II- From Idea to Prototype: The Genesis of Luca® , A Unique Robot for Retinal Surgery

An Ambitious Dream Facing a Medical Challenge

It all started in 2016. Christoph Spuhler, an expert in surgical robotics, discovered the challenges of retinal surgery. Working on structures just a few microns in size, where every gesture counts, seemed to him one of the last technological frontiers in surgery [Read article]. Why has no robot been designed yet to assist these surgeons? The idea took shape: Luca® would be the first robot dedicated to retinal surgery. Far from being just a concept, this project was born from a strong conviction: robotics can bring unparalleled precision, reduce surgeon fatigue, and enable safer procedures. But before reaching that point, significant challenges had to be overcome.

A Technological Feat: Piloting Precision to the Micron

Developing a robot for the retina imposes a fundamental constraint: achieving precision to the micron, far beyond what the human hand can accomplish. From the outset, the team had to design algorithms capable of coordinating micro-movements with absolute fluidity. This challenge is compounded by the complexity of the field, with the retina being just 0.2 mm thick and requiring instruments sometimes measuring less than 0.5 mm. 

"The algorithms to pilot the robot are very complex and must work flawlessly to coordinate the entire action chain. Fortunately, we have a very strong robotics team that made this possible." — Christoph Spuhler, Co-founder of AcuSurgical

Luca® relies on an evolving software platform, incorporating cutting-edge technologies such as real-time 3D imaging, force-sensing assistance for retinal tissue handling, to optimize surgical procedures. This innovative approach aims to increase surgical precision, reduce variability due to the surgeon's learning curve, and improve patient safety.

A Rapid Development: From Idea to Prototype

Luca® didn’t remain a mere project on paper for long. In just two years, the team went from the initial concept to a functional prototype:

• May 2018: First sketches and simulations

• February 2019: First operational prototype

• 2020: First animal testing

"We started working on the first prototype in May 2018, and by February 2019, we had a functional model. Less than a year later, in 2020, we carried out our first animal tests, successfully operating on four rabbits." — Christoph Spuhler

With limited resources, the team adopted a frugal and pragmatic approach, focusing on what mattered most.

Animal Testing: A Crucial Step

During the first animal tests, four rabbits were operated on in a controlled environment in Saint-Étienne. These preclinical trials were essential to validate the robot’s ability to perform surgical gestures with extreme precision, required for retinal surgery. The tests confirmed that Luca® could handle microscopic instruments with great accuracy, simulate retinal interventions, and control movements with a fluidity that surpassed human capabilities.

It was a decisive step in refining the system in real-world conditions. But even in this controlled environment, unforeseen challenges arose. Pierre-Antoine recalls the morning well: "It was 8:00 AM, the surgeons were due at 8:30, and we realized that the manometer was defective and had emptied the compressed air bottle in the room. We couldn’t operate the vitrector... Christoph’s immediate reaction was 'Oh no, now the room is full of air...'. No stress, everyone was laughing. An hour later, we had found a solution, and the tests could proceed with just one hour's delay... An engineering team always has solutions; it’s even what drives them... Everything ended with plates of pasta with clams, truffles, and oysters. Always an opportunity to celebrate!" — Pierre-Antoine Forest, Marketing Director at AcuSurgical.

This anecdote perfectly illustrates AcuSurgical's mindset: a pragmatic and resilient approach. For Christoph, these challenges are part of the innovation process: "Constraints force us to rethink our choices and find effective solutions quickly. That day, we improvised, but that’s also what drives a project like ours forward." — Christoph Spuhler

Thanks to this determination, the team was able to continue testing without major delays and gather valuable feedback from surgeons.

A Prototype That Surprised Surgeons

Luca® was not only a technical achievement; it also had to convince its future users. When the first surgeons finally saw the prototype, their reaction was immediate: enthusiasm. Many expected to see a rudimentary device still in development, but instead, they discovered a highly advanced system. "The first surgeons thought they would find a prototype full of wires, but they found something that already looked like a finished product." — Pierre-Antoine Forest.

For Christoph, this reaction was crucial, as it validated the work done: "We designed Luca® with a clear vision of its ergonomics and compatibility with existing surgical practices. Seeing surgeons immediately comfortable with the system confirmed we were on the right track." — Christoph Spuhler.

This milestone also highlighted the effectiveness of the work done in advance. Instead of following a standardized development approach, the team optimized the design in collaboration with practitioners from the earliest stages, ensuring the robot’s natural integration into the operating room.

A Cohesive Team Behind Luca®

AcuSurgical would be nothing without the talents that shaped it. From the beginning, Christoph surrounded himself with complementary experts:

"The people helping us on our journey over the years have been too many to count. I co-founded the company with two robotics professors (Philippe Poignet, Yassine Haddab) and two retinal surgeons (Philippe Gain and Gilles Thuret), who were key elements in the success of the project. The same applies to the early members of the team, who had a significant impact on the company’s success." — Christoph Spuhler

This collaborative model creates a unique dynamic, where everyone is committed to the success of the project.

From Idea to a Revolution in the Making

Luca® is not just a technological feat. It embodies an audacious vision, agile execution, and a passionate team. In just a few years, AcuSurgical has managed to transform a concept into a tangible tool that could redefine retinal surgery.