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Archive Hot Technology 2017

Ready for Autonomous Surgical Robots?

Q&A with Peter C. Kim, MD, surgical innovator and developer of robotic surgery's next big thing.

Peter C. Kim, MD

Why develop an autonomous robot?
Although a great deal of new technology has been introduced as surgery has evolved from open procedures, to minimally invasive approaches and to teleoperated robots, complication rates haven't changed significantly. At the end of the day, surgeons operate surgical tools with different skill sets, experience and training. Our vision is to program a machine that provides surgeons with access to the best surgical techniques. We want to make surgery safer by democratizing it.

How does the technology work?
We built a smart surgical robot that operates beyond the human visual spectrum and added a degree of artificial intelligence similar to the technology that operates driverless cars. Integrating near infrared florescent markers and 3D plenoptic vision gives the bedside platform an awareness of where target issue is located in relation to the robot's surgical tools. That's the novelty.

Can robots really be trusted to perform delicate surgeries?
Our platform recently performed surgeon-supervised autonomous soft tissue procedures on living pig models. We programmed the robot to attach various bowel segments that varied in size, shape and thickness, and then compared the results to the same tasks performed by experienced surgeons using open surgical tools, minimally invasive instruments and currently available robotic platforms. To our surprise, the robot outperformed the surgeons in several metrics, including the consistency and evenness of suturing, the pressure at which the anastomosis leaked and the number of mistakes that required removing the needle from the tissue.

Will the technology someday make surgeons obsolete?
We're not trying to replace surgeons. Widespread adoption of robotic technology is lacking. One of the ways to increase its usage is to make the tools smarter and able to work with surgeons instead of depending on their dexterity and technical proficiency. Linking smarter robots to cloud-based data of optimal surgical techniques will let surgeons perform more effective and safer surgeries for many different types of procedures from anywhere in the world. That's the ultimate vision. OSM

Dr. Kim (pkim@childrensnational.org) is a pediatric surgeon and the vice president and associate surgeon-in-chief of the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children's National Health System in Washington, D.C.

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