Robot carries out first laparoscopic surgery without human assistance

STAR is the first robotic system to plan, adapt, and execute a surgical plan in soft tissue with minimal human intervention.

Photograph: Johns Hopkins University

A robot performed laparoscopic surgery on the soft tissues of a swine without the guiding hand of a human, an important step from robotics to fully automated surgery in humans. Designed by a team of Johns Hopkins University researchers, the Smart Tissue (STAR) stand-alone robot is described today in Science Robotics.

“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. The STAR performed the procedure in four animals and it produced significantly better results than humans performing the same procedure,” — Axel Krieger, assistant professor of mechanical engineering at Johns Hopkins’ Whiting School of Engineering.

The robot excelled in the intestinal anastomosis, a procedure that requires a high level of repetitive motion and accuracy. Connecting two extremities of an intestine is undoubtedly the most difficult step in gastrointestinal surgery, requiring a surgeon to suture with great accuracy and consistency. Even the slightest tremor of the hand or the misplaced sting can lead to a leak that could lead to catastrophic complications for the patient.

Soft tissue surgery is particularly hard for robots due to its unpredictability, forcing them to be able to adapt quickly to unexpected obstacles, Krieger said. “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”.

A 3-dimensional endoscope based on structural light and a tracking algorithm based on machine learning developed by Kang and her STAR student guides. “We believe that an advanced three-dimensional vision system is essential to making intelligent surgical robots smarter and safer,” Kang said. As the medical domain progresses towards laparoscopic approaches for surgeries, it will be important to have an automated robotic system designed for such procedures, said Krieger.

“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. “We speculate that this will translate into a democratized surgical approach to patient care with more predictable and consistent results for patients.”

Autonomous robotic laparoscopic surgery for intestinal anastomosis appeared on Science Robotics

Cover photograph credits: Johns Hopkins University

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