In interventional radiology, as the robotic tools of the trade get smaller, the accomplishments grow greater.
In the procedure rooms of Miami Cardiac & Vascular Institute on the Baptist Hospital campus, Ripal Gandhi, M.D., is pioneering the use of robotic instruments in minimally invasive, endovascular treatments for cancer patients.
He recently performed the world’s first chemoembolization, followed by the world’s first radioembolization, using a newly created, FDA-approved robotic eKit, which enables robotic control of microcatheters. A microcatheter fits inside an already tiny robotic catheter, a tube so small it can be guided through a blood vessel to deliver cancer-fighting agents directly to the liver, kidney and other organs.
Dr. Gandhi sat at a remote console controlling the delicate movement of the robotic instruments inside the patient’s blood vessels. For the radioembolization procedure, Dr. Gandhi delivered millions of microscopic radioactive beads into the cancer lesions that had recurred in the liver of Nayda Pintado, 54 (pictured above). The procedure aims to kill the cancer and also cut off its blood supply. It’s an option for patients whose cancer isn’t traditionally operable or for those with stage four cancer that has spread to distant organs.
Precision, Control and Flexibility
With the interventional radiologist in control at the remote console, the robotic catheter and microcatheter allow greater precision, control and flexibility, and may reduce the time it takes to complete the procedure. In addition, the comfortable, ergonomic workstation reduces physician fatigue and radiation exposure.
The new device enabling robotic control of microcatheters also gives Dr. Gandhi better access and more versatility. “You can’t get into the smaller arteries with the larger robotic catheters,” said Dr. Gandhi, an associate professor at Florida International University’s Herbert Wertheim College of Medicine. “Now with the microcatheter driver, you can drive the smaller microcatheter exactly where you want it to be and then deliver the therapy.”
Ms. Pintado, who has had extensive cancer treatment at Baptist Hospital since her stage four breast cancer was diagnosed in late 2013, was pleased to take part in a groundbreaking procedure. “It’s been a great opportunity for me and for everybody who can take advantage of it after me,” she said. “The procedure went very well and I recovered very fast and had no pain.”
Ms. Pintado’s cancer already had spread to her liver when she was diagnosed. Her treatment has included a double mastectomy and an operation to remove 40 percent of her liver. When the cancer came back again, she was sent to Dr. Gandhi, who has performed several endovascular procedures, including chemoembolization and radioembolization, to treat the metastatic lesions in her liver.
“Baptist Hospital has been a great blessing for me,” Ms. Pintado said. “I’m in the hands of wonderful doctors.”