Delivering advanced research projects in pediatric surgery

The Sheikh Zayed Institute for Pediatric Surgical Innovation (SZI) at Children’s National Hospital continues to be a leader in pioneering research that enhances surgical care for children. This academic year, SZI investigators have received substantial recognition through  Advanced Research Projects Agency for Health (ARPA-H) awards, facilitating innovative projects that leverage cutting-edge technologies in pediatric and adult surgery.

Breakthroughs in robotic surgery and imaging

On September 15, 2023, Richard Cha, Ph.D., and his team at OptoSurgical received a $3.5 million award for the project titled Translation of Novel Biliary Tract-specific Contrast Agent to Mediate Successful Image-guided Hepatobiliary Interventions. This initiative aims to advance the development of BL-760, a novel near-infrared contrast agent designed for intraoperative identification of bile ducts. Addressing the critical issue of bile duct injury — a significant risk during hepatobiliary surgeries that affects over one million patients annually — this project will produce the contrast agent under stringent Good Manufacturing Practice (GMP) standards. The team plans to conduct rigorous safety tests in a controlled lab environment (Good Laboratory Practice - GLP) to prepare for Investigational New Drug (IND)-enabling studies, ultimately enhancing patient outcomes and setting new standards in hepatobiliary surgery.

Further advancing the field, the team led by Dr. Cha, in collaboration with Yoseph Kim, M.S.E., secured an additional $3.5 million on September 21, 2023, for the Advanced Imaging Aided Autonomous Robotic Cholecystectomy project. This ARPA-H SBIR Phase II project aims to develop a minimally invasive surgical approach that enhances outcomes in procedures like laparoscopic cholecystectomy through advanced robotic tools and a sophisticated vision framework. The project seeks to integrate supervised autonomy into the novel robotic platform, thereby improving the safety and efficiency of gallbladder removal surgery, which is critical in reducing complications and increasing the reproducibility of surgical outcomes.

Support for innovative spinoffs

The impact of SZI’s research is not limited to academic pursuits; it also extends to entrepreneurial efforts. On September 15, 2023, the spinoff company founded by Raj Shekhar, AusculTech Dx, received $3.5 million for its innovative project StrepApp: Deep Learning to Diagnose Streptococcal Pharyngitis, aimed at enhancing pediatric healthcare through advanced diagnostic solutions.

This Phase II project is for the advancement of diagnostic capabilities for detecting Group A Streptococcus (GAS) pharyngitis . The goals under the contract include a comprehensive and diverse database, multiple trained and optimized deep learning models deployable on a mobile device, FDA clearance for the algorithms and the validation of the app’s performance through clinical research. These achievements will establish the foundation for a reliable, accurate and user-friendly diagnostic tool that can effectively detect GAS pharyngitis in children.

That two SZI-affiliated projects were awarded contracts on the same day, highlights the dual emphasis on innovation and practical application that characterizes the work at the Sheikh Zayed Institute.

A year of collaboration and innovation

Looking ahead, Kevin Cleary, Ph.D., was awarded $1 million on April 15, 2024, for a one-year project titled Supervised Autonomous Robotics Renal Tumor Surgery (SARRTS). This initiative is aims to demonstrate a supervised autonomous kidney resection, propelling us towards a future state where a general surgeon could supervise a resection robot in a rural hospital, and patients would no longer have to travel to major oncology centers for the best outcomes. Using a CT scan of the area registered to the 3D point cloud generated by the robot’s RGB-Depth camera, the robot plans and executes the incision and resection. While the robot generates the surgical plan, the surgeon approves the surgical plan and can stop, adjust and replan the surgery at any time. The surgery will be tested and demonstrated in realistic kidney phantoms created for the project. The intent is to demonstrate the feasibility of a supervised autonomous tumor resection and to develop enabling technologies that facilitate the advancement and generalization of this autonomous tumor resection system and other autonomous robotic surgery capabilities.

These ARPA-H awards not only showcase the groundbreaking work of the Sheikh Zayed Institute’s investigators but also underline the institution’s ongoing mission to transform pediatric surgical care through innovation and collaboration. As these projects progress, they have the potential to reshape the landscape of pediatric surgery, ensuring safer and more effective treatments for children in need.