IEEE Spectrum: Robot Surgeons Are Taking Over the OR

A nice article appeared on IEEE Spectrum:

"Surgical robots already make decisions and take independent action more often than you might realize. In surgery for vision correction, a robotic system cuts a flap in the patient’s cornea and plots out the series of laser pulses to reshape its inner layer. In knee replacements, autonomous robots cut through bone with greater accuracy than human surgeons. At expensive clinics for hair transplants, a smart robot identifies robust hair follicles on the patient’s head, harvests them, and then prepares the bald spot for the implants by poking tiny holes in the scalp in a precise pattern—sparing the doctor many hours of repetitive labor.  Surgeries involving the soft tissues within the chest, abdomen, and pelvic region, however, pose a messier challenge. Every patient’s anatomy is a little different, so an autonomous robot will have to be very good at identifying squishy internal organs and snaking blood vessels. What’s more, all the parts that make up a person’s innards can shift around during procedures, so the robot will have to continuously modify its surgical plan.

The da Vinci keeps the human surgeon in complete control; its arms remain inert pieces of plastic and metal until a doctor grasps the levers at the console. Intuitive intends to keep it that way for now, says Simon DiMaio, who manages the company’s R&D on advanced systems. However, he adds, robotics experts are already working toward a future where human surgeons operate “with increasing levels of assistance or guidance from a computer.”

DiMaio likens research in this area to early efforts on self-driving cars. “The first steps were recognition of road markings, obstacles, cars, and pedestrians,” he notes. Engineers next made intelligent cars that used their understanding of the environment to help their drivers; for example, a car that knows the locations of surrounding vehicles can warn its driver if he or she is about to make an ill-advised lane change. For surgical robots to provide similar warnings—by alerting a surgeon whose instruments stray from the typical path, perhaps—they’ll need to get a whole lot smarter. Luckily, some are already getting schooled.

Ken Goldberg darts around his lab, looking like a wild-haired Muppet version of a professor, while the robot carries on. As head of the Berkeley Laboratory for Automation Science and Engineering and a professor in four departments, including electrical engineering and art, Goldberg has a reputation for pulling off surprising feats of robotics. The painted portrait of him that hangs on the wall, which renders his face and torso in clumpy strokes of red and blue, was created by one of his early bots.  While the “flesh” being sutured in his lab is just pink rubber, the technology is the real thing. In 2013, Intuitive began donating used da Vinci systems to robotics researchers at universities around the world. So when Goldberg teaches his da Vinci how to independently perform a surgical task, the same programming could theoretically instruct commercial systems that operate on real patients. “We’re driving on the test track,” Goldberg says, “but one day we’ll take it out on the road.” He believes that simple surgical tasks will be automated within the next 10 years.  To pull off its automated suturing task, Goldberg’s da Vinci calculates the optimal entry and exit points for each stitch, plans the needle trajectory, and tracks the needle’s movements using a combination of location sensors and cameras—the needle is painted bright yellow so the computer vision system can recognize it. The task is still tough. Goldberg’s published results report that the robot completed only 50 percent of its four-stitch procedures; it most often failed when the second grasper couldn’t get a grip on the needle or got it tangled in the thread.  The professor wants to be clear: Even if robots get really good at routine surgical tasks, he still wants human surgeons watching over the machines. What Goldberg envisions is “supervised autonomy.” “The surgeon is still in charge,” he says, “but the low-level aspects of the procedure are being handled by the robot.” If robots carry out the drudge work with precision and uniformity—“think about sewing machines versus hand stitches,” he says—the gestalt of machine and human could create one supersurgeon."

Source: IEEE Spectrum
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