The Kepler Intubation System (KIS), the first intubation robot operated by remote control, may facilitate the intubation procedure and reduce some complications associated with airway management. Developed by Dr. Thomas M. Hemmerling, a McGill University Health Centre (MUHC) specialist and McGill University Professor of Anesthesia and his team, the prototype KIS was used for the first time at Montreal General Hospital earlier this month.
“The KIS allows us to operate a robotically mounted video-laryngoscope using a joystick from a remote workstation,” says Dr. Hemmerling who is also a neuroscience researcher at the Research Institute of the MUHC. “This robotic system enables the anesthesiologist to insert an endotracheal tube safely into the patient’s trachea with precision.”
The insertion of an endotracheal tube allows artificial ventilation, which is used in almost all cases of general anesthesia. Correct insertion of this tube into patients’ airways is a complex maneuver that requires considerable experience and practice to master. “Difficulties arise because of patient characteristics, but there is no doubt that there are also differences in individual airway management skills that can influence the performance of safe airway management,” says Dr. Hemmerling. “These influences may be greatly reduced when the KIS is used.”
After successfully performing tests in the airways of medical simulation mannequins, which closely resemble intubation conditions in humans, clinical testing in patients has now begun.
Future work on the prototype device will focus on providing tactile feedback, so that the operator develops a “feel” for what is happening and thus accelerates thelearning curve. Dr. Hemmerling and his team would also like to automate more of the intubation process with KIS; ideally, once inserted into the patient’s mouth, KIS would, without human guidance, independently move the endotracheal tube into correct position into the patient’s trachea.