Houston-based Dr. Theodoros Voloyiannis was one of six involved in a remote surgery in space demonstration. Photo courtesy of Texas Oncology

A small surgical robot at the International Space Station completed its first surgery demo in zero gravity last week, and one of the surgeons tasked with the remote robotic operations on simulated tissue was Houston-based Dr. Theodoros Voloyiannis.

Voloyiannis took part in what is being referred to as “surgery in space” by being one of the six doctors remotely controlling spaceMIRA — Miniaturized In Vivo Robotic Assistant — that performed several operations on simulated tissue at the lab located in the space station. The surgeons operated remotely from earth in Lincoln, Nebraska. The remote surgeons worked to control the robot's hands to provide tension to the simulated tissue made of rubber bands. They then used the other hand to dissect the elastic tissue with scissors.

“I said during the procedure ‘it was a small rubber band cut, but a great leap for surgery,’“ Voloyiannis tells InnovationMap. “This was a huge milestone for me personally in my career.”

The robot was developed by Virtual Incision Corporation, and made possible through a partnership between NASA and the University of Nebraska. The team of surgeons took part in a demonstration that is considered a common surgical task, as they dissected the correct piece of tissue under pressure.

Latency is the time delay between when the command is sent and the robot receives it, and that was the big challenge the team faced. The delay was about 0.85 of a second according to what the colorectal surgeon who worked on spaceMIRA Dr. Michael Jobst said to CNN. The demo overall was a success according to the team, and posed a new-found adrenaline rush due to the groundbreaking innovation.

“The excitement of the new and the unknown,” Voloyiannis says on the feeling of doing the first operation of its kind. “I never thought I’d be doing something like this when I was in training and in medical school.”

Voloyiannis serves as the chairman of colon and rectal surgery for The US Oncology Network. He was chosen for this experiment due to his experience and expertise performing robotic colorectal surgery. Voloyiannis and the developers are hopeful that this type of technology will soon allow doctors to perform this specialized robotic surgery on patients living in rural areas without a specialized surgeon nearby, military battlefields, as well as regularly in space one day.

“The same concept of remote surgery regularly in space could certainly be entertained,” Voloyiannis says. “When you do things with an absence of gravity and perform a surgery in that environment — of course that changes the way we do things. When you have an absence of gravity with bodily fluids, it is a very hard surgery, but with partial gravity that idea can be entertained.

"Remotely, internet connectivity would have to be considered and you’d have someone remote like me here, while potentially there you’d have someone with less training doing the procedure there guiding the robot," he continues. "It’s quite the concept though.”

The doctors had to account for nearly a second of delay in connectivity. Photo courtesy of Texas Oncology

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Houston doctor wins NIH grant to test virtual reality for ICU delirium

Virtual healing

Think of it like a reverse version of The Matrix. A person wakes up in a hospital bed and gets plugged into a virtual reality game world in order to heal.

While it may sound far-fetched, Dr. Hina Faisal, a Houston Methodist critical care specialist in the Department of Surgery, was recently awarded a $242,000 grant from the National Institute of Health to test the effects of VR games on patients coming out of major surgery in the intensive care unit (ICU).

The five-year study will focus on older patients using mental stimulation techniques to reduce incidences of delirium. The award comes courtesy of the National Institute on Aging K76 Paul B. Beeson Emerging Leaders Career Development Award in Aging.

“As the population of older adults continues to grow, the need for effective, scalable interventions to prevent postoperative complications like delirium is more important than ever,” Faisal said in a news release.

ICU delirium is a serious condition that can lead to major complications and even death. Roughly 87 percent of patients who undergo major surgery involving intubation will experience some form of delirium coming out of anesthesia. Causes can range from infection to drug reactions. While many cases are mild, prolonged ICU delirium may prevent a patient from following medical advice or even cause them to hurt themselves.

Using VR games to treat delirium is a rapidly emerging and exciting branch of medicine. Studies show that VR games can help promote mental activity, memory and cognitive function. However, the full benefits are currently unknown as studies have been hampered by small patient populations.

Faisal believes that half of all ICU delirium cases are preventable through VR treatment. Currently, a general lack of knowledge and resources has been holding back the advancement of the treatment.

Hopefully, the work of Faisal in one of the busiest medical cities in the world can alleviate that problem as she spends the next half-decade plugging patients into games to aid in their healing.

Houston scientists develop breakthrough AI-driven process to design, decode genetic circuits

biotech breakthrough

Researchers at Rice University have developed an innovative process that uses artificial intelligence to better understand complex genetic circuits.

A study, published in the journal Nature, shows how the new technique, known as “Combining Long- and Short-range Sequencing to Investigate Genetic Complexity,” or CLASSIC, can generate and test millions of DNA designs at the same time, which, according to Rice.

The work was led by Rice’s Caleb Bashor, deputy director for the Rice Synthetic Biology Institute and member of the Ken Kennedy Institute. Bashor has been working with Kshitij Rai and Ronan O’Connell, co-first authors on the study, on the CLASSIC for over four years, according to a news release.

“Our work is the first demonstration that you can use AI for designing these circuits,” Bashor said in the release.

Genetic circuits program cells to perform specific functions. Finding the circuit that matches a desired function or performance "can be like looking for a needle in a haystack," Bashor explained. This work looked to find a solution to this long-standing challenge in synthetic biology.

First, the team developed a library of proof-of-concept genetic circuits. It then pooled the circuits and inserted them into human cells. Next, they used long-read and short-read DNA sequencing to create "a master map" that linked each circuit to how it performed.

The data was then used to train AI and machine learning models to analyze circuits and make accurate predictions for how untested circuits might perform.

“We end up with measurements for a lot of the possible designs but not all of them, and that is where building the (machine learning) model comes in,” O’Connell explained in the release. “We use the data to train a model that can understand this landscape and predict things we were not able to generate data on.”

Ultimately, the researchers believe the circuit characterization and AI-driven understanding can speed up synthetic biology, lead to faster development of biotechnology and potentially support more cell-based therapy breakthroughs by shedding new light on how gene circuits behave, according to Rice.

“We think AI/ML-driven design is the future of synthetic biology,” Bashor added in the release. “As we collect more data using CLASSIC, we can train more complex models to make predictions for how to design even more sophisticated and useful cellular biotechnology.”

The team at Rice also worked with Pankaj Mehta’s group in the department of physics at Boston University and Todd Treangen’s group in Rice’s computer science department. Research was supported by the National Institutes of Health, Office of Naval Research, the Robert J. Kleberg Jr. and Helen C. Kleberg Foundation, the American Heart Association, National Library of Medicine, the National Science Foundation, Rice’s Ken Kennedy Institute and the Rice Institute of Synthetic Biology.

James Collins, a biomedical engineer at MIT who helped establish synthetic biology as a field, added that CLASSIC is a new, defining milestone.

“Twenty-five years ago, those early circuits showed that we could program living cells, but they were built one at a time, each requiring months of tuning,” said Collins, who was one of the inventors of the toggle switch. “Bashor and colleagues have now delivered a transformative leap: CLASSIC brings high-throughput engineering to gene circuit design, allowing exploration of combinatorial spaces that were previously out of reach. Their platform doesn’t just accelerate the design-build-test-learn cycle; it redefines its scale, marking a new era of data-driven synthetic biology.”