The retina in Acusurgical's sights

Based at the Montpellier Laboratory of Computer Science, Robotics and Microelectronics (Lirmm), start-up Acusurgical is designing a new medical robot. Its specialty: retinal surgery. A field that this innovation promises to revolutionize, with a tenfold increase in precision.

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"Certain microsurgeries of the eye require such precision in the gesture that they remain, even today, reserved for an elite of surgeons." And therefore to a minority of patients. This observation by Yassine Haddab, a specialist in precision robotics and researcher at Lirmm, forms the basis of the Montpellier-based start-up Acusurgical.

The idea came from Christoph Spuhler, an engineer from Zurich who worked for Bertin Nahoum's company, Med Tech. In the course of his various experiments, he saw the possibility of extending the field of eye microsurgery to new pathologies with the help of robotics. "Intervening on the retina is a procedure that involves a lot of risk and is sometimes not even accessible by hand." His idea: to design a robot capable of reproducing the human gesture with greater precision and safety, and without the slightest tremor.

From robotics to clinical use

In 2017, Christoph Spuhler contacted the LIRMM, a laboratory he knew to have great expertise in the field of surgical robotics. He began working with Yassine Haddab and Philippe Poignet, a specialist in surgical robotics and director of the LIRMM. In May 2018, thanks to funding from SATT Axlr, the three of them began the maturation project that would lead 2 years later to the creation of the start-up Acusurgical. They are co-founders with two surgeons from Saint Etienne who have joined the team in the meantime to contribute their clinical expertise. In addition to the recruitment of three engineers financed by the maturation project, Muse's Companies on Campus program has also funded the recruitment of an OCT (Optical Coherence Tomography) imaging specialist for a 12-month period.

The Rectinoct project combines imaging, robotics and, of course, surgeon expertise. A microscope captures the image of the patient's retina and transmits it, via a screen, to the practitioner, who reproduces the usual operating gestures. No surgical tool in his hand, but a sort of joystick integrated into a console, itself connected to the robot, which instantly performs the surgical gesture on the patient.The robot can do ten times more than the surgeon's hand," explains Philippe Poignet. It allows us to go much further in terms of precision but also operational reliability."

Expand to other pathologies

The key is to be able to treat not only better, but also more. "This opens up therapeutic possibilities for pathologies that could not previously be treated by surgery," continues the director. Epiretinal membrane (ERM), macular holes, diabetic retinopathy and AMD (age-related macular degeneration) are just some of the pathologies that could benefit from this innovation.

Tested on rabbits at the Saint Etienne University Hospital last February, the first trials of this technology on humans are scheduled for late 2021, with marketing in 2023. "We hope to have the CE marking procedure validated in 2022, enabling the product to be placed on the European market.We're targeting the international market, so we'll be launching the FDA marking application for the American market afterwards", explains Christoph Spuhler, who, like his robot, is opening up new horizons for retinal surgery.