Number of the day - 1st in human

"Virtuoso Surgical Inc., a Nashville-based surgical robotics company, today announced the first-in-human use of its Virtuoso system, ushering in a new era of precision and minimally invasive options for bladder cancer patients. The Virtuoso system features two robotically controlled, needle-sized (< 1 mm) manipulators that operate from the tip of a rigid endoscope. The robotic system facilitated a series of endoscopic bladder lesion excisions using the advanced en bloc technique that removes the bladder lesion intact rather than piecemeal. The groundbreaking case series was performed by Dr. Jeremy Teoh, a world-renowned bladder cancer surgeon and researcher, at The Chinese University of Hong Kong (CUHK).  

"We are excited to see the Virtuoso system used successfully in its first human cases, particularly to allow surgeons to provide patients a best-in-class procedure such as the en bloc bladder tumor resection," said Dr. S. Duke Herrell, CEO of Virtuoso Surgical, who is also a urologic surgeon. “This milestone is a testament to our team's dedication to advancing surgical robotics and our commitment to partnering with leading clinicians, like Dr. Jeremy Teoh and CUHK, to transform patient care. The Virtuoso system is engineered to empower surgeons with superior control and precision, which is critical for delicate operations."  Dr. Teoh is a leading advocate for the use of the en bloc technique, which is believed to offer significant advantages, including a reduced risk of tumor cell spillage, potentially helping to reduce the high recurrence rates of bladder cancer. This approach has also been demonstrated to significantly enhance staging accuracy and improve pathological specimen quality in numerous studies.  

 A recent award-winning RCT by Dr. Teoh et al. in European Urology demonstrated a decreased risk of cancer recurrence at 1 year with the manual en bloc technique. Despite noted benefits, en bloc procedures are not commonly performed in the U.S., likely due to the dexterity limitations of current equipment, which makes the procedure challenging to learn and perform effectively. The Virtuoso system is specifically designed to overcome these challenges and was used to remove a total of eleven lesions in six patients successfully.  Dr. Jeremy Teoh commented, "The ability to perform an en bloc resection for bladder cancer with this level of robotic assistance is a game-changer even for an expert in the technique. The Virtuoso system offered exceptional maneuverability, dexterity and visual clarity, enabling meticulous dissection. This approach has the potential to enable the widespread adoption of en bloc techniques, thereby minimizing local recurrence and providing a more definitive pathological specimen, which is crucial for guiding subsequent treatment decisions. We are extremely optimistic about what this technology means for the future of bladder cancer surgery and patient outcomes."  

The Virtuoso system’s advanced instrumentation and multiple-arm dexterity are designed to improve rigid endoscopy by providing retraction and precise control through the company’s patented concentric tube robotic arm technology. The concentric tube robot was an invention originally conceived by Vanderbilt University professor Robert J, Webster, III, Ph.D., founder and President of Virtuoso, while part of a team of advanced medical robotics researchers at Johns Hopkins University. Dr. Webster commented, “Our vision at Virtuoso Surgical is to give surgeons unprecedented dexterity. This will enable them to perform the less invasive, more accurate surgeries that improve patients’ lives and long-term health outcomes.” "

Source: Virtuoso