History was made yesterday as the Smart Tissue Autonomous Robot (STAR) expertly sewed the intestine of a living pig in the Children’s National Medical Center (CNMC) Sheikh Zayed Institute with little to no help.
The intestinal anastomosis is a challenging surgical procedure because the tissue does not retain its shape owing to its softness. STAR employs an intricate and complex layout of both 3D and NIR (near infrared) imaging techniques augmented by a pressure sensor so as to determine the site of stitches as well as the required tension.
The scientists at CNMC had marked the areas to be sewn. When exposed to NIR rays the marked areas were illuminated and hence tracked by STAR. The autonomous surgical robot was able to determine the exact site of operation to an accuracy of millimeters.
STAR’s imaging system analyzed the tissue and customized its operation technique to stitch the intestine at the precise spot. To prevent the stitches from rupturing, the design team of STAR has configured the algorithm of the robot-surgeon such that it would sew according to the tension and spacing considerations.
The research team of STAR engaged professional surgeons to perform the same operation on the pig intestine by employing three different procedures vis-á-vis manual sutures, laparoscopy and the FDA-approved da Vinci Surgical System.
The results were amazing as STAR outshone all the other techniques and the ideally stitched intestine by the autonomous robot tolerated twice the pressure as that endured by the intestines repaired manually.
Nevertheless, the operation was not fully automated as the design team of STAR tweaked the apparatus even as the robot operated. However, the professor of surgery and the head of the Shaikh Zayed Institute, Peter Kim said that the robot could perform autonomously and attributed the adjustments made to the STAR during the operation to excited nervousness of the design team:
“we were like parents with a young child that was about to walk.”
Professor Kim reiterated that this experiment is not intended to find a replacement for the surgeons; rather the focus of the research is on the application of AI to enhance the surgical process. Describing the anastomotic leaks, the surgeon said that a major rupture can be ten times more fatal, thus establishing the need to develop the robotic surgeons that can reduce the potential risks.
The only aspect that remains to be addressed is the amount of control that the surgeons should yield to the robotic surgical systems.