Robot performs first EVER soft tissue operation without human help

Robots performing delicate and complicated life-saving surgery was once an idea that belonged exclusively in science fiction.

But it has now moved one step closer to being reality.

Johns Hopkins University experts got a robot to perform one of the most ‘delicate’ types of operation on four pigs, tasking it with reconnecting two ends of a severed intestine. 

Results showed the Smart Tissue Autonomous Robot (STAR), as it has been dubbed, was actually better than humans. 

It marks a world-first, being the first time a machine has carried out keyhole surgery without the guiding hand of a human.  

Senior author of the project, Professor Axel Krieger, said: ‘Our findings show we can automate one of the most intricate and delicate tasks in surgery.’ 

Connecting two ends of an intestine is one of the most challenging gastrointestinal ops, requiring a surgeon to suture with high accuracy and consistency.  

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

The Smart Tissue Autonomous Robot in action as it ties together two segments of pig intestine, through a tiny hole in the creature’s abdomen, without human assistance. While robots have been used in surgery before they have struggled to advance in the field of soft tissue operations due to the need to adapt quickly to unpredictable factors during the procedure

Robot with a pair of ‘claws’ at the end of humanoid-shaped arms is used to perform surgeries at three US medical facilities 

A robot with a pair of ‘pinching claws’ attached to two humanoid-shaped arms is used to perform hysterectomies, which is the removal of the uterus, in three US medical facilities.

Called Hominis, this surgical system is operated by a human controller who maneuvers the robotic arms while watching the procedure happening on a screen in real time.

The robot features shoulder, elbow and wrist joints to provide human human level dexterity and 360-degree articulation.

An additional arm guides a laparoscopic video camera through a small, separate incision, to help visualize the internal procedure.

Hominis enters through the vagina to perform the hysterectomy and then wraps its arms around the uterus to perform the operation.

The robot was developed by Israel-based Memic Innovation Surgery, which announced the technology is being used at Florida Healthcare’s Kendall Regional Medical Center, AdventHealth Celebration and The Women’s Hospital at Jackson Memorial.

Robot-assisted surgery is not new, with the NHS already using the machines to assist in a range of operations, including complex urological procedures.  

But the machines that carry out keyhole surgery still require the guiding hand or watchful eye of a human, which is what makes the STAR unique.  

Keyhole surgery, also called laparoscopy, involves making a tiny cut into the body to allow surgeons to access the abdomen and the pelvis. 

Surgeons feed a tube that comes with a camera and a light that relays images to a TV monitor, allowing them to watch what they are doing. 

The procedure is used to treat a variety of ailments including the removal of gallstones or the appendix, and repairing hernias. 

Before the advent of keyhole surgery, medics needed to make larger incisions to see what they were operating on. It increased the risk of complications and led to longer recovery times for patients. 

The current STAR is an advanced version of the machine created in 2016, which also successfully in reconnected a pig’s intestine.

But then it needed a large incision and more guidance from human operators to do so. 

The new findings were published in the journal Science Robotics.  

Robots have struggled to perform soft-tissue operations, such as those involving the organs in the lower abdomen. 

This is because of the highly complex and unpredictable nature of this area of the body during surgery as tissues and organs move as the patient breathes.  

However, STAR’s developers have provided it with a system enabling it to adjust its surgical plan on the fly, like a human surgeon would.

Professor Jin Kang, another STAR developer, said this was done by giving the robot an endoscope capable of producing 3D images of the interior surgical environment and an advanced learning programme to help it make the necessary decisions. 

‘We believe an advanced three-dimensional machine vision system is essential in making intelligent surgical robots smarter and safer,’ he said.     

The authors did not detail any next plans for the robot and when it might be used to perform surgery on humans.  

The number of robots currently in use by NHS in the UK is unknown, 

But an investigation by Imperial College London researchers found that of November 2019 there were 61 surgical robots in use in the NHS in England.

Between them they had performed at least 10,000 operations in 2019, with the vast majority of these being urological procedures.