
Smart Tissue Autonomous Robot (STAR), Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Health System.
Surgeons and scientists from Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National Health System are the first to demonstrate that supervised, autonomous robotic soft tissue surgery on a live subject (in vivo) in an open surgical setting is feasible and outperforms standard clinical techniques in a dynamic clinical environment.
The study, published today in Science Translational Medicine, reports the results of soft tissue surgeries conducted on both inanimate porcine tissue and living pigs using proprietary robotic surgical technology, Smart Tissue Autonomous Robot (STAR), developed at Children’s National. This technology removes the surgeon’s hands from the procedure, instead utilizing the surgeon as supervisor, with soft tissue suturing autonomously planned and performed by the STAR robotic system.
Soft tissues are the tissues that connect, support or surround other structures and organs of the body such as tendons, ligaments, fascia, skin, fibrous tissues, fat, synovial membranes, muscles, nerves and blood vessels. Currently more than 44.5 million soft tissue surgeries are performed in the U.S. each year.
“Our results demonstrate the potential for autonomous robots to improve the efficacy, consistency, functional outcome and accessibility of surgical techniques,” said Dr. Peter C. Kim, Vice President and Associate Surgeon-in-Chief, Sheikh Zayed Institute for Pediatric Surgical Innovation. “The intent of this demonstration is not to replace surgeons, but to expand human capacity and capability through enhanced vision, dexterity and complementary machine intelligence for improved surgical outcomes.”
While robot-assisted surgery (RAS) has increased in adoption in healthcare settings, the execution of soft tissue surgery has remained entirely manual, largely because the unpredictable, elastic and plastic changes in soft tissues that occur during surgery, requiring the surgeon to make constant adjustments.
To overcome this challenge, STAR uses a tracking system that integrates near infrared florescent (NIRF) markers and 3D plenoptic vision, which captures light field information to provide images of a scene in three dimensions. This system enables accurate, uninhibited tracking of tissue motion and change throughout the surgical procedure. This tracking is combined with another STAR innovation, an intelligent algorithm that guides the surgical plan and autonomously makes adjustments to the plan in real time as tissue moves and other changes occur. The STAR system also employs force sensing, submillimeter positioning and actuated surgical tools. It has a bed-side lightweight robot arm extended with an articulated laparoscopic suturing tool for a combined eight degrees-of-freedom robot.
“Until now, autonomous robot surgery has been limited to applications with rigid anatomy, such as bone cutting, because they are more predictable,” said Axel Krieger, PhD, and technical lead for Smart Tools at Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National. “By using novel tissue tracking and applied force measurement, coupled with suture automation software, our robotic system can detect arbitrary tissue motions in real time and automatically adjust.”
To compare the effectiveness of STAR to other available surgical procedures, the study included two different surgeries performed on inanimate porcine tissue (ex vivo), linear suturing and an end-to-end intestinal anastomosis, which involves connecting the tubular loops of the intestine. The results of each surgery were compared with the same surgical procedure conducted manually by an experienced surgeon, by laparoscopy, and by RAS with the daVinci Surgical System.
Intestinal anastomosis was the surgical procedure conducted on the living subjects (in vivo) in the study. The Children’s National research team conducted four anastomosis surgeries on living pigs using STAR technology and all subjects survived with no complications. The study compared these results to the same procedure conducted manually by an experienced surgeon using standard surgical tools.
“We chose the complex task of anastomosis as proof of concept because this soft tissue surgery is performed over one million times in the U.S. annually,” said Dr. Kim.
All surgeries were compared based on the metrics of anastomosis including the consistency of suturing based on average suture spacing, the pressure at which the anastomosis leaked, the number of mistakes that required removing the needle from the tissue, completion time and lumen reduction, which measures any constriction in the size of the tubular opening.
The comparison showed that supervised autonomous robotic procedures using STAR proved superior to surgery performed by experienced surgeons and RAS techniques, whether on static porcine tissues or on living specimens, in areas such as consistent suture spacing, which helps to promote healing, and in withstanding higher leak pressures, as leakage can be a significant complication from anastomosis surgery. Mistakes requiring needle removal were minimal and lumen reduction for the STAR surgeries was within the acceptable range.
In the comparison using living subjects, the manual control surgery took less time, eight minutes versus 35 minutes for the fastest STAR procedure, however researchers noted that the duration of the STAR surgery was comparable to the average for clinical laparoscopic anastomosis, which ranges from 30 minutes to 90 minutes, depending on complexity of the procedure.
Dr. Kim said that since supervised, autonomous robotic surgery for soft tissue procedures has been proven effective, a next step in the development cycle would be further miniaturization of tools and improved sensors to allow for wider use of the STAR system.
He added that, with the right partner, some or all of the technology can be brought into the clinical space and bedside within the next two years.
The Latest on: Robotic Surgery
via Google News
The Latest on: Robotic Surgery
- Iowa Company Plans To Capture Midwest Ethanol Plants' Carbon Dioxide, Permanently Store It Undergroundon March 2, 2021 at 1:41 pm
An Iowa company wants to build a pipeline that would pump carbon dioxide from 18 Midwest biorefineries to North Dakota and store it deep underground.
- Carbon dioxide would be stored underground in North Dakotaon March 2, 2021 at 1:40 pm
Summit Carbon Solutions’ project would gather carbon dioxide from at least 17 ethanol plants and pipe it to North Dakota where it would be injected into wells and stored underground. The carbon ...
- Oil Industry Trade Group Poised to Endorse Carbon Pricingon March 2, 2021 at 1:26 pm
The oil and gas industry's premier lobbying group is reportedly working on a statement endorsing carbon pricing as a way to help the United States meet its goals of the Paris agreement. What are we ...
- Governor of top coal-mining state sets carbon-negative goalon March 2, 2021 at 12:36 pm
The governor of Wyoming, the top coal-mining state in the nation, announced a goal Tuesday to capture more carbon dioxide than the state emits, as he criticized plans ...
- Government policies, economics creating market for carbon capture: Exxon CEOon March 2, 2021 at 9:05 am
Exxon, under pressure from activist investors who want the company to develop more ambitious plans for energy transition, recently launched a Low Carbon Solutions business to focus on carbon capture ...
- Iowa Company is teaming up with North Dakota for carbon capture & storageon March 2, 2021 at 8:05 am
An Iowa company is leading a $2 billion effort to capture carbon dioxide from Midwestern ethanol plants and pipe it to North Dakota where it would be buried deep underground. The greenhouse gas is ...
- Eni Shares Insight on Making Carbon Capture Goals a Realityon March 2, 2021 at 5:03 am
Eni is moving forward with carbon capture projects as part of its goal to decarbonize all of its products and services by 2050.
- Reduce, Reuse, Recycle: 5 Carbon Capture & Storage Startups Saving the World!on March 2, 2021 at 4:38 am
From capturing and reducing carbon dioxide to creating negative emissions, we've found the five carbon capture and storage startups putting climate action at the forefront of their mission statement.
- Australian government looks to spur investment in carbon capture and storage projectson March 1, 2021 at 8:22 pm
Fund forms part of the government's wider A$18 billion low emissions technology investment plan over the next decade ...
- Carbon Capture Technology Faces a Difficult Few Years, Finds IDTechEx Researchon March 1, 2021 at 11:56 am
Carbon capture, utilization, and storage (CCUS), or carbon capture and storage (CCS), is a set of technologies used to strip carbon dioxide from industrial waste gases or directly from the atmosphere.
via Bing News