Why Are Robots the Future of Surgery?

Harry Vuong
Nov 2, 2021 12:24:17 PM

The Benefits of Surgical Robots  

The use of robots during surgery offers many benefits to patients in comparison to an open surgery. When robots are used during surgery, it is considered a minimally invasive procedure where doctors control a robot to assist them with the surgical procedure. These robots have a high level of dexterity which allows doctors to operate in a tight space that would otherwise only be reachable via a large incision. Other benefits of the use of surgical robots include: 

  • Higher dexterity 
  • Minimal scarring
  • Quicker recovery time  
  • Reduced pain 
  • Shorter hospitalization time  
  • Greater accuracy and precision 

With all these advantages and more, it is in the best interest of the patient and their doctors to have robots assist in the surgical procedure.  

Typically, the surgeon controls the robots using an operator console during a robotic surgical procedureA vision system is attached to one of the robotic arms and allows them to see a magnified high-resolution display of the surgical site. The surgeons’ hand movements are transmitted from the computer console to the robot’s arms, as the robots have the same range of motion as the surgeon. The surgical team observes the bedside when the surgeon performs the procedure.  

The Steps of a Liver Procedure 

To further explain this process, I will give a real-life example using my grandmother, who was diagnosed with Cholangiocarcinoma (Bile Duct Cancer) and describe how the use of robots can reduce complications. When a tumor is found, there are many tests that are performed to determine the malignancy of the growth. In many cases, these tumors must be removed to ensure a quality and healthy life. The success of the procedure depends on many factors, and there are always risks associated with them. Robot assisted procedures could reduce risks and improve quality of life for all patients. The use of robotics allows more stability and accuracy while giving surgeons full control to provide exceptional outcomes. To give a brief introduction, the bile ducts are a series of thin tubes that go from the liver to the small intestine [1]. The liver is responsible for producing bile which is fluid that breaks down fats into fatty acids and is taken into the body by the digestive tract. In Figure 1, the tumor is in the common bile duct and has grown into the right side. In my grandmother’s case, the tumor blocked bile from flowing into her intestine. 

Diagram

Description automatically generatedFigure 1. Tumor located in the bile duct (red circle) 

The Side Effects of a Procedure Without Robots 

CT scans are performed to detect where the mass is located, in this example, it is in the bile ducts. A Magnetic Resonance Cholangiopancreatography (MRCP) was followed up afterward to obtain more data because it delivers important anatomic details of the biliary tree. After the imaging results, Endoscopic Retrograde Cholangiopancreatographies (ERCPs), a procedure that combines upper gastrointestinal (GI) endoscopy and x-rays to treat problems of the bile and pancreatic ducts [4], were performed:  

  • To obtain samples of the mass for biopsy 
  • To place stents to decompress the biliary system 

My grandmother had multiple ERCPs, which resulted in many complications. She had already developed an infection called Cholangitis, an inflammation of the bile duct system [5], from the first ERCP. The Interventional Radiologist proposed a theory that this was due to bacteria in the intestine traveling along with the medical device up into the bile ducts. To cure the infection, an external biliary drainage catheter was placed through her skin into her liver. She later had another ERCP to replace the stents and internalize the external drainage bag. Then, she developed another infection, which resulted in an additional external drain placed in the gall bladder. The numerous manual procedures lead to my grandmother having many complications. 

How Actin Can Help Reduce Risks and Improve Outcomes 

There are much fewer complications associated with a surgical procedure performed by robots than traditional methods because robotic systems could allow surgeons to have more control and prevent human-factor errors. When appropriate, Surgical robotic systems built around Actin can allow surgical teams and roboticists perform more minimally invasive procedures. Actin enables surgical robots to:

  • Have more degrees of freedom
  • Leverage kinematic redundancy resulting in more dexterity
  • Control multiple robots 
  • Have robots work together cooperatively on the same task 
  • Detect and actively avoid collisions with each other, patients, surgeons, environment, and all other objects the robot can sense  

Let us take an example of my grandmother and how Actin could improve the process of an ERCP. As mentioned earlier, typically an MRCP is performed to get more imaging details, and this could be used to create a 3D environment of the organs. Defining an environment in simulation based on sensor data could allow Actin to detect and avoid unnecessary collisions inside a patient. The Endoscope can be designed as the robot model with many degrees of freedom and Actin can leverage the kinematic redundancy for flexible motion. This type of system can give full control to the surgeon and can allow predictable motion.  

A: Normal biliary and pancreatic ducts during an ERCP; B: ERCP image.Figure 2. ERCP Image 

Actin is not limited to applications like ERCPs. Actin could be used in many other surgical applications such as hepatectomies, where precision and accuracy are critical for removing part of the liver. And, if it were a multi-robot arm system, it would benefit from Actin’s cooperative control.  

A picture containing text, microscope, different

Description automatically generatedFigure 3. SS Innovation’s Robotic System 

Developing surgical robots with Actin can provide essential functionality for medical procedures. This could result in allowing surgical teams to perform more minimally invasive procedures safely. If surgeons can have more control because robots can enable a more controlled procedure, then the risks can  be reduced, resulting in more positive predictable outcomes. 

To learn more about Actin’s medical capabilities, click here. To speak to the author of this blog, Harry Vuong, click here.  

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