The Artificial Surgeon

Coding the steps of a surgery.

How to capture the steps of a surgery and write the code for it so that a robot can operate independently ?

Up till now robotic surgery is synonymous with tele surgery. The doctor sits in front of a screen inside a console and controls the instrument panel on a distant patient by a remote. It’s more like an online video game.

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A new study tries to write the codes for a surgery which can enable a robot to operate without human intervention.

If a driverless car can navigate a busy street risking hundreds of lives, why can’t a robot operate on a single human being ?

At present the main use of this application is limited only to the training of junior surgeons.

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The study led by Germain Forestier, University of Haute-Alsace, Mulhouse, France, tries to predict the steps of surgery on the OT table from a pre-written code.

For this study, the research team used datasets from 24 lumbar disc herniation (LDH) and 18 anterior cervical discectomy (ACD) surgeries.

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The protocol:

Once you open the abdomen on a OT table each step is catalogued under three variables ( codes ).

Variable -1

One action code: eg. cut, coagulate, instill or irrigate.

Variable-2

One part code: (eg, skin, muscle, ligament, dura mater).

Variable-3

One instrument code: (eg, scalpel, dissectors, hooks or retractors).

For example one step is a written code for a dataset consisting of one each from the three variables: eg. <CUTTING> <SKIN> with < SCALPEL >

This completes one data set or one step of surgery ).

Step by step they wrote down the code for the two surgeries. For the LDH group, the dataset included 108 different activities. The ACD dataset included 82 activities.

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With more than 500,000 surgeries performed daily worldwide, the study feels a data set for a surgery can be written with a high degree of confidence.

So the next gen professors will be writing codes for surgery instead of demonstrating steps of surgery to their Juniors

Advantage:

1. The age old process of surgery teaching – “See one, Do one, Teach one” is going to be replaced by books of codes by legendary surgeons.

2. These robots can guide the trainee surgeons on the OT table.

3. In a real time surgery, they can provide a warning system to the surgeon about his deviation from the standard protocol of steps of the surgery.