01-02-2022 | By Robin Mitchell
Recently, a developmental surgical robot designed to operate entirely on its own has successfully performed laparoscopic surgery on four pigs. What challenges do autonomous surgical robots face, what did the new system achieve, and what could this mean for surgery of the future?
If there is one trend that continues to hold, it’s that robots and AI are taking over our jobs. Whether or not this is a good thing is to be determined. What can be said for sure is that the rate at which technology is progressing is far too fast for humanity to cope with.
For a robotic system or AI to perform a job normally done by humans, it has to overcome the challenges faced with that job. For example, delivering goods via roads requires a system to be aware of traffic, understand changes made to the route, and predict if pedestrians are about to run into the road. Such tasks are extremely challenging, and despite the massive amount of progress made, autonomous vehicles are still not ready to be used on roads unsupervised.
Robotic surgeons are another area of interest that researchers are trying to accomplish, and the advantages of a robotic surgeon compared to a human surgeon are numerous. For example, a robotic surgeon would never feel fatigued and thus could perform a 24-hour surgery without flaw. A robotic surgeon would also have far more precision with the use of servos with micrometre precision. Furthermore, a robotic surgeon could have eight limbs that work together, enabling surgeries that even the most skilled surgeons cannot do.
However, making a robotic surgeon comes with a whole range of challenges that make human surgeons far more practical. Firstly, a robotic surgeon needs to be able to recognise what it sees, and this is a major AI vision challenge. It is easy for an AI to tell the difference between a car and a pedestrian, but trying to identify what is the wall of a stomach, where damage to an organ is, or recognise the difference between an artery and vein is unbelievably difficult (considering that they all look the same).
The second challenge is replicating very complex and intricate movements that surgeons are trained to do. Not only does a robotic surgeon need to be able to do these movements, but it may also be required to develop new techniques when faced with a unique situation. Furthermore, these movements need to be controlled and match the natural motion of the human body, which does not remain still.
The third challenge is the speed of work during an emergency. There is no doubt that robotic systems can perform extremely intricate movements, but could the same system be used to perform extremely fast procedures during an emergency? For example, a human surgeon can drop everything safely and quickly focus on a bleeding artery. How would a robotic surgeon even recognise an immediate threat to life, and could it react quickly enough?
Recently, researchers from the US have created a robotic system that can perform operations fully autonomously and has been tested at least four times on live pigs.
The robotic system, called The Smart Tissue Autonomous Robot, is a single-armed robot that uses keyhole surgery which involves a small tube inserted into the body with tools moving in and out of this tube. Such surgery puts less pressure on patients, removes the need to fully open an individual, and can be significantly safer. In the tests performed by STAR, the surgery was performed on pigs and involved connecting two pieces of the intestine.
The researchers noted that this type of surgery is particularly challenging, and the result from STAR was better than those done by trained surgeons. What makes this type of procedure particularly interesting is that even the slightest mistake when stitching two pieces of intestine together can be fatal as leakage from intestines can introduce bacteria into the body.
The robotic system not only has tools for performing a surgical operation it also incorporates fluorescent and 3D imaging to give it a better understanding of the structure of the internal organs. Also incorporated are force sensing modules and submillimetre positioning, allowing the robot to feel resistance from tissue.
There is no doubt that robotic surgeons will become a method for operating on patients in the future, but what remains to be seen is if their access will be restricted. If a robotic surgeon could be developed that provides a cost-effective solution for surgeries, then the cost of medical treatment could be significantly reduced.
This is especially important when considering the expensive nature of procedures and the limited number of surgeons. Furthermore, the use of robotic surgeons would help create a more equal medical service so that all patients receive the industry’s best care, not just those who are wealthy and those who have connections.
Robotic surgery systems are still in their infancy, and they are far from being used in real-life situations. But this robotic system clearly demonstrates that robotic surgeons are not only able to operate on living tissue but do so to a better degree than that of human surgeons.