Automation Tools Assist, but Do Not Replace, Surgeons

(p. D4) Using many of the same technologies that underpin self-driving cars, autonomous drones and warehouse robots, researchers are working to automate surgical robots too. These methods are still a long way from everyday use, but progress is accelerating.

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The aim is not to remove surgeons from the operating room but to ease their load and perhaps even raise success rates — where there is room for improvement — by automating particular phases of surgery.

Robots can already exceed human accuracy on some surgical tasks, like placing a pin into a bone (a particularly risky task during knee and hip replacements). The hope is that automated robots can bring greater accuracy to other tasks, like incisions or suturing, and reduce the risks that come with overworked surgeons.

During a recent phone call, Greg Hager, a computer scientist at Johns Hopkins, said that surgical automation would progress much like the Autopilot software that was guiding his Tesla down the New Jersey Turnpike as he spoke. The car was driving on its own, he said, but his wife still had her hands on the wheel, should anything go wrong. And she would take over when it was time to exit the highway.

“We can’t automate the whole process, at least not without human oversight,” he said. “But we can start to build automation tools that make the life of a surgeon a little bit easier.”

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. . . the Berkeley researchers have been working to automate their robot, which is based on the da Vinci Surgical System, a two-armed machine that helps surgeons perform more than a million procedures a year. Dr. Fer and his colleagues collect images of the robot moving the plastic rings while under human control. Then their system learns from these images, pinpointing the best ways of grabbing the rings, passing them between claws and moving them to new pegs.

But this process came with its own asterisk. When the system told the robot where to move, the robot often missed the spot by millimeters. Over months and years of use, the many metal cables inside the robot’s twin arms have stretched and bent in small ways, so its movements were not as precise as they needed to be.

Human operators could compensate for this shift, unconsciously. But the automated system could not. This is often the problem with automated technology: It struggles to deal with change and uncertainty. Autonomous vehicles are still far from widespread use because they aren’t yet nimble enough to handle all the chaos of the everyday world.

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Many obstacles lie ahead, scientists note. Moving plastic pegs is one thing; cutting, moving and suturing flesh is another. “What happens when the camera angle changes?” said Ann Majewicz Fey, an associate professor at the University of Texas, Austin. “What happens when smoke gets in the way?”

For the foreseeable future, automation will be something that works alongside surgeons rather than replaces them.