10 August 2010
Photo: Sgt 1st Class Roger J. Mommaerts Jr./ US Army
Doctors perform surgery using a robotic system.
Doctors routinely use robotic devices to assist them during surgery. But what if there were no longer doctors sitting at the controls of these machines?
It could happen. Researchers are exploring the use of robots with artificial intelligence to perform routine medical procedures.
Robots perform biopsies
Needle biopsies are often used to diagnose various types of cancer preventing unnecessary surgery if the tissue is deemed benign.
During this procedure, the doctor inserts a hollow needle into the tissue, obtaining a sample of the suspect cells.
But researchers at Duke University say that computer imaging technology combined with robotic artificial intelligence, or AI, may soon free doctors from having to perform this routine procedure.
"We first tried to simulate a breast tumor biopsy," says Stephen Smith, professor of biomedical engineering, radiology and medical physics at the North Carolina school. "So we make an image of a turkey breast, and inside that turkey breast we made a simulated tumor by inserting a grape into the turkey breast."
Smith says experiments with the AI system have shown that it can accurately manage these simple surgical procedures.
"So then we make a 3D ultrasound image of that turkey breast. And we then send the image to a computer, and the computer has artificial intelligence, so it finds the center of the tumor and the computer then tells the robot where to insert the needle."
Smith says that this system can locate and obtain a biopsy within two millimeters of the center of these simulated tumors.
The system can also be adapted to obtain evenly spaced samples across the entire tissue. This procedure is important for diagnosing diseases like prostate cancer, where specific elevated protein levels without the presence of a tumor can warrant a biopsy.
Intelligent robots go where doctors don't
Smith believes the technology can eventually be used in developing countries, where doctors, especially radiologists, might not be available. This allows early diagnosis that could help save lives.
"What we envision is a mobile van that would go from town to town, and the patients would get an x-ray mammogram, and if there was a lesion seen in artificial intelligence in the x-ray, then they would have a 3D ultrasound scan. And again, if the lesion was visualized by the computer, then the robot would take a biopsy."
The entire procedure currently takes one minute to complete. But, with faster computers and more flexible robots, Smith says that a minute can be reduced to seconds, during which a patient can hold his or her breath while the needle biopsy is performed.
Future of robotic surgery
Dr. Vipul Patel of the Society of Robotic Surgery says that this technology is very exciting. He's cautiously optimistic that it will pave the way to easier, less painful and more precise surgery.
"Ultimately, I guess, the goal is to have surgeries somewhat computerized and automated, where the robot, well the machine, would do the surgery, through minimal or no incision," says Patel.
He notes that doctors have already begun moving in that direction.
"The first step was the introduction of robotic surgery into urology and prostate cancer and it's become the standard. Eighty-five percent of patients get their surgeries done robotically now. We would not have thought that possible a decade ago."
The technology is being fine-tuned, and computer-located tumors are being compared to lesions found by a radiologist.
Smith says clinical trials could be underway in three to five years, and hopes the device will be commercially available within a decade.