The big idea is to move toward autonomous surgical robots, removing the surgeon’s hands from certain tasks that a machine might perform all by itself.
In small tests using pigs, the robot performed at least as well, and in some cases a bit better, as some competing surgeons in stitching together intestinal tissue.
Dr. Peter C.W. Kim of Children’s National Health System in Washington told the Science Translational Medicine journal that the big idea was not to replace surgeons.
“If you have an intelligent tool that works with a surgeon, can it improve the outcome? That’s what we have done.”
Robot-assisted surgery has been controversial, as some studies have shown it can bring higher costs without better outcomes.
The Robot is designed to do one specific task, stitch up tissue. Dubbed the Smart Tissue Autonomous Robot (STAR) it is a bit like a programmable sewing machine.
Kim’s team at Children’s Sheikh Zayed Institute for Pediatric Surgical Innovation took a standard robotic arm and equipped it with suturing equipment plus smart imaging technologies to let it track moving tissue in 3-D and with an equivalent of night vision. They added sensors to help guide each stitch and tell how tightly to pull.
The surgeon places fluorescent markers on the tissue that needs stitching, and the robot takes aim as doctors keep watch.
STAR could reconnect tubular pieces of intestinal tissue from pigs. Any soft-tissue surgeries are tricky for machinery because those tissues move out of place so easily. And the stitches in these connections must be placed precisely to avoid leaks or blockages.
Using pieces of pig bowel outside of the animals’ bodies as well as in five living but sedated pigs, the researchers tested the STAR robot against open surgery, minimally invasive surgery and robot-assisted surgery.
None of the pigs ended up as someone’s dinner and the machine did a pretty good job. In a couple of cases STAR had to reposition fewer stitches than the surgeons performing minimally invasive or robot-assisted suturing. But in the living animals, the robot took much longer and made a few suturing mistakes while the surgeon sewing by hand made none.
Kim, whose team has filed patents on the system, said the robot can be sped up. He hopes to begin human studies in two or three years.