Flemish surgeon at the helm of a medical revolution

Summary

With more than 3,000 robot-assisted surgeries behind him, Alex Mottrie is convinced the traditional scalpel will soon become a relic of the past

Domo arigato, Dr Roboto

With the unstoppable train of automation hurtling forward, robots have entered our hospitals’ operating rooms. But don’t worry, Alex Mottrie has them under control.

The 53-year-old doctor (pictured) is considered one of the absolute pioneers in the field of robotic surgery. Together with his team from the OLV Hospital in Aalst, Mottrie, who specialises in urology and nephrology, has completed more than 3,000 robot-assisted surgeries. This means he has spent more time operating with the help of robots than with a traditional scalpel.

When I show up for our interview, Mottrie immediately invites me to attend a surgery. Moments later, dressed in green scrubs and a surgical mask, I find myself hustled into the operating theatre, with no time to prepare myself for the sight of blood and intestines. What’s worse, Mottrie’s speciality is prostate interventions.

But there is not a drop of blood in sight. The patient lying on the operating table is attended to by Da Vinci, a white, tubular robot equipped with four arms and a camera.

Routine matters

I move in for a closer look and watch as the tiny metal tube disappears inside the patient’s stomach – the only way for Da Vinci’s long spidery arms to access the intestines.

But where is Mottrie? I find him again a few metres away from the operating table, perched over a controller that reminds me of microfilm readers of bygone days.

But the surgeon isn’t merely looking at the screen, which displays a magnified image of the inside of the patient’s body. Wrapped around two joysticks, his hands guide the robot’s mechanical claws, as if they were part of an arcade game at an amusement park.

The combination of hyper-accurate incisions and the surgeon’s hands bring collateral damage down to a minimum

- Surgeon Alex Mottrie

“The word ‘robot’ is a misleading term,” says Mottrie, all the while working on the patient. “We prefer the term ‘tele-manipulator’. It is the extension of our eyes and hands. We can see a lot better and our manoeuvres are much more refined.”

For Mottrie this is a routine surgery; he often performs several in a day. The atmosphere is relaxed, and there is no hierarchy on the team. What a change from only a decade ago, when Mottrie’s team was the first in the world to remove a kidney tumour with the help of a robot.

Someone cracks a bad joke. “Dirty words don’t hurt,” says Mottrie, casually snipping away another lymph gland.

Out with the old

Since the early 2000s, when the OLV Hospital was only one of a handful of institutions in the world to perform such surgeries, robots have come and gone, illustrating the fast pace of innovation in this high-tech industry. But if you believe Mottrie’s claims, Flanders is well on its way to becoming the hub of a medical revolution.

Robotic surgery holds many advantages over the traditional practice. One of the absolute strengths of working with a robot is that it recreates the surgeon’s joystick manoeuvres in real time and scales them down by a factor of five. This enables the surgeon to, for example, make a knot inside a blood vessel that’s only millimetres wide.

“Thanks to the robots, the surgeries are much less invasive,” explains Mottrie. “The combination of hyper-accurate incisions and the surgeon’s hands brings collateral damage down to a minimum.”

To avoid disturbing the prostate’s normal functions, like continence and erection, the tumorous cells have to be removed with the highest precision. “You could compare this to keyhole surgery,” says Mottrie, “though performed with a very specialised instrument.”

With a decade of robotic surgeries behind him, Mottrie is convinced that it’s time for the next phase in the revolution – the establishment of a training platform for surgeons of all backgrounds, from urology to heart and brain surgery.

In with the new

“Today’s graduates from university hospitals have only learned to cut and snip with their own hands,” says Mottrie. “That’s because their education and training is still rather traditional. Nowadays, surgeons are allowed to worked with robots without a minute of additional training. It’s a striking fact.”

He compares it to holding a violin for the first time and being asked to play Vivaldi. “It’s illustrative of how far behind our legal and medical frameworks are.”

Mottrie dedicates an increasing amount of time to the expansion of Orsi Academy, a robotic-surgery institute he founded in Melle, East Flanders. His ambition is to transform the institute into a school and research centre for innovative medicine. Two multinationals from the United States have reportedly expressed interest in the project, estimated to cost from €15 to €20 million.

The surgeon also hopes to establish a validation mechanism to guarantee that training in robotic surgery adheres to the highest standards. And he envisions putting Flanders on the map of top medical research. 

“We should aim to become the next Vlerick,” says the surgeon. “Just like the world-renowned business school, only for medicine.” 

Photo: Peter De Schryver