The first robotic surgery took place in 1985 that was the first documented use of a robot-assisted surgical procedure with the PUMA 560 robotic surgical arm used in a delicate neurosurgical biopsy being the first laparoscopic procedure surgery. This might have been the first case of robotics being incorporated into medical surgery but over 60 years later, advances in technology have resulted in the first operation completed by a robot without human assistance.
The Smart Tissue Autonomous Robot (STAR) performed delicate laparoscopic keyhole surgery on the soft tissue of a pig connecting two ends of an intestine. One of the most challenging steps of this gastrointestinal procedure is connecting two ends of an intestine requiring a surgeon to apply sutures or stitches with consistency and high accuracy. The smallest error in this part of the procedure is with a misplaced stitch that can leak resulting in complications for the patient.
This historic surgery is an integral part of progressing towards a future of fully automated operations on humans and reports indicate the robot excelled at executing the procedure requiring a high level of repetitive, precision movements. The STAR performed this procedure on four animal test subjects producing better results than humans performing the same procedure.
Senior author on the study of STAR, Dr. Axel Krieger from Johns Hopkins University, helped create the surgical robot utilizing a vision-guided system designed to suture soft tissue. Dr. Krieger is also a professor of computer and electrical engineering a John Hopkins. Dr. Krieger worked on the project in collaboration with Jin Kang and the Children’s National Hospital in Washington D.C.
The current version of STAR is an improved version of the 2016 model that repaired a pig’s intestines that required more guidance from humans and a large incision during the procedure to access the intestine. The success of the recent procedure was attributed to the new feature for improved surgical precision with specialized imaging systems and suturing tools providing a more accurate visualization of the surgical area.
Another issue in perfecting this procedure is the difficulty in performing soft-tissue surgery for robots because of how unpredictable the material can be, forcing the robot to adapt quickly to handle unexpected obstacles. The study details a novel control system in STAR to adjust the surgical plan in real-time, similar to a human surgeon.
Dr. Krieger published his findings in Science Robotics stating, “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. Robotic anastomosis (surgically joining two structures) 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 the surgeon’s skill. We hypothesize that this will result in a democratized surgical approach to patient care with more predictable and consistent patient outcomes.”