What can AI do in robotic surgery?
Nearly every available technology is incorporating Artificial Intelligence (AI) in some capacity. Robotic surgery may also follow suit
Robotic surgery is undoubtedly one of the major advancements in healthcare. Robotic arms, generally guided by surgeons, can mimic and even exceed the capabilities of human hands.
This technology ensures smaller incisions, reduced blood loss and minimal scarring; and leads to quicker recovery. The precision and enhanced visualization guarantees greater accuracy, especially in complex procedures such as brain tumour removals.
The impact of robotic surgery has reached Bangladesh with the first robotic-assisted surgeries performed at the National Institute of Cardiovascular Diseases in January 2024.
One of the most remarkable features of AI is its ability to learn from extensive surgical procedure databases. By analysing thousands of surgeries, AI systems can identify patterns and trends, discovering new, optimal techniques. This deep learning, driven by complex algorithms, can capture the nuances of surgeons' movements and enhance precision control to submillimeter accuracy.
Keep updated, follow The Business Standard's Google news channel
Now in the age of AI, can its integration into robotic surgery make it more effective? Enayet Ullah Khan, a pharmaceutical and medical equipment specialist in Dhaka, said "AI has the potential to revolutionise surgical robotics by enhancing precision, improving decision-making, and providing real-time analytics."
However, at the same time, it also presents challenges, particularly high costs. We take a brief look into the potential use of AI in robotic surgery, the existing market for robotic surgery and beyond.
The potential role of AI in robotic surgery
Nearly every available technology is incorporating AI in some capacity. Robotic surgery may also follow suit.
Although AI-equipped robotic surgery is yet to take place, Enayet said, "It can assist surgeons by predicting outcomes, offering recommendations, and learning from vast datasets to continually improve surgical techniques and patient care."
One of the most remarkable features of AI is its ability to learn from extensive surgical procedure databases. By analysing thousands of surgeries, AI systems can identify patterns and trends, discovering new, optimal techniques. This deep learning, driven by complex algorithms, can capture the nuances of surgeons' movements, enhancing best practices and precision control to submillimeter accuracy.
For instance, an AI-equipped surgical robot, trained in hundreds of brain tumour removal surgeries, can learn efficient techniques from expert neurosurgeons. During surgery, the AI can guide the robotic arms, navigating complex anatomy to remove tumours with minimal tissue damage, ensuring highly precise and effective procedures.
Training AI-equipped surgical robots is a lengthy and complex process but it allows these robots to guide surgical procedures with extreme accuracy. They can correct a surgeon's hand tremors or deviations in real time, ensuring precise movements and reducing human error.
AI can also play a vital role in preoperative planning and intraoperative navigation, allowing surgeons to input patient-specific data for personalised surgical plans. This can lead to improved outcomes by considering the patient's anatomy, pathology and optimal pathways.
During surgery, AI can ensure precise guidance of robotic arms, further enhancing the accuracy and effectiveness of the procedure.
The market for robotic surgery
Robotic surgery has revolutionised medical procedures since its inception nearly 50 years ago with the Programmable Universal Machine for Assembly (PUMA) 560 in 1978. Dr Yik San Kwoh performed the first robot-assisted brain biopsy in 1985. These systems have evolved.
The market for these devices has expanded significantly growing from $800 million in 2015 to over $3 billion by 2023. There are continuous efforts from leading healthcare organisations and innovative startups to further advance surgical robotic systems.
The following prominent companies have significantly advanced robotic surgery technology. These include Intuitive Surgical known for its Da Vinci Surgical System and Medtronic's Hugo system.
There's also Johnson & Johnson which offers the Monarch and Velys systems. These systems cater to specific surgical fields like urology and gynaecology. It also includes robotic bronchoscopy and precise knee-replacement surgeries, among other things.
Stryker manufactures the Mako system — a robotic-arm-assisted surgery machine that perfects the process of total knee, total hip, and partial knee replacements.
The benefits of robotic surgery are manifold. It minimises human error and improves patient outcomes by reducing recovery times and complication risks. Primarily, the use of robotic arms in surgeries offers extreme precision and makes the procedure minimally invasive. This system also allows preoperative planning and intraoperative navigation, which enable more personalised surgical plans.
It can prove particularly beneficial in complex procedures such as brain tumour removal. In the case of Bangladesh's first use of robotic surgery, robotic assistance was used to place stents in two patients with heart vessel blockages at the National Institute of Cardiovascular Diseases (NICVD).
Impacts and challenges
Not only AI-equipped robot arms could learn from vast databases of previous surgeries but also it could redefine surgical care.
Dr Joseph Nathan, co-founder and chief medical officer of Foresight Robotics, told Forbes, "Today two-thirds of the global population, around 5 billion people, lack proper access to surgical treatment. So, AI-based systems can help close this gap by ensuring worldwide access to proper surgical care.
It can provide more physicians with learning opportunities from top models in their field, supporting more medical professionals in performing surgeries regardless of their location and resources. Moreover, surgeons can use AI-based robotics to expand their subspecialties and reach a broader patient population."
By analysing global data, AI can also recognise microscopic differences and identify new trends. However, the high cost of AI-equipped robotic surgery is a significant challenge.
As of 2017, robotic procedures cost around $3,568 each, and over 13 years, they were about $2,700 more per patient compared to traditional surgeries. AI integration will further increase these costs, making affordability a major issue, especially in developing countries.
"Bangladesh has increasingly adopted digital health technologies like telemedicine and electronic health records, showing a willingness to integrate new technologies. This is promising for AI and robotics, but the high costs make them challenging to fund in a country with limited healthcare budgets," concluded Enayet.
