A medical robot has performed laparoscopic surgery on pig tissue without the need for human intervention, marking a breakthrough in the field of autonomous robotics in healthcare.
The STAR robot mid-surgery. Credit: Axel Krieger and Jin Kang via John Hopkins University
Designed by researchers at Johns Hopkins University, the Smart Tissue Autonomous Robot (STAR)'s groundbreaking new process was laid out in the Science Robotics Journal on January 28.
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More specifically, the robot performed a surgical technique known as intestinal anastomosis, a procedure known for being highly repetitive and needing peerless precision which involves allowing passage between two formerly disjointed parts of the intestine, usually due to a bowel condition or blockage. It is often considered one of the most difficult to perform surgeries in the field.
Even the slightest error can cause a tear or leak, with potentially catastrophic results.
"Our findings show that we can automate one of the most intricate and delicate tasks in surgery: the reconnection of two ends of an intestine", said senior author Axel Krieger, an assistant professor of mechanical engineering at Johns Hopkins' Whiting School of Engineering.
"The STAR performed the procedure in four animals and it produced significantly better results than humans performing the same procedure".
For the project, the team worked alongside the Children's National Hospital in Washington DC and other scientists at the university to perfect the design for suturing soft tissue. It was based on an earlier 2016 design that performed a surgery that successfully repaired a pig's intestines.
The team equipped STAR with new features for enhanced autonomy and improved surgical precision, including specialised surgical tools and high tech interfaces that provide a more detailed picture of the surgical field.
The team reports that soft tissue surgery is often difficult for robots due to unpredictability - perhaps due to the increased precision required with less overall or softer matter - which requires adaptability and lightning reflexes to handle unexpected obstacles.
The authors claim it is the first robotic system to plan, adapt, and execute a surgical plan in soft tissue with minimal human intervention.
Jin Kang, a Johns Hopkins professor of electrical and computer engineering, who helped design the STAR system, said: "We believe an advanced three-dimensional machine vision system is essential in making intelligent surgical robots smarter and safer".
He added that a light-based 3D endoscope and a machine learning-based tracking algorithm helps guide the STAR during the surgery.
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"Robotic anastomosis is one way to ensure that surgical tasks that require high precision and repeatability can be performed with more accuracy and precision in every patient independent of surgeon skill", Krieger said.
"We hypothesize that this will result in a democratized surgical approach to patient care with more predictable and consistent patient outcomes".
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