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CMU-developed technology allows surgeons to navigate hard-to-reach areas

| Monday, Feb. 1, 2016, 11:28 p.m.
Jasmine Goldband | Tribune-Review
Dr. Umamaheswar Duvvuri uses a robotic device during a surgery at UPMC Presbyterian hospital in Oakland Wednesday, Jan. 27, 2016.
Jasmine Goldband | Tribune-Review
Dr. Umamaheswar Duvvuri explains how a robotic device works during a surgery at UPMC Presbyterian hospital in Oakland on Wednesday, Jan. 27, 2016.
Jasmine Goldband | Tribune-Review
A photograph of a live image is displayed using a robotic device during a surgery at UPMC Presbyterian hospital in Oakland Wednesday, Jan. 27, 2016.
Jasmine Goldband | Tribune-Review
Dr. Umamaheswar Duvvuri demonstrates the flexibility of a tool used in conjunction with a robotic device used during surgery at UPMC Presbyterian hospital in Oakland Wednesday, Jan. 27, 2016.

After 12 years of diligent work, the time had arrived for the makers of “HARP” the robot to turn him loose.

Carnegie Mellon University robotics professor Howie Choset half-jokingly likened his emotions to parents letting go of a child. After all, he considers HARP's creation his proudest professional accomplishment.

Last summer, the Food and Drug Administration approved the large, crane-like contraption to assist surgeons in the operating room.

“We had let go of our baby,” Choset quipped. “It was definitely a bittersweet experience.”

HARP has found a home at UPMC Presbyterian in Oakland, where surgeons say the robot brings the power of precision to difficult surgeries of the head and neck. Though surgeons increasingly are turning to robotic equipment, Presby was the first hospital in the country in September to use this specific type of machinery to assist doctors looking for hard-to-reach lesions.

“It is never going to remove the human surgeon, never going to supplant the human element, but it is going to allow us to do things easier and with more precision,” said Dr. Umamaheswar Duvvuri, an assistant professor of otolaryngology at the University of Pittsburgh School of Medicine. “It's very neat to be on the cutting edge.”

Duvvuri has used the $900,000 robot to operate on seven patients, all head and neck procedures.

HARP, initially known as Highly Articulated Robotic Probe, is trademarked with a new name — Flex Robotic System by Medrobotics Corp. Choset and others co-founded the company in Pittsburgh, and it operates out of Raynham, Mass.

“The company did all the heavy lifting and got it through the clearance process,” Choset said. “All I did was help invent it. It's pretty good, but because of them, this robot operates on people.”

Last week at Presby, Duvvuri sat in operating room using remote controls to steer the snakelike robot into the throat of a male patient. His goal: remove tissue from his vocal chords to be biopsied.

“There's the lesion there,” he pointed out to a group of a dozen assistants. The FLEX comes with a high-definition monitor for better viewing.

“That's really nice,” responded Dr. Meghan Turner, a fellow in the department of otolaryngology.

The flexibility of the robot's scope and an attached camera allowed Duvvuri to navigate twists and turns of the oral cavity and park at the legion's site. Ports alongside the camera accommodate tools for cutting or grasping tissue, he explained.

“Its flexibility is allowing me to turn corners,” said Duvvuri, who specializes in head and neck cancers. “To be able to circumnavigate the areas and gain access to hard-to-reach areas is a true benefit.”

Krista Kauffman, 19, a student at The Art Institute of Pittsburgh, was intrigued and then excited when doctors explained to her that a robot could be used to remove excess thyroid tissue without the need of a large neck incision.

The condition, called lingual thyroid, caused her to cough frequently and created a feeling that she always had something in her throat.

“They explained that the robot was flexible and it would work much better than having to cut my throat,” she said. “I guess it was pretty cool that a robot was involved.”

Duvvuri, using the robot, removed the excess tissue Dec. 4.

“I feel a lot better,” Kauffman said.

Samuel Straface, CEO of Medrobotics, said surgeons tend to find the robot and accompanying equipment easy to use.

“We're having great response from all the surgeons using it,” he said. “That simplicity is by design, and we're obviously continuously working to make it even better.”

Choset believes Pittsburgh was the perfect setting for the technology because of the region's expertise in robotics at Carnegie Mellon and medicine at the University of Pittsburgh and UPMC.

“It's great, but it's also a little surreal,” he said. “It still doesn't feel real to me. My high point was watching the first procedure.”

He foresees the robots getting smaller and being used for surgeries in other portions of the body.

Duvvuri views the technology as the next wave of surgery.

“I really hope that Pittsburgh will remain the hotbed of activity for this type of technology,” he said. “I believe this concept of flexible robotics is going to be the next revolution in surgical science.”

Ben Schmitt is a Tribune-Review staff writer. Reach him at 412-320-7991 or bschmitt@tribweb.com.

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