Artificial intelligence and the future of surgical robotics

Abstract

In 2016, Shademan et al reported complete in vivo, autonomous robotic anastomosis of porcine intestine using the Smart Tissue Autonomous Robot (STAR).1,2 Although conducted in a highly controlled experimental setting, STAR quantitatively outperformed human surgeons in a series of ex vivo and in vivo surgical tasks. These trials demonstrated nascent clinical viability of an autonomous soft-tissue surgical robot for the first time. Unlike conventional surgical robots which are controlled in real-time by humans and which have become commonplace in particular subspecialties, STAR was controlled by artificial intelligence (AI) algorithms, and received input from an array of visual and haptic sensors. Applications of AI to clinical data for diagnostic purposes have already begun to demonstrate capability approximating that of specialist physicians.3,4 Consequentially, clinical AI has received much attention from within and outside the medical community.5 The STAR trials give clinical AI a surgical context and provide a glimpse into the future, should autonomous surgical devices be further developed. Nevertheless, their development must be rationalized and, for widespread utilization, they must confer either technical or financial advantages over conventional surgical techniques. We henceforth expand upon how this may unfold. DEFINITIONS OF AUTONOMY The International Organization for Standardization (ISO 8373:2012) defines autonomy as “an ability to perform intended tasks based on c…