Tag: surgical robots

Mastering a Third Robotic Arm is Surprisingly Quick

Interfaces for DoF augmentation (figure by Tobias Pistohl). From Eden at al., Nature Communications. 2022

Busy doctors and nurses may have often found themselves wishing they had an extra arm to help with a patient or help with a difficult suture. Researchers around the world are developing supernumerary robotic arms to help workers achieve certain tasks unaided, or with less strain – but how long would it take to master learning an additional limb? The answer is: not long at all. One hour’s worth of training is enough for people to carry out a task with their ‘third arm’ as effectively as with a partner, according to the results of a new study published in IEEE Open Journal of Engineering in Medicine and Biology.

A new study by researchers at Queen Mary University of London, Imperial College London and The University of Melbourne has found that people can learn to use supernumerary robotic arms as effectively as working with a partner in just one hour of training.

The study investigated the potential of supernumerary robotic arms to help people perform tasks that require more than two hands. The idea of human augmentation with additional artificial limbs has long been a staple of science fiction.

Demonstrating performing a suture with an assistant robotic arm.

“Many tasks in daily life, such as opening a door while carrying a big package, require more than two hands,” said Dr Ekaterina Ivanova, lead author of the study from Queen Mary University of London. “Supernumerary robotic arms have been proposed as a way to allow people to do these tasks more easily, but until now, it was not clear how easy they would be to use.”

The study involved 24 participants who were asked to perform a variety of tasks with a supernumerary robotic arm. The participants were either given one hour of training in how to use the arm, or they were asked to work with a partner.

The results showed that the participants who had received training on the supernumerary arm performed the tasks just as well as the participants who were working with a partner. This suggests that supernumerary robotic arms can be a viable alternative to working with a partner, and that they can be learned to use effectively in a relatively short amount of time.

“Our findings are promising for the development of supernumerary robotic arms,” said Dr Ivanova. “They suggest that these arms could be used to help people with a variety of tasks, such as surgery, industrial work, or rehabilitation.”

Source: Queen Mary University of London

Robot Performs Surgery Without Human Assistance

Photo by Tara Winstead from Pexels

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

Manufacturer Shuts Down its Robot Mid-surgery

Photo by Piron Guillaume on Unsplash
Photo by Piron Guillaume on Unsplash

One of a series of lawsuits against the company that makes the da Vinci surgical robot alleges that the company shut down its robot mid-surgery, forcing the surgeons to switch to an open surgery.

Several hospitals have launched a legal battle against the company Intuitive Surgical, the manufacturer of the da Vinci surgical robot. They allege that the company’s monopoly position forces hospitals to buy its maintenance services and spare parts at inflated prices even though cheaper alternatives are available.

One hospital alleges that, after it said that it was considering a service contract with a third party, Intuitive Surgical remotely shut down its surgical robot “in the middle of a procedure”, forcing the surgeon “to convert the procedure to open surgery with the patient on the operating table”.

Separately, malfunctions of the instrument arms have been reported, requiring additional, sometimes larger, incisions in patients in order to complete the surgical procedure manually. Use of the robotic technology also requires longer operating and anesthesia times as well as several complications occurring from the use of the da Vinci Surgical System itself.

Intuitive Surgical sells its da Vinci surgical robot to hospitals for anywhere from $500,000 to $2.5 million each. However, a majority of Intuitive Surgical’s $4 billion of annual revenue comes from the parts and services that are required to keep the robots running. Its executives are among the most highly paid in the healthcare industry.
Franciscan Health, Valley Medical Center and Kaleida Health filed class-action lawsuits. These hospitals that claim Intuitive Surgical has a monopoly on minimally invasive surgical robots, giving the company a “near-stranglehold” on the parts and services market for the robots.

One lawsuit alleges hospitals cannot have their da Vinci robots serviced by third parties because Intuitive Surgical forces hospitals to sign “multi-year, exclusive servicing agreements” at rates that are much higher than other vendors’. Hospitals also allege they are coerced into buying new, expensive instruments and attachments for their robots (called EndoWrists) after 10 uses, even if the parts are in good working condition. A limited extension of these uses has been launched by the company. The lawsuit alleges that Intuitive Surgical engineers have threatened hospitals with turning the machines into “paperweights” should hospitals seek outside vendors for parts or repairs.

While Intuitive Surgical has faced antitrust lawsuits from third-party repair and service companies since 2019, these hospital class-action lawsuits are new.

In an email, an Intuitive Surgical spokesperson told MedPage Today that the medical robotics company “does not have the ability to remotely shut down a da Vinci system during a surgical procedure underway at hospital.”

“There is risk associated with deviating from the validated processes cleared by regulatory authorities,” the spokesperson stated. “Continued use beyond an instrument’s determined useful life may reduce safety, precision, and dexterity. Further, third parties may use incompatible or unvalidated parts or processes in servicing or repairing the systems, which could cause damage and put patient safety at risk.”

Source: Axios