to the busted pipe? That’s the concept we’re trying to put forward with flexible robots.” DuvvuriisusingtheFlex® RoboticSystem,developedbyCarnegieMellon University and its spinoff company, Medrobotics Corp. As an engineer, head-and-neck surgeon and medical director of Pittsburgh CREATES, he helped modify the Flex® robot forFDA-approved applications for surgeries on eyes, ears and nose. Now, he is working to modify the probe for a longer tripintotheesophagus.Intheoperatingroom,Duvvurioftencollaborates with surgeons who specialize in esophageal procedures, and for this new roboticfrontier,heisworkingwithaspecialist,Dr.InderpalSarkaria,director of Robotics Thoracic Surgery at UPMC. The Flex® robot is designed to be pliable yet rigid, making it ideal for thistypeofnoninvasivesurgery.“It’slikeasnake,”saysSarkaria.“Wehope these robots will enable us to do a better and more technically precise job and offer minimally invasive approaches to more patients.” The technology may completely change the way a surgeon goes about removing a tumor from the esophagus. Instead of standing over a patient andreachingintothechestcavitywiththeirownhands,surgeonswillstand awayfromtheoperatingtableanduseajoystickonaconsoletocontrolthe movement of the probe. “You can open and close your fingers like a pincer andgrabsomethingandpullitup,”saysDuvvuri,demonstratingtheprocess. “Movements of the joystick can translate into precise movements of the instrument inside the body, but like driving a car, proficiency requires practice,” says Max A. Fedor, executive director of Pittsburgh CREATES. Dr.EugeneMyers,formerchairmanofthedepartmentofotolaryngology attheUniversityofPittsburghSchoolofMedicineandfounderoftheMyers FamilyFoundationFundatThePittsburghFoundation,saysthatduringhis 40-year career, he has always searched for promising surgical innovations. Now,byteamingupwithThePittsburghFoundation,heishelpingtofund the next generation of technology. “We can do a lot with the Flex® robot as far as minimizing the extent of surgery procedures,” says Myers, who also volunteers at Pittsburgh CREATES. Once Duvvuri completes the next step in the process — working with a manufacturer to fine-tune the shape of the robotic arm so it reaches the esophagus — he will move on to testing the procedure on cadavers before seeking FDA approval. Kelly Uranker, director of the Foundation’s Center for Philanthropy, says the promising new surgical research fits with theFoundation’sphilosophyoffundinginnovations developed in the field. “Ideas can come from every- where. It’s not top down. Pittsburgh CREATES puts engineersandresearcherstogethersothatlife-saving tools and techniques get to the market quicker.” In addition, working with industry leads to solutions that are cost-effective. As Fedor puts it, “While we are saving lives and reducing morbidity, we are also saving costs and time.” ▪ LESSON LEARNED Whilethetechnologies are innovative and beingdevelopedand adapted,the main drawback istime. The processfromthe idea to appliedreality can take many years. Thisinnovate-as-you-go model expedites that process. 26 ENGINEERING A CURE