My surgeon, Dr. Robot

Robots have become more and more popular in the last decade, popping up in all sorts of new different sectors but they have been around a lot longer than you may think when it comes to surgery.

In 1983, while most Spaniards were enjoying the cutting-edge technology of colour television, the first robot was being used in the operating theatre. The Biomedical Engineering department of the General Hospital in Vancouver (Canada) gave life to ARTHROBOT, which conducted the surgery by listening to voice commands. ARTHROBOT helped to move or rotate the legs of patients during a knee operation.

Let’s talk about what exactly we mean by a robot. There are robots which are just mechanisms that assist clinical staff during surgeries and then there are fully autonomous robots. Even though more and more robots are popping up which can complete a surgery from beginning to end, the majority of surgical robots are systems that serve to assist the surgeon. The most popular robot to date is the Da Vinci robot, developed by the American company Intuitive Surgical.

The most advanced robot that exists is the STAR robot, developed by the American Children’s National Hospital is a robot that performs soft tissue sutures by itself and apparently does a better job than surgeons themselves. 

STAR is designed to perform anastomosis, which is a surgical connection between two tubular structures that are shaped like a tube, such as blood vessels or bowel loops. So when a part of an intestine is surgically cut, the two remaining ends are sewn or stapled together. 

Another show stopper is the tiny robot developed by a group of researchers at the Children’s Hospital in Boston (USA) that has managed to navigate autonomously inside a pig, reaching its heart in order to repair a leak.

Hipernav, robots against cancer

The new Hipernav project has allowed Europe to excel and enable robots to operate on soft tissue tumours. Currently, extensive progress has been made in liver cancer and after that, all attention will be turned to the pancreas. 

It all starts with the reconstruction of three - dimensional images from MRI, CT scans or ultrasounds. Then navigation algorithms are put in place to make the laparoscopic instruments autonomous. After that, the structure of the tissues is analyzed with the idea of making the resection more precise, without damaging healthy tissue, veins and arteries. 

Imagine an operation with tiny cameras inside the body, which should help to differentiate between the different organs and tissues, a flattened soft mass which deforms with the pressure of the instruments and to which you add blood and smoke. 

By increasing the precision of operations as well as performing them in the least invasive way possible you can cut the time of surgery significantly thus making it less invasive and the patient may recover much sooner. 

Virtual manipulation of the liver within the HIPERNAV projet 

When a person suffers from liver cancer, traditionally the liver is divided into eight portions delimited by the main blood vessels. Open surgery is then performed and the sections containing tumours are removed. In contrast, a laparoscopy only makes a few small holes in the patient and resects the tumour and some tissue around it as a safety perimeter.

All the advantages

As a result, the patient has gone from undergoing an operation lasting several hours to leaving the operating room in less than one. In addition to the fact that he/she has lost a much smaller part of their organ, there has been less blood loss, his/her liver will recover much sooner and the patient will take less medicine and painkillers as the recovery period will be much faster.

On top of that, because the time at the operating theatre and hospital was significantly reduced, more people were able to be operated on, costs were lowered and less blood was used.

The robots in surgery can provide precision, can work in complex positions, in small spaces and be autonomous in some cases but there are still enormous challenges as they need to handle expert knowledge, make decisions, perfectly recognise the type of tissue they have to work with, and what and how they should work with it. It is easy to predict that they will still be functioning for a long time under the supervision of expert surgeons but it is also unquestionable that artificial intelligence techniques, nanotechnology, advanced processors, are going to help a lot.