While companies, such as Intuitive Surgical Inc., are utilizing robots in the operating room to assist with surgery, researchers from Johns Hopkins University and the Children’s National Health System have developed a robotic surgeon that recently performed a soft-tissue surgery with limited guidance from humans.
Called the Smart Tissue Automation Robot (STAR), the system “consists of tools for suturing as well as fluorescent and 3D imaging, force sensing, and submillimeter positioning,” the researchers wrote in their paper appearing in Science Translational Medicine.
Dr. Azad Shademan and Ryan Decker during supervised autonomous in-vivo bowel anastomosis performed by the Smart Tissue Autonomous Robot. (Credit: Axel Krieger)
Each year in the U.S., roughly 44.5 million soft-tissue surgeries are performed. With autonomous surgeries, medical practitioners will be able to provide substantial benefits through improved safety by pushing out the likelihood of human error, according to the researchers.
Interestingly, another study recently published in BMJ by Johns Hopkins University researchers suggests medical error may be the third leading cause of death in the country, claiming about 251,000 lives per year.
Under a surgeon’s supervision, the STAR system performed a procedure called anastomosis, where two tubular ends are connected with sutures. The procedure is performed more than 1 million times per year in the U.S., according to the researchers. Leakages occur nearly 20 percent of the time in colorectal surgery, and 25 to 30 percent of the time in abdominal surgery.
Researcher Simon Leonard, a computer scientist with Johns Hopkins University, worked for four years to program SMART’s robotic arm.
“Unlike rigid tissue surgery, autonomous decision support and execution of surgical tasks in soft tissue must constantly adjust to unpredictable sense changes, including non-rigid deformations as a result of cutting, suturing, or cauterizing,” the researchers wrote.
Fluorescent markers along the edges of the tissue helped keep the robot’s needle on track.
“If you want to throw in 20 stitches, it is not enough that a human being does 19 out of 20 well,” Dr. Peter Kim, of the Children’s National Health System’s Sheikh Zayed Institute for Pediatric Surgical Innovation told BBC News. “You have to do all 20 of them well to have a good outcome … This machine will consistently throw in 20 perfect sutures.”
Kim, who contributed to the study, told the media outlet that supervisors had to tweak what the robot was doing around 40 percent of the time when being used in live animal trials.
According to Johns Hopkins University, the researchers compared STAR’s work with the work of five surgeons using three different methods to complete the same procedure. The methods included open surgery, laparoscopic and robot-assisted surgery.
The robotic surgery took between 35 and 57 minutes, while the open surgery was performed in eight minutes. Otherwise the results were comparable to those from human surgeons.
Robotic surgery expert Naeem Soomro told The Verge that while the paper was “high quality” it will probably be around a decade until such surgical systems are readily used.
Credit: Greg Watry, http://www.rdmag.com/articles/2016/05/paging-dr-robot%E2%80%94autonomy-computerized-surgery
Picture Credit: http://www.wired.com/wp-content/uploads/2015/03/davinci-inline.jpg