surgery, and it’s just slightly larger than a bread box.
Weighing less than two pounds, the miniaturized in vivo robotic assistant (MIRA) is about the size of a human hand and fits into a patient’s abdomen through a single 2.5- to 3-cm umbilical incision. Assembled together, the robot and a camera extend no more than 24 inches.
“When we started our research into robotic surgery, we thought the current iteration on the market—the very large and expensive da Vinci system [Intuitive Surgical]—was probably not the right way to go about it,” said Dmitry Oleynikov, MD, the co-founder and chief medical officer of Virtual Incision, a medical device company that develops miniaturized robotic support systems. “The analogy we use is comparing the big mainframe computers from the 1970s and 1980s to what we have now, in our watches and iPhones.”
Dear medical futurists,
Back in 2017, I wrote about the future of surgery and included a U.S.-based company that developed a robot that can be placed inside a patient’s abdomen and then controlled remotely by a surgeon. This enables surgeries with minimally invasive tools and techniques that are familiar to surgeons, and does not require a dedicated operating room or specialized infrastructure. The device can become a cost-effective and accessible option for laparoscopic surgery reducing the number of incisions by 50%.
The idea, that seemed so far-fetched when I first wrote about it, recently received an FDA approval to start clinical trials in select hospitals. I asked John Murphy, the CEO of the company about the future of robots in surgery and if robots will replace doctors in the future.