In a significant step toward fully automated surgery on humans, a robot has performed laparoscopic surgery on the soft tissue of a pig without human guidance.
Designed by a team of Johns Hopkins University researchers, the Smart Tissue Autonomous Robot (STAR) is described in Science Robotics.
“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. The STAR performed the procedure in four animals and it produced significantly better results than humans performing the same procedure,” said senior author Axel Krieger, PhD, an assistant professor at John Hopkins University.
The robot excelled at intestinal anastomosis, which connects the two ends of an intestine. It is a procedure that requires a high level of repetitive motion and precision and is arguably the most challenging step in gastrointestinal surgery, requiring a surgeon to accurately and consistently suture. A slight hand tremor or misplaced stitch can result in a leak with potentially catastrophic complications for the patient.
The team developed a vision-guided system designed specifically to suture soft tissue. Their current iteration advances a 2016 model that repaired a pig’s intestines accurately, but required a large incision to access the intestine and more guidance from humans.
The team equipped the STAR with new features for enhanced autonomy and improved surgical precision, including specialised suturing tools and state-of-the art imaging systems that provide more accurate visualisations of the surgical field.
Soft-tissue surgery is especially hard for robots because of its unpredictability, forcing them to be able to adapt quickly to handle unexpected obstacles, Dr Krieger said. STAR features a novel control system that can adjust the surgical plan in real time, just as a human surgeon would.
As the medical field moves towards more laparoscopic approaches for surgeries, it will be important to have an automated robotic system designed for such procedures to assist, Dr Krieger said.
“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,” Dr Krieger said.
“We hypothesise that this will result in a democratised surgical approach to patient care with more predictable and consistent patient outcomes.”
Source: John Hopkins University
