Robot Performs First Fully-Automated Laparoscopic Surgery

A new robot developed by a team at Johns Hopkins University has performed the first laparoscopic surgery without human help. It performed the surgery on the soft tissue of a pig, and it is a major step towards fully automated surgery on humans.

Smart Tissue Autonomous Robot (STAR) 

The robot is called the Smart Tissue Autonomous Robot (STAR), and it was described in a paper published in Science Robotics. 

Axel Krieger is an assistant professor of mechanical engineering at Johns Hopkins’ Whiting School of Engineering. He is also senior author of the research. 

“Our findings show that we can automate one of the most intricate and delicate tasks in surgery: the reconnection of two ends of an intestine. The STAR performed the procedure in four animals and it produced significantly better results than humans performing the same procedure,” said Krieger.

The robot proved especially efficient at intestinal anastomosis, which is a procedure that requires repetitive motion and precision. It is one of the more challenging aspects of gastrointestinal surgery since it requires high accuracy and consistency. A slight hand tremor could result in massive complications for a patient. 

Building Upon 2016 Model

Krieger worked with a team at the Children’s National Hospital in Washington, D.C. and Jin Kang, who is a Johns Hopkins professor of electrical and computer engineering. Together they created the robot with a vision-guided system designed to suture soft tissue. The current model is built upon a 2016 model that was able to repair a pig’s intestines. However, the previous model required a large incision and guidance from humans. 

The current STAR system was given new features that enhance autonomy and improve surgical precision. These include specialized suturing tools and state-of-the-art imaging systems. 

According to Krieger, soft-tissue surgery is a major challenge for robots given the unpredictability. To overcome this, the STAR was equipped with a novel control system that can adjust the surgical plan in real time, similar to a human surgeon.

“What makes the STAR special is that it is the first robotic system to plan, adapt, and execute a surgical plan in soft tissue with minimal human intervention,” Krieger said.

Kang and his team of students developed a structural-light based three-dimensional endoscope and machine learning-based tracking algorithm to guide the system. 

“We believe an advanced three-dimensional machine vision system is essential in making intelligent surgical robots smarter and safer,” Kang said.

It is becoming increasingly important to have automatic robotic systems designed for laparoscopic procedures. 

“Robotic anastomosis is one way to ensure that surgical tasks that require high precision and repeatability can be performed with more accuracy and precision in every patient independent of surgeon skill,” Krieger said. “We hypothesize that this will result in a democratized surgical approach to patient care with more predictable and consistent patient outcomes.”

Some of the other team members responsible for the STAR include Hamed Saeidi, Justin D. Opfermann, Michael Kam, Shuwen Wei, and Simon Leonard from Johns Hopkins. The research was also assisted by Michael H. Hsieh, director of Transitional Urology at Children’s National Hospital.