Surgical robots take step towards fully autonomous operations

An AI-powered robot was able to remove a gall bladder from a dead pig in what researchers claim is the first realistic surgery by a machine with almost no human intervention.

The robot is powered by a two-tier AI system trained on 17 hours of video encompassing 16,000 motions made in operations by human surgeons. When put to work, the first layer of the AI system watches video from an endoscope monitoring the surgery and issues plain-language instructions, such as “clip the second duct”, while the second AI layer turns each instruction into three-dimensional tool motions.

In all, the gall bladder surgery required 17 separate tasks. The robotic system performed the operation eight times, achieving 100 per cent success in all of the tasks.

“Current surgical robotic technology has made some procedures less invasive, but complication rates haven’t really dropped from previous laparoscopic [keyhole] surgeries [by human surgeons],” says team member Axel Krieger at Johns Hopkins University in Maryland. “This made us look into what is the next generation of robotic systems that can help patients and surgeons.”

“The study really highlights the art of the possible with AI and surgical robotics,” says Danail Stoyanov at University College London. “Incredible advances in computer vision for surgical video with the availability of open robotic platforms for research make it possible to demonstrate surgical automation.”

But many challenges remain to make the system practical in clinical use, points out Stoyanov.

For one thing, while the robot completed the task with 100 per cent success, it had to self-correct six times per case. For example, this could mean a gripper designed to grasp an artery missed its hold on the first try.

“There were a lot of instances where it had to self-correct, but this was all fully autonomous,” says Krieger. “It would correctly identify the initial mistake and then fix itself.” The robot also had to ask a human to change one of its surgical instruments for another, meaning some level of human intervention was required.

Ferdinando Rodriguez y Baena at Imperial College London is enthused about the growing potential of robotic surgery. “The future is bright – and tantalisingly close,” he says. “Though to realise this safely in humans, regulation will need to follow suit, which remains a significant open challenge in our sector.”

The next step, says Krieger, is to let a robot operate autonomously on a live animal, where breathing and bleeding could complicate things.