By Emily Bary
Illustration by Doug Chayka
The same sorts of detection and emergency-braking features that have helped make cars safer may soon be coming to the operating room. These could show surgeons things they can’t see with their eyes, such as real-time blood flow, and enable them to avoid tissue damage as they operate.
Advancements in artificial intelligence and sensing technologies are breathing new life into the market for robotic-assisted surgical devices, making it easier for surgeons to navigate small incisions, understand changes to the body and limit strain on joints.
Performing a robotic procedure today can look a bit like playing a video game, but as the technology progresses, some futurists think we’ll reach a day when surgeons won’t even need to be in the operating room at all during a procedure.
“We want to remove surgeons from doing the fine precision work, which is really about how good you are with your hands, and move them into a more supervisory role of how and where you treat disease,” said Michael Yip, an assistant professor of electrical and computer engineering at the University of California, San Diego.
Part of Yip’s research involves ways for a robot to explore the body and give the doctor several courses of action from which to choose. Once the doctor picks, the robot could execute the procedure while the doctor supervises.
The concept of autonomous robotic surgical machines can seem straight out of science fiction, and they’re admittedly many years from ever becoming reality. But Yip thinks the technology could broaden access to top surgeons and specialists, making it so patients in rural hospitals or on battlefields can get the same treatment as those in big metropolitan areas with a wealth of nearby specialists.
Robotic surgery has long been part of American operating rooms, driven primarily by Intuitive Surgical /zigman2/quotes/204935713/composite ISRG +2.46% , which dominates the market for soft-tissue robotic-assisted devices. But a crop of new entrants that happen to be some of the largest health-care companies in the world — Johnson & Johnson /zigman2/quotes/201724570/composite JNJ +0.68% , Medtronic /zigman2/quotes/206816578/composite MDT +1.87% and Stryker /zigman2/quotes/207664662/composite SYK +3.04% — are investing billions of dollars into a new wave of surgical robots.
“We want to remove surgeons from doing the fine precision work, which is really about how good are you with your hands, and move them into a more supervisory role of how and where you treat disease.”
Michael Yip, assistant professor of electrical and computer engineering at the University of California, San Diego
After robotic-assisted devices broke on to the scene with fanfare near the beginning of the millennium, excitement plateaued amid questions about whether machines were actually contributing to better patient outcomes compared with traditional laparoscopies, or minimally invasive procedures.
Now, scientists are excited about the potential for artificial intelligence, improved connectivity, and other technological advancements to make robotic surgery more accurate and accessible, giving a boost to a surgical phenomenon that still makes up a sliver of procedures done today.
In robotic-assisted surgery, doctors sit behind a controller and operate computerized instruments as they perform minimally invasive surgery. The technology is meant to let doctors perform these procedures with more precision and control than they might achieve by standing above a patient’s body and maneuvering the surgical instruments by hand.
The market for robotic-assisted surgery is $4 billion, according to estimates from Medtronic, already half the size of the market for traditional minimally invasive surgery.
That’s striking because robotic procedures currently only make up about 2% of all procedures, by the company’s estimates, while traditional minimally invasive surgery accounts for 30% to 35%. More than 60% of procedures are traditional open surgeries done with larger incisions.
“Both [open and traditional minimally invasive surgeries] will be drawn into robotic-assisted surgery,” said Robert White, Medtronic’s executive vice president for minimally invasive therapies, at an investor briefing in September according to a transcript. The company plans to launch a soft-tissue robot soon.
Hospitals tend to view robotic machines as marketing vehicles that can make their facilities stand out from rivals. Yet adoption varies depending on procedure type, and the scientific literature is mixed on whether robots provide benefits over more conventional procedures.
Technological enhancements could help the machines more uniformly bear out their early goals of improvements in patient outcomes and cost.
One key issue the surgical industry is looking to solve is visibility. Doctors can only see so much inside the body under regular “white light,” but some are upbeat that sensory improvements can help them detect in real time what can’t be seen with the naked eye.
Merged with 3-D scans of the body taken before a procedure, this information can help surgeons plot a course of action and adapt as a procedure unfolds.