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Although Intuitive Surgical’s da Vinci system was approved by the U.S. Food and Drug Administration almost two decades ago, surgical robot adoption has been slow, partly because of technical limitations and the high demand for precision. Advances in processing and better data analysis could help make robotic surgery more effective.
Robots that mimic a surgeon’s hand movements can unintentionally retain hand tremors or shakes, making incisions less precise. Plus, slow connections have made remote operations difficult — until now.
AI-powered diagnostics and surgical robotics
Artificial intelligence in healthcare used to be limited to research or creating training tools for surgeons. AI can now increasingly help improve robot-assisted surgery.
AI can also lead to more accurate diagnoses and treatment. With better data monitoring, doctors can determine risks to patient health that they might not otherwise catch. Robot surgeons could soon use AI and healthcare data, like medical imaging or X-rays, to automatically diagnose patients without a physician.
Robots with AI are already assisting surgeons with microsurgery. For example, researchers at the Maastricht University Medical Center in the Netherlands used an AI-assisted robot to suture microscopically small blood vessels — some as small as .03 millimeters across.
The robot replicated the surgeon’s hand movements at a miniature scale. AI was used to normalize those movements and prevent tremors or sudden motions from transferring to the surgical robot. The procedure was successful.
Baltimore, Md.-based Galen Robotics is working on similar technology for otolaryngology procedures based on research at Johns Hopkins University (see video above).
Some surgical robots run off a preset routine. They’re not wholly autonomous, and surgeons still need to monitor operations and verify that procedures get carried out correctly. They can also adjust the routine if necessary.
However, scientists at Stanford University claim that AI will make fully-autonomous surgical robots possible by the end of the century.
Telemedicine and remote healthcare
Even if Moore’s Law is broken, computing speeds have accelerated steadily, while data-transmission speeds have not. With 5G wireless networking, telemedicine is becoming possible for the first time.
Telemedicine can be a life-saver when patients need immediate care, but no doctor is available. In rural areas, when specialized care is unavailable, this technology can save lives.
In addition, with augmented reality and virtual reality, surgery and interactions between patients and doctors could acquire a new dimension.
Telemedicine and remote, robot-assisted surgery require networks that can support real-time, high-quality video and audio. In many cases, 4G speeds aren’t enough to support telemedicine. Connection speeds limit telemedicine to wired access, making it less useful in rural areas with underdeveloped internet infrastructure.
5G promises to increase network speeds to nearly 20 times faster than 4G. The technology will likely increase the reach of online programs, allowing patients quicker access to doctors, or the ability to talk to specialists, when none were previously available.
Telesurgery and real-time feedback
While some kinds of remote healthcare are possible with slow connections, surgeons see their procedures as too risky. Still, one of the first remote surgeries was performed back in 2001, when two surgeons in New York performed successful gallbladder surgery on a patient in Strasbourg, France.
Advances in telesurgery lagged after this initial breakthrough. Gallbladder surgery was chosen to be one of the first remote surgeries because it is relatively straightforward, and live audio and video streams from the operating room were costly to transmit. Surgeons feared that more complicated procedures either weren’t possible with existing technology or would be too costly for most hospitals.
More recently, surgeons in China monitored three remote orthopedic surgeries with surgical robots and 5G. Each robot conducted a preset surgical routine, while the surgeons watched a video feed of the broadcast online.
In February, a team of Spanish doctors directed surgery live from the Mobile World Conference in Barcelona. In this case, the doctors provided advice, warned about potential complications, and drew diagrams over a live video feed of the surgery. The images drawn were instantly broadcast to a screen in the operating room.
The ability to instantly transmit the drawings is a major advancement. “Before 5G, we had to freeze the image to draw,” one of the doctors said, “but the surgeon is moving on, and that is not ideal.”
The next month, a Chinese surgeon performed remote brain surgery on a patient with Parkinson’s disease more than 1,800 miles away. It was the first brain surgery performed over 5G and was followed by other procedures in China, India, and Spain. So far, however, 5G telesurgery hasn’t arrived in U.S., partly because of the a slower rollout of 5G there compared with China.
Surgical roboticists and healthcare professionals hope the technology will slowly become more robust. Eventually, these robots should allow specialized surgeons to perform surgery in rural locations without the need to travel.
Better data protection needed
Unfortunately, privacy concerns have slowed the adoption of mobile and digital tools to manage client data. In 2017, Memorial Healthcare System (MHS) paid $5.5 million in fines to the U.S. Department of Health and Human Services after more than 115,000 patient records were improperly accessed.
As personal data becomes more valuable, and cybercrime becomes a more significant threat, hospitals and healthcare providers may become more cautious when it comes to trusting third-party software with health data.
Still, there have been relatively few healthcare data breaches, and the benefits for patients may outweigh the potential risks.
Still, telesurgery providers have yet to fully address security holes that might slow down technology adoption. While no hacker gained access to a robot during an actual operation, researchers at the University of Seattle hijacked a telesurgery robot called Raven II in 2015. The researchers cautioned that wireless connections — like those over 5G — are more vulnerable than wired connections.
The Robot Report is launching the Healthcare Robotics Engineering Forum, which will be on Dec. 9-10 in Santa Clara, Calif. The conference and expo will focus on improving the design, development, and manufacture of next-generation healthcare robots. Learn more about the Healthcare Robotics Engineering Forum, and registration is now open.
Better data and healthcare robotics
As robots become more common in assistive, therapeutic, materials handling, and surgical uses in healthcare, they will increasingly rely on AI for better data management and analysis. Procedures once considered impossible could become a reality with more flexible surgical robots.
China, South Asia, and Europe have taken the early lead with telemedicine and telesurgery. In the U.S., the FDA has been cautious because of concerns about safety and security, but several systems are in the works and have been submitted for approval. As 5G and robotic surgery trials continue, the technology could spread and become commercially successful.
In the not-too-distant future, you may not need to travel far from home to receive help from a medical specialist. Robotics could allow doctors to once again make house calls.
Moji Ghodoussi says
Your reference to remote surgery in 2001 has a wrong conclusion. In case you are interested you can reach me and I’ll elaborate.