In 1996, the da Vinci surgical robot was introduced by Intuitive Surgical in the United States. As the da Vinci robot began to be widely used in various departments of hospitals around the world, people started to wonder: what role will robots play in the operating room in the future? Will they replace surgeons?
At the recent 2017 World Robotics Conference, Professor Yang Guangzhong, a Fellow of the Royal Academy of Engineering and Director of the Hamlyn Centre for Robotic Surgery at Imperial College London, discussed the development direction of future medical robots under the theme of “Human-Machine Symbiosis – The Future of Medical Robots.” The following content is excerpted from Professor Yang’s speech:
Professor Yang Guangzhong, Fellow of the Royal Academy of Engineering
I come from the Hamlyn Centre, and my main work now is to develop safe, effective, and accessible technologies. We know that medical robotics has attracted a lot of attention from a high-tech perspective, but in the next five to ten years, our focus will be on how to enable this technology to benefit everyone. Some people may think about this issue not only from a technical perspective but also from a surgeon’s perspective, which is how to promote the development of surgical techniques.
In the past few hundred years, open surgery has been standard; today, we still use this method in surgical procedures. At the same time, minimally invasive surgery, which reduces bleeding and has many other benefits, is also being researched. Some technologies for minimally invasive surgery emerged in the 1970s, and now we already have some minimally invasive surgical techniques. However, there are challenges in performing minimally invasive or less invasive techniques, including the complexity of tool control and coordination between different tools, which require assistance from our medical robots. The first generation of medical robots was designed for certain surgical procedures.
Medical robots have made significant progress in the past twenty-five years. What may have been specialized robots in the past have now expanded their application scope, including platforms like the da Vinci system. Therefore, significant advancements have been made in various fields. Currently, there are about 4,000 such robots in use globally.
da Vinci Surgical Robot
The next generation of systems is continuously being developed, and we have never stopped the development process. However, the latest products have not yet been officially launched. The new technologies can incorporate the latest advancements, including performing practical tasks through visual and voice technologies. Surgical robots have evolved from a very small application field twenty-five years ago to being used in many areas today, and their precision and medical quality are expected to improve in the coming years. From a commercial perspective, the prospects are also significant, as many startups have entered this field, with an annual compound growth rate of 13%, and by 2020, the market size is expected to reach nearly $18 billion. Of course, this is still a relatively conservative estimate. In the future, we will see more specialized robotic platforms that will be smarter and capable of being used in various types of surgical procedures.
What problems, challenges, and opportunities do we face? Medical robots have entered a golden era. Looking back at past experiences and current specific heroic examples in the medical field, will we need larger and more complex systems in the future? Will robots play a major role in the operating room, or will we need smaller robots? These are questions we need to answer, so it’s not just about legal, ethical, and commercial issues; from a technical perspective, it also brings many challenges.
What direction will future medical robots develop in? We need to enhance their visual and perceptual capabilities, including better feedback functions and more powerful intelligence.
The first step is addressing the issues of access and control, specifically how to respond accurately in this complex environment. How can we make these robots stable yet very agile? This is a crucial area. In the medical field, robots need to maintain stability at a specific position to provide the stability required during surgery; at the same time, they also need to move very flexibly.
Next, we need to provide better visual capabilities that fully utilize preset image functions, including real-time visual capabilities, and even combine past images and videos for learning. Robots can assist surgeons in seeing areas that are not visible, for instance, by moving tissues or avoiding impacts caused by human errors. This tool must be very precise and sensitive, so by combining robotic technology with augmented reality and visual technology, we can make the surgical process safer. This requires further enhancement of the robot’s perceptual and visual capabilities. More importantly, for it to be used in daily clinical work, it should even be operable on an iPad.
The next level requires integrating various imaging and visual technologies. Robots at this level could even change the entire surgical process, such as in tumor surgeries. With the use of robotic technology, we can provide real-time information, making procedures more precise and accurate. Through robotic observation, we can see not just a static state but also a real-time dynamic state, with a delay of only milliseconds, which presents us with significant opportunities.
The real benefit is that you can observe things more closely. In interventional and minimally invasive surgeries, robotic observation can reveal specific deformations in certain areas. Even minor changes in some organs can significantly impact the surgical process. Considering the actual environment of surgery and incorporating real-time visuals, all these can be applied. Through robotic arms, we can perform surgeries more precisely, locating the cells we want. This is the true added value of robots; it is not about having robots do what surgeons can currently do.
We can even delve deeper into the molecular and atomic levels. Robots can now detect cancer and even understand diseases at the atomic level. The next level requires making robots smarter, allowing them to learn from the information during surgical processes and utilize this perceptual function to ensure that robots better understand patient conditions. This even requires interaction between patients and robots. How to achieve interaction between humans and machines so that robots can better understand patient symptoms is something we need to continuously improve.
In addition to the examples mentioned above, there are many other areas to explore. Future robots should become safer, more effective, and have a wider range of applications. We also hope to make robots more streamlined, with more functions, easier to use, and better machine vision, but ultimately, we hope for the best surgical outcomes. We aim to combine particularly large systems with micro-material technologies, such as nanotechnology, which are our development directions.
There are also small robots that can be used in water, as well as nanorobots that can treat common diseases. Other types of small robots can be used for eye surgeries, and some can be used for auditory repairs, all of which are robots performing surgeries at very miniature levels. These robots will be promoted in traditional surgical procedures. Due to the development of medical technology over the past sixty years, I believe the next milestone will be medical robots, enabling us to perform many tasks that were previously impossible.