STAR has autonomous operation, which makes it capable of performing tasks on its own. And autonomous robots have so far only made themselves useful for digging into rigid body parts, such as bones, while historically failing with slippery, wiggly soft tissue. Suturing two structures, the robot used in the study – which is published in Science Translational Medicine – proved it could essentially join up two blood vessels.
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Recently, though, a supervised autonomous robot performed soft tissue surgery-and did it better than human doctors.
“We chose the complex task of anastomosis as proof of concept because this soft tissue surgery is performed over 1 million times in the United States annually”, said Kim.
When compared to the intestinal anastomosis procedures carried out both manually by experienced surgeons and with existing robot-assisted surgical techniques using the daVinci Surgical System, STAR was found to outperform both in terms of surgical quality. Because STAR was only able to perform four successful pig intestine surgeries, Zarnegar believes that tests must be carried out on a larger scale before these could be considered successful. While people not involved in a sci-fi universe shouldn’t ever need such a procedure, robotic surgery certainly has its benefits.
USA doctors have shown for the first time that soft tissue surgery can now be performed entirely by a robot, putting surgery one step closer into the realm of intelligent machines. Equipped with a robotic arm and surgical tools, the STAR robot performed the procedure under the supervision of a human surgeon. Researchers compared consistency of suture spacing, pressure at which the seam leaked, mistakes that required removing the needle from the tissue or restarting the robot, and completion time.
Although the robot is capable of stitching up wounds with no human assistance, it is meant to work with surgeons rather than replace them. Soft tissue can move and change shape in complex ways as stitching goes on, requiring a surgeon’s skill to respond to these changes and keep suturing as tightly and evenly as possible. “While in a technical sense, semi-autonomous suturing is a “grand challenge” problem of surgical robotics, clinically much suturing and bowel anastomosis is done by staplers which can do the whole thing in seconds”, he wrote in an email. The robot’s mechanical eye takes images in near-infrared fluorescent light, “similar to a night vision technology that military uses”, says Kim.
STAR showed that it was better than a human surgeon at placing regularly spaced stitches, and avoiding leakages in the intestines being operated on.
According to Kim, they tweaked what the robot was doing about 40 percent of the time.
The most notable exception had to do with speed: The robot took more than 20 minutes to perform a procedure that would take a human less than 10 minutes to do by hand. Rushing down the hill, he had a realization: “I didn’t get down safely”, he says, “it wasn’t good for me, and it wasn’t good for the patient”. He hopes to begin human studies in two or three years. The future, or at least the future envisioned here, is one of harmony and cooperation between humans and robots.
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Dr Kim says that the next step in STAR’s development will be to create improved sensors and further miniaturise the tools used by the robot.
