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Researchers at Bristol Robotics Laboratory recently developed a robotic surgery system that allows surgeons to repair complex joint fractures without making a large incision. | Photo source SMARTsurg

Tech Explained: Surgical Robots

Healthcare & Wellbeing

Innovations in robotics are making surgery safer and more precise

You may have seen movies where a patient is placed in an automated surgical device and is completely healed by a robot. This may seem hundreds of years away, but what many do not realise is that some types of surgical robots are already in common use. So, how do these robots work, and what types of surgery are they used for?

How it works

Robot-assisted surgery is used to allow doctors to perform complex surgeries with greater precision, flexibility and control. Robots are used most frequently to perform keyhole surgery – procedures that are performed through tiny incisions. The instruments on the robot are miniaturised so they can fit through the incision.

The most common types of surgical robots have a camera arm and one or more mechanical arms, with miniaturised surgical instruments attached to them. The camera is a magnified high-definition camera that provides a 3D image of the inside of the body. The surgeon sits at a computer console positioned next to the operating table.

The surgeon controls the arms while seated at a computer console near the operating table. The console allows the surgeon to operate all of the arms of the robot at once, while the screen gives her a stereoscopic view of the inside of the patient. As the surgeon moves the controls, the movements are replicated exactly by the robot. 

With the most common types of surgical robots, the surgeon can also change the scale of the robot’s movement. For example, by selecting a three-to-one scale, the surgeon can make the tip of the robot’s arm move one inch for every three inches the surgeon’s hand moves. 

Advantages

Using robots to help perform surgery has several benefits. In addition to giving the surgeon an enhanced visual field and greater dexterity, their use allows smaller incisions to be made, which reduces the risks to the patient. The robots help surgeons to both visualise and reach those hard-to-reach places inside the body – making them especially useful for delicate and complex urological, gynaecological, and cardiothoracic procedures. 

Innovations

A report by VynZ Research estimated the global surgical robots market at €4.9 billion in 2018 and expected the market to have a compound annual growth rate of more than 10 per cent between 2019 and 2024. Given this expected growth, there have been a large number of innovations in surgical robots in recent years.

Researchers at Bristol Robotics Laboratory recently developed a robotic surgery system that allows surgeons to repair complex joint fractures without making a large incision. The system interprets CT scans using a mathematical algorithm that determines the exact displacement and rotation needed to put each bone fragment back in the correct place. This, in turn, allows surgeons to place the fragments more precisely and with a smaller incision.

Other advances include using a technique called plenoptic imaging to create a 3D model of the inside of the body, using the viewpoints of several robotic cameras. The real future of surgical robots, however, may be in miniaturisation. This allows doctors to insert the robot into the body through a small incision, and also keeps down the cost of the robots. There are already a number of robots designed for abdominal surgery that can do this, as well as a miniaturised robot designed for cataract surgery which uses instruments just 1.8mm in diameter

A Massachusetts-based start-up, Vicarious Surgical, is also working on combining miniature robots with the ability to see from the robots’ perspective using virtual reality headsets. One benefit of this would be to allow surgeons to perform procedures remotely, giving patients access to a larger pool of surgeons. The company has already raised €28.7 million from investors like Bill Gates and Salesforce founder Marc Benioff, to develop its technology.

With advances in robotics, haptics and virtual reality continuing at a rapid pace, there is every reason to believe these will allow continuing innovations in surgical robots.