Last week saw the publication of news that a robot had ‘beaten’ a human surgeon in sewing up pigs’ intestines. The robot concerned placed stitches that were more accurate, better spaced and withstood pressure better than a human surgeon. It sounded like a massive breakthrough, although other reports noted that while the robot was more accurate, the human surgeon was considerably quicker. This, of course, would have implications in a human patient under anaesthetic, when time can be crucial.
The researchers were quick to sound a note of caution, by pointing out that it was early days, and that developments in animal surgery do not always translate into humans. There is clearly a lot of work to be done before any of us is stitched up by a robot alone. But what was more surprising was that there did seem to be considerable consensus, even among surgeons, that automated surgery was likely to happen in the foreseeable future, and would probably be a good thing.
Robots, we would have to assume, are at least unlikely to leave their tools behind inside their patients, and improving consistency has long been a goal among surgeons.
Not just the future
Early days or not, it seems robotic surgery is not only the future, but also the present to a certain extent. Robotics are already used extensively in surgery, although they are at the moment still routinely controlled by a human surgeon, rather than autonomous.
Robots have been used to semi-automate some operations in healthcare, a technique reported in the scientific literature over ten years ago. This application of artificial intelligence to healthcare has since been adopted around the world, in various forms.
At Guys and St Thomas’ NHS Foundation Trust in London, surgical teams in urology, gynaecology, ear nose and throat, and maxillofacial specialties currently use, or are developing programs to use, a Da Vinci robot, controlled by a surgeon seated at a console. Not only does the robot have four arms, so that two surgeons can operate at once, but its magnification allows surgeons to see in much more detail than with the naked eye. The robot also allows surgeons much finer control than they would have by hand. Guy’s Hospital has had a Da Vinci robot since 2004, and is now a major robotics specialist centre in urology.
Robotics is clearly becoming ubiquitous in healthcare if Google is getting in on the act. In March last year, Google announced a partnership with Johnson and Johnson, the healthcare company, to develop surgical robots that use artificial intelligence. Like Guy’s Hospital’s Da Vinci robot, the new platform will be used by human surgeons, rather than replace them. It will provide human operators with the ability to be more accurate and precise than is possible by hand, and also supports minimally invasive procedures.
A partnership between humans and machines
The key with these developments is the use of robotics and computers to supplement the capacity of humans, not to replace them. These robots, for example, reduce the potential for human error through a hand tremor. When working at this micro-level of detail, the smallest movement, even a twitch, can have disastrous consequences, and eliminating it will improve consistency and outcomes.
We have seen that both humans and computers are at their most powerful when they work together. It seems that this pattern also holds true in healthcare, at least at the moment.
But what of the new development announced last week, the autonomous robot surgeon? Well, it may be autonomous, but it is totally dependent on its programmers to give it the right tools. The researchers, for example, provided their robot with infrared vision and a 3-D camera, so that it could see and locate structures around it. They also gave it the best quality surgical tools, and a sensor so that it can detect how tight it is pulling sutures. Finally, but perhaps most importantly, they gave it information about best-practice surgical techniques for its task, so that it could ‘decide’ what to do to best achieve its objective.
In other words, the robot could not have achieved its success without the humans who programmed it. Whether the human is controlling the robot by sitting at a console and directing it in real time, or by providing it with the tools and information it needs, and then standing back, the human is still a crucial part of the system. Human-machine partnership looks very much like being the future, in healthcare as well as other areas where artificial intelligence is being applied.