From internship project to the European market: LUMC device allows surgeons to detect tumors more precisely

25 February 2021• NEWSITEM

The DROP-IN gamma probe technology developed at the LUMC has received CE certification. This means that hospitals throughout Europe can use the device. The probe improves the detection of tumors during operation procedures with a surgical robot. The technology is currently being commercialized by Crystal Photonics. What started off as an internship project has turned into a product that has reached the market. What did this process look like?

Matthias van Oosterom, a postdoc in the Department of Radiology, began his internship at the LUMC in 2014 with the Interventional Molecular Imaging group. His project entailed developing a device that would enable better detection of prostate tumors during image-guided surgery. “During image-guided operations, such as radio-guided surgery, patients are first administered a tracer that goes into the tumor. With a probe that detects the tracer, the surgeon know when the tracer is near the tumor, allowing the precise removal of tumor tissue”, explains Van Oosterom.

Frustration for surgeons

Within the field of urology, using surgical robots for laparoscopic procedures is common practice. “For this type of surgery, the traditional tracing gamma probe cannot be used properly because it consists of a rigid rod”, says Van Oosterom. “The probe’s movement capacity becomes limited because it enters the abdomen through a small hole. In addition, the surgeon cannot use the probe with the robot and requires further help of an assistant.” This is a true frustration for surgeons, which called for a solution. 

An LUMC production

Van Oosterom decided to take his ideas to the LUMC’s internal workshop, the Instrumental Development Department that is part of the Facility Management Department. Various electronic and mechanical instruments needed at the LUMC are produced and tested in the basement of the research building. “Our department helps LUMC staff develop unique medical devices and experimental setups”, says Jerry van der Ploeg, department head. 

“With the help of the workshop, we began designing prototypes with a 3D printer”, says Van Oosterom. These new prototypes were then tested ''dry'' by the surgeons. Subsequent prototypes were also tested on patient tissue.

In the corner of the surgery room

Once Van Oosterom completed his internship, he initiated a PhD but also continued to work on his internship assignment. In order to create an optimal product, taking into account the experience of surgeons was essential. “The advantage is that we developed this product in cooperation with instrument makers and surgeons. We would stand in the corner of surgery rooms and could immediately conclude what worked for the surgeon and what didn’t work.”

After several years of hard work, the final version of the DROP-IN gamma probe was assembled. “This probe is small and attached to a flexible cable. It is lowered into the body through a small incision, hence the name ‘drop-in’. The surgeon can then pick up the probe with their robotic instruments and start looking for the tumor”, describes van Oosterom, to which Van der Ploeg adds: “The probe is much more maneuverable and made so that it fits perfectly into the instruments of the surgical robot. In other words, it is much more user-friendly.” 

To the market

The first patient with prostate cancer received surgery with the probe in 2018, and the present count is at 40 patients. Now that the LUMC product has received the CE certification for the product, that number will increase even more, as it also enables other hospitals to use the probe. Since the obtention of the certification is time-consuming and costly, LUMC researchers partnered with an industrial partner that had vast experience with this technology. “By working together with a company, we can achieve greater steps towards product commercialization” says Van Oosterom. “In addition, this product creates a new market for them. So we complement each other nicely”, explains Van der Ploeg. 

A LUMC collaboration

The entire process took almost six years to complete. According to Van Oosterom, “It is very nice to see that all the work - and in a sense my internship project – has now been rewarded with the CE certification.” Van der Ploeg also expresses his enthusiasm: “Not only is it nice to witness the passion of a researcher during such a process, but also thinking along with the doctors or researchers and establishing new collaborations within the LUMC is of extreme value. It was truly a multidisciplinary LUMC team effort. There were also students from the Leiden Instrumentation School involved, which promotes regional cooperation with educational institutions.”

More study fields

The DROP-IN gamma probe has advanced image-guided surgery, making it possible for a surgical robot to perform radio-guided surgery. At present, the product has only been used for the purpose of prostate cancer. “I expect that this technique can also be used within other specialties, such as gynecology. I look forward to seeing which way ‘our’ probe will go after the CE certification”, says van Oosterom. 

All activities within the Interventional Molecular Imaging-Laboratory revolve around developing innovative technologies that ‘make the invisible visible’ and thus facilitate new forms of (molecular) image-guided therapy. In these efforts, there is a particular focus on creating a seamless transition between the  diagnostic imaging performed at Radiology and the image guidance required for precision surgery. Ultimately leading to improved treatment accuracy with minimal side effects.

This project was funded by the Dutch Research Council (NWO) within the domain of Applied and Engineering Sciences.

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