ENvue Medical Unveils New Robotic System for Feeding Tube Placement

ENvue Drive illustrates the process of inserting a feeding tube into a patient. | Source: ENvue Medical

ENvue Medical Inc. recently introduced ENvue Drive, a robot-assisted tool that automates the insertion of feeding tubes. Built upon the company’s FDA-approved electromagnetic navigation platform, this system integrates artificial intelligence, real-time navigation capabilities, and robotic assistance into a cohesive clinical workflow.

Each year, more than one million feeding tubes are inserted into patients in the United States. “These procedures are performed on critical care patients, including elderly adults, general adult patients, as well as pediatric patients and pre-term infants,” explained Dr. Doron Besser, CEO of ENvue Medical, in an interview with The Robot Report.

Most commonly, feeding tubes are inserted manually by clinicians who rely on their experience and any resistance they feel during the procedure to ensure proper placement.

Besser noted that while these procedures are always ordered by a doctor, they can also be carried out by nurses and dietitians.

“Approximately 3% to 5% of these procedures result in the tube being placed in the wrong location, specifically within the lungs,” he said. “When this happens, it can trigger a series of serious complications, such as lung collapse. In some cases, the feeding tube remains inside the lungs, causing fluid and nutrients to accumulate there.”

Besser emphasized that the core objective behind ENvue’s system is to enhance patient safety, simplify the workflow for clinicians, and reduce costs for hospitals.

How does ENvue Drive function?

ENvue Drive is developed using its FDA-approved ENvue Navigation Platform. This platform is currently deployed in hospitals across the United States to provide real-time electromagnetic guidance during enteral feeding tube placement. ENvue Drive builds upon this by employing a robot to perform the actual insertion of the feeding tube.

The system includes a sensor mounted at the end of the feeding tube, which gives physicians clear visibility as the tube is inserted. It also incorporates the company’s AI navigation software, Ask Oscar.

“When the feeding tube with this sensor enters the field of electromagnetic waves that cover the patient’s chest and abdomen, it aligns properly,” Besser explained. “Once aligned, the system becomes active, and no matter how the tube moves — in any direction within a 360º range — its position is calculated and displayed on the screen in real time.”

Besser added that ENvue developed this sensor internally. “A critical requirement for electromagnetic navigation systems is that their sensors must have an extremely high refresh rate,” he said. “Our sensor updates approximately 40 times per second. This high frequency is essential because clinicians need immediate feedback on screen to avoid any delay during insertion.”

Once inside the patient, the system allows movement in five degrees of freedom, providing clinicians with greater flexibility throughout the procedure.

“Our system provides steering guidance, meaning clinicians can always determine the direction the feeding tube is pointing,” Besser said. “This functionality acts like a GPS system, similar to Google Maps or Waze, offering real-time direction assistance.”

ENvue addresses patient movement during procedures

In its latest demonstration, ENvue showed that its system can identify anatomical pathways, detect deviations in the tube’s trajectory, provide corrective guidance, and assist in moving the tube to the target position in the small intestine — all under clinician oversight.

Feeding tube insertion presents several unique challenges, one of the most significant being the unpredictable movement of patients themselves.

“Even heavily sedated or mechanically ventilated patients may move during the procedure,” Besser said. “Nurses must focus on calming the patient while attempting to insert the feeding tube.”

To counter this issue, ENvue utilizes additional ECG sensors placed on the patient’s body. “If the patient moves, becomes upright, or becomes slightly agitated during the procedure, the system maintains its accuracy,” Besser explained.

Clinicians retain full control throughout the procedure

When developing ENvue Drive, Besser said the team focused on creating a user-friendly tool with straightforward instructions.

“Nurses and dietitians are under immense pressure,” he noted. “They are often fatigued, and staffing shortages are common. We want to support them by providing step-by-step guidance for performing these procedures.”

During the procedure, if the system detects that the tube is approaching an incorrect location, it alerts the clinician and offers suggestions on how to proceed. The person performing the procedure remains in full control and makes the final decisions about what to do next.

“We do not want robots to replace clinicians,” Besser said. “Our goal is for the robotic arm to assist, increase confidence among practitioners, and streamline procedures, while ensuring that highly skilled clinicians retain ultimate control of the system.”

ENvue aims to expand robotics use to more bedside procedures

Besser stated that many healthcare robotics initiatives have initially focused on complex surgeries performed in operating rooms, such as orthopedic or spinal operations. However, simpler bedside procedures are far more common, and as production costs for robotics decline, these procedures are becoming increasingly suitable for automation.

“The first step in this development will likely be internal feeding tube placement, followed by vascular access, particularly the insertion of peripherally inserted central catheters,” Besser said. Millions of such catheters are inserted into patients’ arms each year, and their precise positioning is essential for administering medications effectively.

By integrating chest X-rays into its system, ENvue aims to develop a robot capable of automating these procedures as well.

The core technology behind ENvue Drive has already received FDA approval under the 510(k) designation. ENvue plans to pursue additional regulatory approvals for this system in the coming years.