Smart Tissue Autonomous Robot

Robot successfully performs surgery on a pig without human assistance

Image credit: PA

A robot has performed keyhole surgery on the soft tissue of a pig, without the guiding hand of a human, for the first time.

The project was designed by a team of Johns Hopkins University researchers who believe their Smart Tissue Autonomous Robot (Star) it is a significant step toward fully automated surgery on humans.

“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,” said senior author on the study Axel Krieger. “The Star performed the procedure in four animals and it produced significantly better results than humans performing the same procedure.”

The robot excelled at intestinal anastomosis, a procedure that requires a high level of repetitive motion and precision. It involves connecting two ends of an intestine in gastrointestinal surgery, typically requiring a surgeon to suture with high accuracy and consistency.

Even the slightest hand tremor or misplaced stitch can result in a leak that could have significant complications for the patient.

The robot uses a vision-guided system designed specifically to suture soft tissue. Their current iteration is an advancement upon a 2016 model that repaired a pig’s intestines accurately, but required a large incision to access the intestine, along with 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 visualizations 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, Krieger said. The Star has a novel control system that can adjust the surgical plan in real time, just as a human surgeon would.

“What makes the Star special is that it is the first robotic system to plan, adapt and execute a surgical plan in soft tissue with minimal human intervention,” said first author Hamed Saeidi.

A structural light–based three-dimensional endoscope and machine learning–based tracking algorithm is used to guide Star.

“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,” Krieger said.

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