New Surgical Techniques and Artificial Intelligence

By John Paul Mueller, Luca Massaron

Robots and artificial intelligence (AI) routinely participate in surgical procedures today. In fact, some surgeries would be nearly impossible without the use of robots and AI. However, the history of using this technology isn’t very lengthy. The first surgical robot, Arthrobot, made its appearance in 1983. Even so, the use of these life-saving technologies has reduced errors, improved results, decreased healing time, and generally made surgery less expensive over the long run.

Making surgical suggestions

You can view the whole idea of surgical suggestions in many different ways. For example, an AI could analyze all the data about a patient and provide the surgeon with suggestions about the best approaches to take based on that individual patient’s record. The surgeon could perform this task, but it would take longer and might be subject to errors that the AI won’t make. The AI doesn’t get tired or overlook things; it consistently views all the data available in the same way every time.

Unfortunately, even with an AI assistant, surprises still happen during surgery, which is where the next level of suggestion comes into play. According to this article, doctors can now have access to a device that works along the same lines as Alexa, Siri, and Cortana (the AI in devices you may actually have in your own home). No, the device won’t take the doctor’s request for music to play during the surgery, but the surgeon can use the device to locate specific bits of information without having to stop. This means that the patient receives the benefit of what amounts to a second opinion to handle unforeseen complications during a surgery. Mind you, the device isn’t actually doing anything more than making already existing research created by other doctors readily available in response to surgeon requests; no real thinking is involved.

Getting ready for surgery also means analyzing all those scans that doctors insist on having. Speed is an advantage that AI has over a radiologist. Products such as Enlitic, a deep-learning technology, can analyze radiological scans in milliseconds — up to 10,000 times faster than a radiologist. In addition, the system is 50 percent better at classifying tumors and has a lower false-negative rate (0 percent versus 7 percent) than humans. Another product in this category, Arterys, can perform a cardiac scan in 6 to 10 minutes, rather than the usual hour. Patients don’t have to spend time holding their breath, either. Amazingly, this system obtains several dimensions of data: 3-D heart anatomy, blood-flow rate, and blood-flow direction, in this short time. Watch this video about Arterys.

Assisting a surgeon

Most robotic help for surgeons today assists, rather than replaces, the surgeon. The first robot surgeon, the PUMA system, appeared in 1986. It performed an extremely delicate neurosurgical biopsy, which is a nonlaparoscopic type of surgery. Laparoscopic surgery is minimally invasive, with one or more small holes serving to provide access to an organ, such as a gall bladder, for removal or repair. The first robots weren’t adept enough to perform this task.

By 2000, the da Vinci Surgical System provided the ability to perform robotic laparoscopic surgery using a 3-D optical system. The surgeon directs the robot’s movements, but the robot performs the actual surgery. The surgeon watches a high-definition display during the surgery and can actually see the operation better than being in the room performing the task personally. The da Vinci System also uses smaller holes than a surgeon can, reducing the risk of infection.

The most important aspect of the da Vinci Surgical System, though, is that the setup augments the surgeon’s native capabilities. For example, if the surgeon shakes a bit during part of the process, the da Vinci Surgical System removes the shake — similarly to how anti-shake features work with a camera. The system also smoothes out external vibration. The system’s set up also enables the surgeon to perform extremely fine movements — finer than a human can natively perform, making the surgery far more precise than the surgeon could accomplish alone.

The da Vinci Surgical System is a complex and extremely flexible device. The FDA has approved it for both pediatric and adult surgeries of the following types:

  • Urological surgeries
  • General laparoscopic surgeries
  • General noncardiovascular thoracoscopic surgeries
  • Thoracoscopically assisted cardiotomy procedures

The point behind including all this medical jargon is that the da Vinci Surgical System can perform many tasks without involving a surgeon directly. At some point, robot surgeons will become more autonomous, keeping humans even further away from the patient during surgery. In the future, no one will actually enter the clean room with the patient, thereby reducing the chances of infection to nearly zero. You can read more about the da Vinci Surgical System.

Replacing the surgeon with monitoring

In Star Wars, you see robotic surgeons patching up humans all the time. In fact, you might wonder whether any human doctors are available. Theoretically, robots could take over some types of surgery in the future, but the possibility is still a long way off. Robots would need to advance quite a bit from the industrial sort of applications that you find today. The robots of today are hardly autonomous and require human intervention for setups.

However, the art of surgery for robots is making advances. For example, the Smart Tissue Autonomous Robot (STAR) outperformed human surgeons when sewing a pig intestine. Doctors supervised STAR during the surgery, but the robot actually performed the task on its own, which is a huge step forward in robotic surgery. This video is quite informative about where surgery is going.