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A robot just performed autonomous surgery. The future is now present

Ranjan Crasta | Updated on: 10 February 2017, 1:50 IST

Precision, focus, intelligence and composure are all essential traits for a surgeon. But while most surgeons embody these traits to varying degrees, you know who has mastered all of them?

Robots.

And, as if to prove it, the world just saw the first instance of a robot autonomously performing a soft-tissue surgery.

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Granted, the surgery conducted by the Smart Tissue Autonomous Robot (STAR), was performed on a pig rather than a human, but the achievement is no less momentous. The robot performed an intestinal anastomosis surgery - a surgery required after a particular segment of the intestine has been removed. It involves the suturing and reconnection of two severed sections of the bowel intestines.

STAR performed the procedure on four living, anaesthetised pigs. All the subjects survived the surgery with no complications.

While robot-assisted surgery has been around for over a decade, this was unique for two reasons.

The first being that it was largely autonomous, with surgeons supervising rather than controlling the procedure. The second, and arguably more incredible reason, that it was soft-tissue surgery, something believed to be near-impossible for robots.

Soft-tissue surgery has been considered off limits to robots because of the constantly-changing nature of soft-tissue during surgery that requires constant adjustment. However, the 4 years of research that have gone into designing STAR mean that the robot is able to keep track of the changes and adjust accordingly.

The robot, a product of the Sheikh Zayed Institute for Pediatric Surgical Innovation at the Children's National Health System in Washington, comes equipped with a dexterous tool for suturing along with the latest in robotic imaging technology, allowing it to differentiate between different layers of tissue - something that's challenging even to doctors themselves.

In a medical first a robot just performed surgery autonomously.

According to Peter Kim, the associate surgeon-in-chief who headed the development of STAR, the robotic eye functions by taking images in near-infrared fluorescent light, allowing it to view the procedure in a way "similar to a night vision technology that military uses".

This combined with an algorithm that allows the robot to view where things are in 3-dimensional space allows the robot to track changes to the constantly moving soft-tissue, something that's hard to manage with the naked eye.

But just performing surgery isn't enough. To be a practical tool in the medical field, the robot needs to match up to its human counterparts.

It achieves that on almost every level.

STAR's performance was compared to the open, laparoscopic and robot-assisted variants of the same surgery. While STAR is markedly slower than open surgery by an actual surgeon, clocking in at 35 minutes as opposed to the 8 minutes that a surgeon takes, it's comparable to the laparoscopic anastomosis which can sometimes take more than double the time. Even the robot-assisted procedure was slower than STAR.

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However, the team behind STAR are quick to point out that the robot can go much faster, but had sacrificed speed for precision thus far. Even so, when it comes to consistency and precision, STAR largely outperformed its human counterparts, achieving sutures that were evenly spaced, taut and error-free.

While the robot operated on its own, surgeons were on hand to assist the robot, ensuring that the suture thread didn't get tangled during the procedure. Kim believes that the achievement is proof of concept that soon a vast range of soft-tissue surgeries can now be outsourced to robots, freeing doctors to focus on far more complex procedures.Dr Kim and his team are now working on further miniaturising STAR's technology. With proper backing, Kim hopes it will be widely available within the next two years, which means soon robots will be able to both tear you to shreds and reassemble you as well. We just hope they take a shine to the latter rather than the former when Skynet takes over.

Edited by Payal Puri

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First published: 6 May 2016, 6:09 IST
 
Ranjan Crasta @jah_crastafari

The Ranjan (Beardus Horribilis) is a largely land-dwelling herbivorous mammal. Originally from a far more tropical habitat, the Ranjan can now be found wandering the streets of Delhi complaining about the weather, looking for watering holes and foraging for affordable snacks. Mostly human, mostly happy and mostly harmless, the Ranjan is prone to mood swings when deprived of his morning coffee. Having recently migrated to the Catch offices, he now inhabits a shadowy corner and spends his time distracting people and producing video content to distract them further.