[LUM#17] Innovating from head to toe
On the Saint-Priest campus, robotics engineers, computer scientists, and electronics engineers are putting their expertise to work in the field of surgery. Whether they are working on smart prostheses, like the RFEF team at the Institute of Electronics and Systems (IES)*, or on surgical robots, like the Dexter team at the Montpellier Laboratory of Computer Science, Robotics and Microelectronics (Lirmm)**, their motivation is the same: to give innovation a strong social impact.
In France, 100,000 people undergo knee replacement surgery every year. To improve patient follow-up, orthopedic surgeon Stéphane Naudi, founder of the start-up Bonetag, has designed a smart prosthesis equipped with an adhesion sensor to anticipate bone loosening and traceability to ensure continuity of care.
Techno to the bone
"Stéphane Naudi came to see us in 2013 because he had heard about our expertise in sensors and RFID tags," recall Brice Sorli and Arnaud Vena, researchers atIES and scientific collaborators at Bonetag. RFID tags are a radio identification technology used to track clothing, packaging, and even our dogs and cats. "It's a device that contains a microprocessor, memory, and antenna, but doesn't require a battery, " explains Arnaud Vena. "Bonetag needed a technology that would work for the entire life of the prosthesis without having to reoperate on the patient to change a battery. " The inactive tag in the knee emits a radio frequency signal when activated by a reader during the consultation.
The challenge of this innovation lay in miniaturizing the implant. "Existing electronic prosthesis projects have not taken off due to their complexity," explains Brice Sorli, "whereas Bonetag's implant is easy to integrate into any prosthesis thanks to a notch system for which the company has filed a patent. " The electronics engineers have succeeded in developing a micro device containing the RFID tag, equipped with a miniature antenna, also patented, and a sensor that measures the adhesion between the bone and the prosthesis. They even added a temperature sensor "to detect possible tissue infection," explains Arnaud Vena. With four patents already to its name, the Bonetag micro-implant may be small... but it's powerful!
Compass in the eye
Surgical robots are also powerful. First used in operating rooms in California in 1985, their precision has continued to improve ever since, as confirmed by Philippe Poignet, director of Lirmm: "We perform operations with a precision of less than 10 microns. That's ten times more precise than a surgeon's hand." In 2020, this robotics engineer founded the start-up AcuSurgical with his colleague Yassine Haddab and Zurich-based engineer Christophe Spuhler. Their credo? Robotics applied to retinal surgery, "a form of microsurgery so precise that it remains the preserve of an elite group of surgeons." In partnership with two surgeons from Saint Etienne, they launched the Retinoct project, combining imaging and robotics. Instead of a scalpel, the surgeon holds a joystick integrated into a console and connected to a robotic arm that instantly replicates their movements on the patient. The first human trials are planned for 2023.
In the skin
Another example is the Astrid Blockprint project, which is reviving the Dermarob robot developed in the 2000s by LIRMM to take skin samples during reconstructive surgery for burn victims. Its updated version is back in service as part of a project with Lyon-based start-up LabSkinCreations, which manufactures liquid artificial skin. "Its mission," explains Philippe Poignet, " will be to perform robotic bioprinting of skin in situ, precisely controlling the geometry and thickness of the print."
Strong kidneys
Ergonomics is also a key area for improvement in surgical practice. Since 2015, Philippe Poignet, Nabil Zemiti (LIRMM), and Stéphane Droupy from Nîmes University Hospital have been working with STERLAB to develop an assistive robot for the laser treatment of kidney stones. This is a long and delicate procedure involving the insertion of a flexible camera equipped with a laser into the patient's urethra and guiding it to the kidney.
"To treat a 1 cm stone,it takes about 1 hour during which the surgeon remains in an uncomfortable position, standing between the patient's legs," describes Philippe Poignet. With the ILY robot, which will reproduce all of his movements remotely, he will now be able to sit in front of a console and take advantage of an imaging system and an augmented environment. Thanks to extremely sophisticated algorithms, ILY will be able to compensate for the natural physiological movements of the patient and surgeon, providing additional precision. Currently, 80 operations have already been performed, and two sales are planned for this year.
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