A surgeon in Panama has successfully removed a blood clot from a stroke patient's brain from more than 200 kilometres away, using a UAE-funded robotic system. Developers say the system proves that the technology can perform delicate procedures remotely.
The patient was treated in Panama City by a doctor operating from Santiago in the country's Veraguas province and has fully recovered.
The Houston company XCath developed the Iris robotic system with backing from Sharjah's Crescent Enterprises, one of the project's founding investors.
Thrombectomies, in which clots are removed to restore blood flow to the brain, are usually performed manually using small surgical tools, but the procedure remains unavailable in many parts of the world. According to XCath chief executive Eduardo Fonseca, fewer than three per cent of people globally have access to it.
“The mechanical thrombectomy is one of the most powerful medical therapies, but only 2.8 per cent of humanity has access to it,” Mr Fonseca said.
Speed is important in treating stroke, as research cited by the surgical team found that 1.9 million brain cells die every minute blood flow remains blocked. Neurosurgeon Dr Vitor Mendes Pereira said the Panama City patient's chances of survival without the procedure would have been slim.
“He was critically ill,” Dr Pereira said. “The chances of survival for him would have been very low. Every minute counts. If you save time, you increase the chances of the patient surviving.”
Mr Fonseca described the operation as "an incredible procedure to prove the power of the technology".
“We’ve proved that we can have the precision necessary to operate within the very delicate intracranial [within the cranium] blood vessels, and proved the robot could be safe and effective in that situation,” he said.
The Iris system guides a small robot through a catheter into the patient's blood vessels, navigating to the blockage site. Dr Pereira controlled the robot remotely using magnified, rotatable live camera footage.
In an operation that lasted about an hour, he removed the obstruction using a small wire device called a stent retriever, and a local team in Panama City closed the entry point. The remote robotic surgery took place in March, but the results have only recently been described.
The operation followed an earlier simulation in May 2024, when Dr Pereira remotely operated on a model located in South Korea while at Abu Dhabi Global Health Week, a test run more than 4,000 miles removed from his own location.
Further remote thrombectomies are planned in the first quarter of 2027 with Dr Pereira in Toronto and the patients about 500 miles away in one case and about 2,500 miles away in another.
Such remote operations widen the area a single surgeon can cover, potentially increasing the number of patients who can have a thrombectomy or making one available faster.
Mr Fonseca, who was Panama’s ambassador to the UAE from 2014 to 2019, said he was pleased to receive support from the Emirates, which he called “a place of visionaries”. Crescent Enterprises were, he said, the technology’s “founding investors”, and their input had been crucial to its development.
The Sharjah organisation has provided financial support since XCath was founded in 2017 and recently co-led a $30 million funding round. The tie-up came about because XCath is based in Houston, Texas, a major centre for medical technology and a location for significant investments by Crescent Enterprises.
The Iris system has not yet received regulatory clearance in any country, though it is on the US Food and Drug Administration's Breakthrough Devices programme, which fast-tracks review for treatments addressing serious conditions. When it is commercially available, the system is expected to be used mainly for in-person procedures, with potential applications extending to aneurysms and certain cardiac conditions
Within the next year, XCath hopes to set up permanent trial sites in cities with no or limited access to them. “Our focus is on ensuring it’s low-cost, to widen access by the thousands, not the hundreds.”
The aim, he added, is to make a robot that costs about one-third the price of one used for laparoscopy, a keyhole surgery procedure in the abdomen used for diagnosis.
Mr Fonseca declined to suggest a price for the Iris robotic system, but one robot used for laparoscopies, the da Vinci 5 from a company called Intuitive Surgical, costs $1.8 million to $2.5 million, according to figures published by the American College of Surgeons.
