Snakes on an operating table

A snakelike robot that operates in a patient’s throat and a steady-hand that cancels out a surgeon’s natural tremor may operate alongside doctors in future operating rooms.

Johns Hopkins University researchers are designing systems and instruments which could someday help doctors treat patients more safely and effectively and allow them to perform surgical tasks that are nearly impossible today.

The tools include a snakelike robot that could enable surgeons, operating in the narrow throat region, to make incisions and tie sutures with greater dexterity and precision. Another robot, the steady-hand, may curb a surgeon’s natural tremor and allow the doctor to inject drugs into tiny blood vessels in the eye, dissolving clots that can damage vision.

Teams in the National Science Foundation Engineering Research Centre are building these and other projects for Computer-Integrated Surgical Systems and Technology, based at Johns Hopkins.

Working closely with physicians from the Johns Hopkins School of Medicine, the centre’s engineers and computer scientists are building robotic assistants intended to enhance a surgeon’s skills. They are devising detailed visual displays to guide a doctor before and during a difficult medical procedure and planning digital workstations that would give the physician instant access to an enormous amount of medical information about the patient.

One promising example is the team’s snakelike robot. Currently, a doctor performing throat surgery must insert and manually manipulate long inflexible tools and a camera into this narrow passageway. The snakelike robot would provide an alternative. It could enter the throat with two thin rods tipped with tentacle-like tools capable of moving with six degrees of freedom. If directed, the tools can bend easily into an S-curve.

The steady-hand system, also devised by a Johns Hopkins team, was built to help with microsurgery. At this scale, even the best surgeons display some tremor in their hands. Yet the slightest uncontrolled movements can be troublesome during surgery on microscopic structures, such as tiny blood vessels in the eye. To address this problem, the steady-hand robot can grasp a needle and move it carefully in tandem with the surgeon in a technique called cooperative manipulation.

In tests of the device, the researchers have successfully injected a liquid into a chicken embryo’s blood vessels, which resemble structures in the human eye.

Before they are used on human patients, both the snakelike robot and the steady-hand system will require up to five more years of lab testing and prototype advancement.