Robot Successfully Performs First Laparoscopic Surgery Without Human Help

A robot has performed laparoscopic surgery on the soft tissue of a pig without the guiding hand of a human, marking a significant step toward fully automated surgery on humans.

The Smart Tissue Autonomous Robot (STAR) designed by researchers at Johns Hopkins University (Baltimore, MD, USA) excelled at suturing two ends of intestine - one of the most intricate and delicate tasks in abdominal surgery. Connecting two ends of an intestine, a procedure known as intestinal anastomosis, 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.

In 2016, the researchers had created the robot, a vision-guided system designed specifically to suture soft tissue. Their current iteration advances the 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.

The STAR has a novel control system that can adjust the surgical plan in real time, just as a human surgeon would. STAR is guided by a structural light-based three-dimensional endoscope and machine learning-based tracking algorithm. 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.

"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.

"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," added Krieger. "We hypothesize that this will result in a democratized surgical approach to patient care with more predictable and consistent patient outcomes."

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