The robot will see you now. For the first time, a robot has successfully operated on live soft tissue without human assistance. The surgeons who developed the robot hope that in two or three years it will be ready to perform routine surgeries, such as removing an inflamed appendix or blocked gall bladder.
鈥淚t鈥檚 a proof of concept to show it can be done,鈥� says Peter Kim at the Children鈥檚 National Medical Center in Washington DC. 鈥淲e鈥檝e shown a robot can do soft-tissue surgery, that it can be done autonomously, and that the outcome is better than that of a real surgeon.鈥�
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Operating on the bowel and internal organs is tricky because soft tissues move and slide around, making it hard for a robot to keep track of where things are. But Kim鈥檚 team have overcome this by giving their Smart Tissue Autonomous Robot (STAR) a 3D camera and the ability to see near-infrared wavelengths. 鈥淭he robot can see more than humans can,鈥� says Kim.
When the team placed fluorescent tags on the surface of pig guts, their robot was able to use near-infrared light to precisely home in on its target by monitoring the positions of these tags. That meant it could 聽stitch together tissue that had been surgically cut 鈥� a common procedure during operations.
[youtube]https://www.youtube.com/watch?v=XYYKpRw4W1A[/youtube]
After the robot had got to work on four pigs, the team compared its handiwork with that of a real surgeon as well as the da Vinci robotic system, which is 聽controlled directly by a surgeon.
They say their robot performed better on several measures, including spacing the sutures more evenly, and repairing the guts in such a way that they were less likely to leak.
鈥淭he risk of a patient dying after an operation goes up by five to 10-fold if the gut leaks, so this could potentially prevent complications,鈥� says Kim.
Robotic team mate
But STAR was slower, taking an average of 50 minutes to complete a task a surgeon would wrap up in a mere 8 minutes. Kim says they hope to improve on this.
Although the robot is capable of stitching up wounds with no human assistance, it is intended to work with surgeons rather than replace them. The idea is that humans will supervise the robot, and will intervene if something goes wrong. 鈥淭he surgeon is just a finger-press away from stopping the robot,鈥� says Kim.
The team now plans to develop their robot for testing in patients, targeting relatively simple but common procedures such as gall bladder and appendectomies.
鈥淚鈥檓 a fan of robotics in surgery, and this is a careful step in the right direction,鈥� says Shafi Ahmed at the Royal London Hospital. 鈥淯ltimately, robots will come in, and working with them could become part and parcel of being a surgeon,鈥� he says.
Not everyone is convinced we are ready for robotic surgical approaches. 鈥淲e鈥檝e seen a rush to adopt new technologies before they鈥檙e thoroughly proven,鈥� says at the University of South Florida in Tampa. 鈥淲hile I certainly look forward to further research in this field, for now I will focus on surgical approaches that I know work best for my patients.鈥�
Journal reference: Science Translational Medicine, DOI:聽
