Virtuoso’s system delivers two robotically controlled, needle-sized manipulators that work from the tip of a rigid endoscope less than half the diameter of a U.S. dime. | Source: Virtuoso Surgical
Virtuoso Surgical Inc. yesterday announced that it has participated in a multi-institution award from the federal Advanced Research Projects Agency for Health (ARPA-H) program. The up to $12 million award brings together robotics and artificial intelligence experts from many of the top surgical robotics and computer science labs in the U.S.
The award supports the placement of the Virtuoso Surgical System at three of the participating research sites. All AI and machine learning (ML) development will take place using the platform. The project also creates a team of embedded AI/ML experts within Virtuoso Surgical to support the university research teams.
The ARPA-H program aims to advance autonomy at a less-invasive scale in surgery (ALISS) and enable fully autonomous surgical procedures. Robert J. Webster, III, Ph.D., a Vanderbilt engineering professor and co-founder and president of Virtuoso Surgical, plus robotic surgical experts from Vanderbilt University Medical Center (VUMC) and Johns Hopkins, are leading clinical development efforts in the project.
“Fully autonomous surgical robots will transform medicine,” said Webster. “Not only will they make routine procedures safer and more affordable, but they will also address the worldwide shortage of surgeons and expand global access to lifesaving surgeries.”
Flexible tool maker joins academics
Virtuoso Surgical claimed that its endoscopic surgical system can replace straight tools in almost any rigid endoscopic procedure and enable the surgeon to grasp, manipulate, and cut tissue with greater dexterity than the current rigid endoscopy. The system delivers two robotically controlled, needle-sized manipulators that work from the tip of a rigid endoscope less than half the diameter of a U.S. dime.
The Nashville, Tenn.-based company said the system reduces the need for awkward and potentially dangerous endoscope movements. It added that it enables surgeons to manipulate tissue as though their hands were inside the body.
The research team includes advanced robotics, imaging, and AI researchers from Vanderbilt University, Johns Hopkins University, the University of Tennessee-Knoxville, and the University of Utah. It has 14 Ph.D.s, 22 postgraduate researchers, and five leading surgeon-scientists.
Virtuoso uses demonstration-based learning
Virtuoso Surgical said the key to its novel approach is demonstration-based learning.
“By enabling robots to learn from, and be coached by, human surgeons, we will create brand new machine learning algorithms beyond anything that exists today,” said Webster. “Surgeons will literally train robots just like they train residents and fellows today. The result will be systems that initially help surgeons be more accurate and efficient, and eventually fully automate surgical procedures.”
By initially having human surgeons teleoperate the Virtuoso Surgical System as the human performs surgery, the robot can “shadow” the human’s decision-making, learning more generalized skills.
“Our algorithms are watching the commands the surgeon sends to the robot and what they were looking at through the robot’s camera at the time,” said Alan Kuntz, Ph.D., assistant professor at University of Utah, and one of the leaders of the AI algorithm development.
“By looking at the history of those commands, the algorithms can infer how what the surgeons did changed based on what they saw,” he said. “The robot can then apply these learned strategies to new surgical decisions that it hasn’t encountered before.”
“We will further enable the robot to understand its own uncertainty, knowing what it doesn’t know so that it can ask a human surgeon for input, clarification or to take over when it is unsure of how to proceed,” added Kuntz. “That’s a key building block for robust autonomy.”
Within the next three years, the research team plans to demonstrate a robotic surgical device capable of removing tumors from the trachea and prostate without the direct intervention of a surgeon. These will initially be demonstrated in simulated conditions and not on live patients.
“Creating a system that can learn from human surgeons — and continue to improve performance — will be a game changer,” said Duke Herrell, a professor of urology, founder of VUMC’s Minimally Invasive Urologic Surgery and Robotics Programs, and Virtuoso’s CEO “Our vision is not to replace surgeons, but to vastly expand the work they do to improve patients’ lives and long-term health outcomes.”
The team also foresees this research having future applications to uterine fibroids, bladder tumors, spine procedures, and brain cysts, among other clinical applications in the future.
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