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Watch this robot because it learns to stitch up wounds

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Watch this robot because it learns to stitch up wounds

An AI-trained surgical robot that could make a number of stitches by itself is a small step toward systems that may aid surgeons with such repetitive tasks.

A video taken by researchers on the University of California, Berkeley, shows the two-armed robot completing six stitches in a row on a straightforward wound in imitation skin, passing the needle through the tissue and from one robotic arm to the opposite while maintaining tension on the thread. 

Though many doctors today get help from robots for procedures starting from hernia repairs to coronary bypasses, those are used to help surgeons, not replace them. This recent research marks progress toward robots that may operate more autonomously on very intricate, complicated tasks like suturing. The teachings learned in its development is also useful in other fields of robotics.

“From a robotics perspective, it is a really difficult manipulation task,” says Ken Goldberg, a researcher at UC Berkeley and director of the lab that worked on the robot.  

One issue is that shiny or reflective objects like needles can throw off a robot’s image sensors. Computers even have a tough time modeling how “deformable” objects, like skin and thread, react when poked and prodded. Unlike transferring a needle from one human hand to a different, moving a needle between robotic arms is an immense challenge in dexterity.

The robot uses a pair of cameras to soak up its surroundings. Then, having been trained on a neural network, it’s in a position to discover where the needle is and use a motion controller to plan all six motions involved in making a stitch. 

Though we’re a good distance from seeing these kinds of robots utilized in operating rooms to stitch up wounds and organs on their very own, the goal of automating a part of the suturing process holds serious medical potential, says Danyal Fer, a physician and researcher on the project. 

“There’s a variety of work inside a surgery,” Fer says, “and oftentimes, suturing is the last task you might have to do.” Meaning doctors usually tend to be fatigued when doing stitches, and in the event that they don’t close the wound properly, it could actually mean an extended healing time and a number of other complications. Because suturing can be a reasonably repetitive task, Goldberg and Fer saw it as a great candidate for automation.

“Can we show that we actually get well patient outcomes?” Goldberg says. “It’s convenient for the doctor, yes, but most significantly, does this lead to higher sutures, faster healing, and fewer scarring?”

COURTESY OF KEN GOLDBERG

That’s an open query, for the reason that success of the robot comes with caveats. The machine made a record of six complete stitches before a human needed to intervene, however it could only complete a median of about three across the trials. The test wound was limited to 2 dimensions, unlike a wound on a rounded a part of the body just like the elbow or knuckle. Also, the robot has only been tested on “phantoms,” a kind of fake skin utilized in medical training settings—not on organ tissue or animal skin.

Axel Krieger, a researcher at Johns Hopkins University who was not involved within the study, says the robot made impressive advancements, especially in its ability to seek out and grasp the needle and transfer it between arms.

“It’s quite like finding a needle in a haystack,” Krieger says. “It’s a really difficult task, and I’m very impressed with how far they got.”

Krieger’s lab is a pacesetter in robotic suturing, albeit with a distinct approach. Whereas the Berkeley researchers worked with the da Vinci Research Kit, a shared robotics system used for laparoscopic surgeries in an extended list of operating rooms, Krieger’s lab built its own system, called the Smart Tissue Autonomous Robot (STAR). 

A 2022 paper on the STAR showed it could successfully put stitches in pig intestines. That was notable because robots have a tough time differentiating colours inside a sample of animal tissue and blood. However the STAR system also benefited from unique tech, like infrared sensors placed within the tissue that helped tell the robot where to go, and a purpose-built suturing mechanism to throw the stitches. The Berkeley robot was as a substitute designed to stitch by hand, using the less specialized da Vinci system. 

Each researchers have a laundry list of challenges they plan to present to their robot surgeons in the long run. Krieger desires to make the robot easier for surgeons to operate (its operations are currently obscured behind a wall of code) and train it to handle much smaller sutures. 

Goldberg desires to see his lab’s robot successfully stitch more complicated wound shapes and complete suturing tasks faster and more accurately. Pretty soon, the lab will move from testing on imitation skin to animal skin.

Chicken is preferred. “The good thing is you only exit and buy some chicken from the food market,” he says. “No approval needed.”

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