An autonomous surgical robot joined sections of intestine together inside the abdominal cavities of live pigs, with limited intervention from human surgeons
A robot has successfully carried out keyhole surgery on the bowels of pigs mostly autonomously for the first time, which researchers say is a significant step towards human trials.
Small parts of human operations are often automated, but they tend to focus on rigid parts of the body that don’t change shape, such as bone. Robots controlled entirely by human surgeons are also becoming more common.
Justin Opferman at Johns Hopkins University in Maryland and his colleagues programmed a similar robot to conduct intestinal anastomosis, the joining of two ends of intestine after a section is removed, with limited human intervention.
The robot performed the surgery on four pigs, carrying out 86 stitches in total. Two-thirds of the time, the robot placed the stitch autonomously, while the rest of the time it had to be guided into place manually before attempting the stitch again.
When the tissues were examined one week after surgery, the results were comparable to those achieved by human surgeons. The operation is particularly sensitive because any leak can cause catastrophic complications.
The same group programmed a robot to perform the operation on pigs in 2016 by pulling the intestine outside the body cavity before suturing it. This time, the robot successfully completed the task inside the cramped confines of the abdomen via a small opening, which is far more challenging because the organs move rhythmically with the animal’s breathing.
“Once you open the body, everything kind of moves inside the patient so you can’t plan ahead of time,” says Opferman. “If you’re doing soft tissues like intestines, as soon as you touch it, it moves out of the way. So you need to constantly be updating the robot’s plan to figure out what it needs to do and how to complete the task.”
Custom software controlled the robot during suturing, using images from a 3D camera on the robot’s arm to sense depth and map the changing layout inside the abdomen. The researchers used a standard medical robot from the manufacturer Kuka, but they believe their software could run on any comparable machine.
Opferman says the trial is the first step towards fully autonomous surgery in humans, although this goal is probably decades away. As the research progresses, the team will train the robot to carry out incrementally larger portions of the operation, such as opening the cavity and closing it afterwards, until it proves itself capable of the entire procedure. Human trials in which robots perform some part of the surgery could begin within five years, he says.
Journal reference: Science Robotics, DOI: 10.1126/scirobotics.abj2908
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