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An Australian medtech start-up has completed the world’s first fully remote robotic surgical procedures, marking a breakthrough that could transform healthcare access for millions living in rural and remote areas.
Remedy Robotics, founded by Perth-born cardiac surgeon David Bell, successfully performed multiple neurointervention procedures in Toronto via surgeons controlling robotic catheters from a distance – a feat that has eluded the surgical robotics industry for nearly three decades.
The San Francisco-headquartered company is now partnering with the Australian Stroke Alliance to bring the technology home. It plans trials in which stroke patients in Darwin and Alice Springs would be treated remotely by specialists potentially thousands of kilometres away.
Remedy Robotics chief executive David Bell.Credit: Remedy Robotics.
“Australia has a unique geography,” Bell said in an interview. “The idea is that Pete in Alice Springs or Lucy in Tennant Creek had the exact same outcome as whoever is at the Royal Melbourne.”
The company’s N1 System mounts custom-built catheters to a surgical robot controlled by proprietary software, allowing physicians to perform cardiovascular interventions from anywhere with a good internet connection. Advanced machine learning handles the delicate task of navigating what Bell described as “really, really fine, floppy tools in the brain at such a long distance”.
Patients will still need to attend a hospital with a catheter laboratory, the type used for cardiac procedures, where a local doctor inserts a catheter into the groin artery. The remote specialist then takes over, controlling the robotic system to navigate the catheter through blood vessels to the brain and remove a clot.
Bell says his lightbulb moment came during his MBA at Stanford, where he was surrounded by engineers obsessing over self-driving cars. “I kind of got to thinking, ‘if you can teach a car to drive around the streets of San Francisco, surely you can teach a catheter to move through the human blood vessels, and in doing so, radically expand access to care’,” he said.
The Remedy Robotics tech in action.Credit: Remedy Robotics
The insight led him to hunt down his co-founder Jake Sganga, a robotics PhD student, after convincing a professor to introduce him. “I bugged the robotics professor and said, ‘Give me your smartest graduating PhD student; let me go chat with him’,” Bell said. “I think he thought I was crazy, but I won him over.”
Remote operation of surgical robots has long been the industry’s holy grail. Market leader Intuitive Surgical, now NASDAQ-listed, began with similar aspirations, but technical challenges over nearly 30 years made it impractical to deliver.
Remedy has cracked it by building a full-stack solution, the hardware and software, to control everything from latency to the streaming of medical images. The company holds 45 patents on the system.
The breakthrough is particularly significant for stroke treatment. Endovascular thrombectomy, where doctors thread catheters through arteries to remove blood clots from the brain, is considered the gold standard for stroke emergencies. But the procedure is so complex it is available only at specialist hospitals in big cities.
Surgeons at the University of Toronto after completing the successful world-first procedure.Credit: Remedy Robotics
For the 445,000 stroke survivors in Australia, a figure expected to more than double by 2050, geography can be deadly. The economic cost of strokes alone is estimated at over $32 billion annually.
Australian Stroke Alliance co-chair Professor Stephen Davis said the technology addressed a critical gap in care. Currently, Darwin stroke patients must be transferred 3000 kilometres to Adelaide for treatment.
“Remote indigenous communities virtually can’t access this modern treatment because of the time barrier,” Davis said. “This new technique allows the doctor in Darwin to put the catheter into the groin artery, and then the remote expert can do the rest.”
The technology will be validated through trials led by Professor Bernard Yan from the Royal Melbourne Hospital and Professor Hal Rice in Queensland. Initial procedures will be backed up by on-site specialists.
“We believe it’s possible, but it requires high-quality research to validate the technique,” Davis said. “In the first instance, we’ll be performing these studies with a back-up expert neurointerventionist at the rural centre, so that if the technique doesn’t work remotely, there’s someone on site who can do it.”
Blackbird Ventures partners Phoebe Harrop, Tom Humphrey and Michael Tolo.Credit: Blackbird
Remedy Robotics’ 18-person team,15 of whom are technical, is now raising funds in the US to pursue Food and Drug Administration approval for local use while simultaneously planning Australian trials for remote stroke treatment. Bell declined to specify the funding target, but he said the company was “relatively close to closing” the round.
Blackbird Ventures, which backed Remedy alongside US firm DCVC and Tony Fadell’s Build Collective, sees the surgery milestone as validation of the company’s ambitious vision.
“Remedy Robotics is pushing the boundaries of what’s possible in modern medicine,” said Blackbird partner Michael Tolo. “The team’s ability to combine cutting-edge robotics, advanced machine learning, and real-time imaging to enable remote cardiovascular intervention is nothing short of transformative.”
The company has published academic articles on remote robotic neurointervention in leading journals and serves as the exclusive robotic partner of Mission Thrombectomy, a global stroke initiative.
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Bell, who spent eight years as a doctor including cardiac surgery training in Sydney and air retrieval work across the South Pacific, said he never really loved medicine despite his family’s medical dynasty.
“I’m a creative person – like a frustrated engineer,” Bell said. “What I find crazy is that we would tolerate that where someone lives should affect their access to healthcare.”
While some might see fully autonomous surgery in the future, Bell suspects “a doctor will be involved for a very long time to come, even if they’re just sitting back watching nothing goes wrong”.
Patient response to the world-first procedures has been enthusiastically positive. “The response so far has been very, very good,” Bell said. “I think patients see the upside of the technology.”
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