STAR robotic surgeon performs laparoscopy independently

In 2016, a team from Johns Hopkins University (JHU) demonstrated in a study that STAR, a robotic surgeon, can adapt to precise movement and deformation of soft tissues to perform precise, consistent sutures. Simon Leonard, an assistant research professor in the Whiting School of Engineering at Johns Hopkins University, worked for four years to program this robotic arm. An improved version of STAR has been developed to perform laparoscopy completely independently. Testing against manual laparoscopy and robot-assisted surgery for a porcine intestinal anastomosis, researchers found that the standalone surgery offered by the STAR system was more accurate and therefore superior.

Laparoscopy, commonly known as laparoscopy, is performed by inserting an optical device and various instruments into the peritoneal cavity to view the organs and perform surgery without opening the abdomen. Surgeons are increasingly using this method, which allows the patient to recover faster. Many scientists are trying to develop robotic assistants to help them through these processes like Hominis, for example.

The team that designed STAR began in 2016 by noting that even the most reliable surgeon’s hand isn’t as stable and cohesive as a metal-plastic robotic arm, which is programmed to perform the same repetitive motions. She was able to demonstrate the accuracy and consistency of the robot, but the operation (intestinal anastomosis) required a large incision in the abdomen and the supervision of a surgeon. The anastomosis, which is suturing two structures such as a blood vessel or in this study, the two ends of the intestine, is very sensitive because soft tissues can move and change shape in complex ways as the suture must continue. According to the researchers, complications such as leakage along the seams occur approximately 20% of the time in colorectal surgery and 25-30% of the time in abdominal surgery.

new star

Stand-alone anastomosis requires complex imaging, tissue tracing, and surgical planning techniques, as well as careful execution, often in unstructured and deformable environments; It becomes even more difficult when performing a laparoscopy.

Researchers from Children’s National Hospital in Washington, including Axel Krieger and Jane Kang, professor of electrical and computer engineering at Johns Hopkins University, have improved the robot by adding new features to increase autonomy and improve surgical precision, thanks to specialized suture tools and case. The latest imaging systems that provide more accurate visualizations of the surgical field. A 3D endoscope based on structural light and a tracking algorithm based on machine learning developed by Kang and his students to guide STAR. Jin Kang says:

“We believe an advanced 3D robotic vision system is the key to making smart surgical robots smarter and safer.”

In addition, the autonomous control system adapts to the surgical plan in real time, as does the surgeon. For his part, Axel Krieger adds:

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

Study conclusions

Axel Krieger, lead author of the study says:

“Our results show that we can automate one of the most complex and sensitive tasks in surgery: reconnecting the two ends of the intestine. STAR performed the procedure in four animals and achieved significantly better results than humans who performed the same procedure.”

Still he says:

“The use of robotics in anastomosis will help ensure that surgical tasks that require high precision and reproducibility can be performed with greater precision and accuracy for each patient, regardless of the skill of the surgeon. We believe this will lead to the democratization of surgical care with more predictable outcomes.”

Article Sources: Autologous Robotic Endoscopic Surgery for Intestinal Anastomosis

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