Keith M. Sterling, MD, is chief of cardiovascular and interventional radiology at Inova Alexandria Hospital and an associate professor of radiology at George Washington University School of Medicine. He is board certified in diagnostic, vascular and interventional radiology and has particular clinical interest in peripheral vascular disease, pulmonary embolism, acute stroke and women’s intervention. Read Dr. Sterling’s profile.
Recently, I became the first physician in the United States to use a new, completely robotic system to treat uterine fibroids, noncancerous growths in the uterus.
This exciting new system promises to have benefits for treating a variety of medical conditions, from head to toe.
What is Interventional Radiology?
As an interventional radiologist, I specialize in performing minimally invasive procedures using X-rays, CT scans and ultrasounds to guide me. Typically, this involves threading tiny tubes, or catheters, into blood vessels to reach tumors or blood clots.
To treat uterine fibroids, we can perform a procedure called uterine fibroid embolization (UFE). In this procedure, we insert a thin hollow tube called a catheter into the main blood vessel at the top of the thigh. Then we thread the catheter through the vessel into the main artery, or blood vessel, that carries blood to the uterus.
Once we reach our target, we inject tiny beads to block blood flow to the growths. Without blood to feed them, the fibroids shrink and die.
Traditional treatments for fibroids include myomectomy (surgery to remove the growths) or hysterectomy (surgery to remove the entire uterus). With UFE, we can use catheters, along with X-rays and other imaging technologies, to avoid open surgery altogether. The minimally invasive UFE procedure involves an incision just 1 to 2 millimeters long.
The Magellan™ Robotic System
About two years ago, Inova Alexandria Hospital became the first hospital in the Washington, D.C. metropolitan region to begin using a robotic system called Magellan™ to perform these catheter-based procedures. Instead of inserting the catheters manually, Magellan™ allows us to guide the catheters into place using a robotic arm.
The system is a great advance. The robot is extremely stable, allowing us to navigate blood vessels with ease.
The system is also very flexible. In manual procedures, we might need to use a number of different catheters, depending on the size and shape of the blood vessels we’re passing through. But the Magellan™ robotic system allows the use of a single, moldable catheter that can change shape as needed to pass through each unique vessel.
By using a single catheter to get the job done, there is less variability, and we can complete the procedure in much less time. That’s important, since we use X-rays to guide us. We want to minimize the amount of radiation we expose a patient to, so the more efficiently we can complete the procedure, the better.
A Fully Robotic System
The Magellan™ provides a lot of benefits, but until recently, we’ve had to complete the last step of the procedure manually, using our hands to insert a smaller “microcatheter” to deliver the vessel-blocking beads. But this past February, we treated fibroids with a robotic microcatheter, making it the first fully robotic UFE treatment in the country.
The procedure went very well, and we were able to cut off blood flow to the fibroids efficiently and safely.
We expect to use this fully robotic system to treat a variety of medical conditions beyond fibroids. We perform microcatheter procedures to treat enlarged prostate glands, cancerous tumors in the liver and even to break up blood clots in the brain caused by stroke.
At Inova Alexandria Hospital, we pride ourselves on offering patients the newest, most advanced medical technology. This robotic system is an exciting new addition to our toolkit.