SCIENCE: A robot performs complex intestinal surgery on pigs without human assistance.

Accord­ing to a study from Johns Hop­kins Uni­ver­si­ty (pub­lished in Sci­ence Robot­ics), a robot suc­cess­ful­ly per­formed “key­hole” intesti­nal surgery on pigs with­out any human assis­tance. Addi­tion­al­ly, the Smart Tis­sue Autonomous Robot (STAR) han­dled the del­i­cate pro­ce­dure “much bet­ter” than human doc­tors. The break­through marks an impor­tant step towards auto­mat­ed surgery that could one day help “democ­ra­tize” patient care, the researchers said.

Laparo­scop­ic or key­hole surgery requires sur­geons to manip­u­late and stitch the intestines and oth­er organs through tiny inci­sions, a tech­nique that requires high lev­els of skill and has lit­tle mar­gin for error. The team opt­ed to do the “intesti­nal anas­to­mo­sis” (join­ing the two ends of an intes­tine), a par­tic­u­lar­ly dif­fi­cult key­hole procedure.

Soft tis­sue surgery in gen­er­al is dif­fi­cult for robots due to its unpre­dictabil­i­ty. To deal with this, the STAR robot was equipped with spe­cial­ized sutur­ing tools and state-of-the-art imag­ing sys­tems capa­ble of pro­vid­ing extreme­ly pre­cise visualizations.

Specif­i­cal­ly, it had a “3‑dimensional endo­scope based on struc­tur­al light and a track­ing algo­rithm based on machine learn­ing” to guide the robots. “We believe that an advanced three-dimen­sion­al machine vision sys­tem is key to mak­ing intel­li­gent sur­gi­cal robots smarter and safer,” said John Hop­kins pro­fes­sor Jin Kang. In addi­tion to that,

STAR is the first robot­ic sys­tem that can “plan, adapt and exe­cute a sur­gi­cal plan in soft tis­sue with min­i­mal human inter­ven­tion,” said first author Hamed Saei­di. Using all of this tech­nol­o­gy, the STAR robot suc­cess­ful­ly per­formed the pro­ce­dure in four animals.

Laparo­scop­ic surgery is min­i­mal­ly inva­sive com­pared to reg­u­lar surgery, which helps ensure bet­ter out­comes for patients. How­ev­er, because it takes so long to mas­ter it, there is a rel­a­tive­ly small pool of doc­tors who can do it.

“Robot­ic anas­to­mo­sis is a way to ensure that sur­gi­cal tasks that require high pre­ci­sion and repeata­bil­i­ty can be per­formed with greater accu­ra­cy and pre­ci­sion in every patient, regard­less of sur­geon skill,” said the lead author. John Hop­kins’ Axel Krieger. “We hypoth­e­size that this will result in a democ­ra­tized sur­gi­cal approach to patient care with more pre­dictable and con­sis­tent out­comes for patients.”

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