Robot performs first laparoscopic surgery without human help

Date:
January 26, 2022
Source:
Johns Hopkins University
Summary:
A robot has performed laparoscopic surgery on the soft tissue of
a pig without the guiding hand of a human -- a significant step
in robotics toward fully automated surgery on humans.



FULL STORY ==========================================================================
A robot has performed laparoscopic surgery on the soft tissue of a pig
without the guiding hand of a human -- a significant step in robotics
toward fully automated surgery on humans. Designed by a team of Johns
Hopkins University researchers, the Smart Tissue Autonomous Robot (STAR)
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," said senior author Axel Krieger, an assistant professor of mechanical engineering at Johns Hopkins' Whiting School of Engineering.

The robot excelled at intestinal anastomosis, a procedure that
requires a high level of repetitive motion and precision. Connecting
two ends of an intestine is arguably the most challenging step in gastrointestinal surgery, 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 catastrophic complications
for the patient.

Working with collaborators at the Children's National Hospital
in Washington, D.C. and Jin Kang, a Johns Hopkins professor of
electrical and computer engineering, Krieger helped create the robot,
a vision-guided system designed specifically to suture soft tissue. Their current iteration advances a 2016 model that repaired a pig's intestines accurately, but required a large incision to access the intestine and
more guidance from humans.

The team equipped the STAR with new features for enhanced autonomy and
improved surgical precision, including specialized 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," Krieger said.

A structural-light based three-dimensional endoscope and machine
learning-based tracking algorithm developed by Kang and his students
guides STAR. "We believe an advanced three-dimensional machine vision
system is essential in making intelligent surgical robots smarter and
safer," Kang said.

As the medical field moves towards more laparoscopic approaches for
surgeries, it will be important to have an automated robotic system
designed for such procedures to assist, Krieger said.

"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 hypothesize that this will result in a democratized surgical
approach to patient care with more predictable and consistent patient outcomes." The team from Johns Hopkins also included Hamed Saeidi,
Justin D. Opfermann, Michael Kam, Shuwen Wei, and Simon Leonard. Michael
H. Hsieh, director of Transitional Urology at Children's National
Hospital, also contributed to the research.

The work was supported by the National Institute of Biomedical Imaging
and Bioengineering of the National Institutes of Health under award
numbers 1R01EB020610 and R21EB024707.

========================================================================== Story Source: Materials provided by Johns_Hopkins_University. Original
written by Catherine Graham. Note: Content may be edited for style
and length.


========================================================================== Journal Reference:
1. H. Saeidi, J. D. Opfermann, M. Kam, S. Wei, S. Leonard, M. H. Hsieh,
J.

U. Kang, A. Krieger. Autonomous robotic laparoscopic surgery
for intestinal anastomosis. Science Robotics, 2022; 7 (62) DOI:
10.1126/ scirobotics.abj2908 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/01/220126143954.htm

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