First robotic tracheal intubations in humans using the Kepler intubation system

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Abstract
Intubation is one of the most important anaesthetic skills. We developed a robotic intubation system (Kepler intubation system, KIS) for oral tracheal intubation. In this pilot study, 12 patients were enrolled after approval of the local Ethics board and written informed consent. The KIS consists of four main components: a ThrustMaster T.Flight Hotas X joystick (Guillemot Inc., New York, NY, USA), a JACO robotic arm (Kinova Rehab, Montreal, QC, Canada), a Pentax AWS video laryngoscope (Ambu A/S, Ballerup, Denmark), and a software control system. The joystick allows simulation of the wrist or arm movements of a human operator. The success rate of intubation and intubation times were measured. Eleven men and one woman aged 66 yr were included in this study. Intubation was successful in all but one patient using KIS at a total time of [median (inter-quartile range; range)] 93 (87, 109; 76, 153) s; in one patient, fogging of the video laryngoscope prevented intubation using KIS. We present the first human testing of a robotic intubation system for oral tracheal intubation. The success rate was high at 91%. Future studies are needed to assess the performance and safety of such a system.

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