Medical Robotics




Medical Robotics










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Medical Robotics

by James G. Barr

Copyright 2022, Faulkner Information Services. All
Rights Reserved.

Docid: 00018028

Publication Date: 2206

Publication Type: TUTORIAL

Preview

The term “robotics” refers to the engineering and operation of machines
that perform physical tasks on behalf of humans.1 Robots are typically used to perform functions that are either highly
repetitive, potentially dangerous, or require extreme precision. Originally deployed to automate industrial processes like automobile
assembly, robots and robotics have evolved to encompass numerous missions,
from guiding vehicles that survey planets to acting as adjunct
physicians that assist surgeons in the performance of
delicate operations. This last example is part of a subgenre of
modern robotics called “medical robotics,” or the application of robotics
to the maintenance of human health and well-being.

Report Contents:

Executive Summary

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The term “robotics” refers to the engineering and operation of machines
that perform physical tasks on behalf of humans.2 Robots are typically used to perform functions that are either:

  • Highly repetitive
  • Potentially dangerous, or
  • Require extreme precision

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Originally deployed to automate industrial processes like automobile
assembly, robots and robotics have evolved to encompass numerous missions,
from guiding vehicles to survey planets to acting as adjunct
physicians that assist surgeons in the performance of
delicate operations. This last example is part of a subgenre of
modern robotics called “medical robotics,” or the application of robotics
to the maintenance of human health and well-being.

Medical Subfields

A rapidly expanding field, medical robotics is divided into a number of
subfields, including:

  • Laparoscopic – Using robots to perform minimally-invasive
    surgeries.

  • Non-laparoscopic – Using robots to perform general surgeries.
  • Assistive wearable –
    Using robots to improve the mobility of
    patients with musculoskeletal or neuromuscular impairments.
  • Therapeutic rehabilitation – Using robots to perform repetitive
    movement therapies for patients with neurological injuries.
  • Capsule – Using robots, in the form of a patient-swallowed
    “smart pill” to perform gastrointestinal imaging.
  • Radiotherapy – Using robots to deliver precise radiation
    treatments without unnecessarily exposing clinical personnel.
  • Laboratory – Using robots to safely perform lab tests involving
    potentially harmful chemical agents or biological matter.
  • Prosthetic – Using robots to replace lost limbs and limb
    functionality.
  • Hospital – Using robots to deliver meals and medication,
    transport biological specimens, and sanitize rooms and exposed surfaces.
  • Social – Using robots to provide patients with cognitive
    support, especially children and the elderly.3,4

Laparoscopic Robotics

As researchers recently reported, “Laparoscopic robotics is perhaps the
most mature and certainly the most commercially successful subfield of
medical robotics.”5 A major contributing factor is the development of the Da Vinci
Surgical System, manufactured by Intuitive. As described by
the Cleveland Clinic, the Da Vinci Surgical System (as pictured in Figure
1) is a medical robotics tool that helps surgeons perform a variety of
procedures including gynecological surgeries, urological, head and neck,
thoracic, colorectal, cardiac, and general surgeries. The system is
minimally-invasive, employing small incisions (less than or equal to one
centimeter), miniature surgical instruments, and a laparoscope
(essentially a telescope consisting of a thin tube, a light, and a camera
lens).6

Figure 1. Da Vinci Xi Surgical Systems

Figure 1. Da Vinci Xi Surgical Systems

Source: Intuitive

Medical Horizon

Among the more promising but still-emerging innovations in the field of
medical robotics are:

  • Soft robots that are made from soft, flexible materials rather than
    conventional metal, thus improving their ability to negotiate tight
    biological spaces.
  • Self-healing robots capable of diagnosing and repairing
    themselves.7

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Rapid Market Growth

Renub Research predicts that the global medical robotics market will
expand at a compound annual growth rate (CAGR) of 21 percent during the
period from 2021 to 2027, reaching a very respectable $30.41 billion in
2027.

This growth will be largely fueled by:

  • “The global benefits of robotic-assisted surgery and robot-assisted
    training in rehabilitation therapy,
  • “Technological advancements in robotic systems,
  • “Improving reimbursement scenarios,
  • “Increasing adoption of surgical robots, and
  • “Increased funding for medical robot research.”8

Patients and Physicians

Commercial research and development (R&D) efforts “follow the money”
with the heaviest spending funneled into areas promising the largest
financial gains. In the case of medical robotics, however, measuring
return on investment (ROI) can be complicated, particularly as researchers
recently revealed, quite remarkably, that medical robotics “cannot yet
point to comprehensive clinical trials that show that robotic surgical
procedures provide improved procedural outcomes for patients or reduced
procedure cost compared with non-robotic surgery.”

While such clinical findings may be missing, there exists substantial
testimonial evidence that medical robotics provide tangible benefits for
both patients and physicians. For patients, these advantages
include:

  • “Shorter hospital stays,
  • “Faster recuperation,
  • “Fewer re-operations [‘getting it right the first time’], and
  • “Reduced blood transfusions.”

For physicians, particularly surgeons, medical robotics provides
“improved ergonomics, leading to reductions in:

  • “Neck and back pain,
  • “Hand and wrist numbness,
  • “Physical and mental stress, and
  • “Markedly [reduced] radiation exposure.

“These factors increase a surgeon’s quality of life and could potentially
lengthen their career.”9

An Aging Population

As reported by GlobalData Thematic Research, “The primary driver of the
[medical] robotics market is the increasing number of surgical procedures,
propelled by [an aging] population. The population of individuals
aged 60 and over will be approximately 1.5 billion by 2050, which is
derived from a 3 percent annual growth rate according to the United
Nations.

“Aging populations are at a higher risk of developing a host of diseases
and conditions necessitating the need for surgical interventions. This trend will drive higher volumes of both open and minimally-invasive
procedures, generating the increased need for robotic surgical systems.”10

The COVID-19 Hangover

While the COVID-19 pandemic is generally receding, critical staffing
shortages continue – most acutely in hospitals but also across the
healthcare and eldercare sectors. This phenomenon will increase
demand for radiotherapy, laboratory, hospital, social, and other species
of medical robots.

Technological Considerations

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Robotics and Edge

Cost-conscious hospitals and other healthcare facilities are pursuing
cloud-based surgical options, variously designated “Robotics as a Service”
(RaaS), “Surgery as a Service” (SaaS), or “Digital Surgery as a Service”
(DSaaS). However, the analysts at GlobalData Thematic Research
remind us that an edge-based solution is probably preferable since
“security and latency issues may require robots to process real-time data
about their operational environments and respond immediately. Edge
computing has the potential to improve the performance of robots due to
lower latency. It also improves security as the edge is safer than
the cloud. Edge computing will make cyber attacks more difficult
when combined with robotics’ self-contained ‘sense-decide act’ firmware
loops.”11

Robotics and ML

While already impressive in terms of function and performance, medical
robots, specifically, surgical robots, are in the process of being AI
boosted. As Dr. Liz Kwo observes, "With the help of [machine learning (ML)]
techniques, [Ai-enabled] surgical robots [can] help identify critical insights
and state-of-the-art practices by browsing [pre-operatively] through millions of
[clinical] data sets. Asensus
Surgical has a performance-guided laparoscopic AI robot that provides
information back to surgeons, such as size of tissue, rather than
requiring a physical measuring tape. At the same time, human skills
are used for programming these robots by demonstration – and for teaching
them by imitating operations conducted by surgeons.”12

Robotics and Cybersecurity

In most instances, cyber attacks are digital incursions designed to steal
money or sensitive data. While not diminishing their impact to
healthcare organizations, these standard-issue attacks do not – at least,
normally – put people at risk. In the case of medical robotics,
however, especially delicate robotic surgery, cyber attacks can
potentially cause injury, even death. Chief medical officers (CMOs)
and chief security officers (CSOs) should cooperate to ensure maximum
protection for medical robotics systems, devices, instruments. databases,
and communications channels.

Autonomous Operations

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From the public perspective, at least, the most exciting development in
robotics is the autonomous or self-driving vehicle. This is due
primarily to the potential they provide to revolutionize not just
day-to-day travel, but also commercial shipping, traffic management, and
road safety.

While autonomy is a major objective for medical roboticists – imagine
performing a laparoscopic procedure to remove cancerous lesions without
the active involvement of a high-priced surgeon – “autonomy in medical
robots is currently limited,”13 reserved for subfields like
assistive wearable and therapeutic rehabilitation robots.

The are technical challenges, of course, but also regulatory, ethical,
and legal hurdles with which to contend. Nonetheless, the ready
availability of a fully-autonomous robot surgeon is the “Holy Grail”14
of medical robotics, enabling critical surgical care in isolated areas, or
during long-duration human space missions, for example.

Finally, as often depicted in science fiction films, future autonomous
capsule robots might be deployed – either swallowed or injected – to:

  • Remove plague from coronary arteries,
  • Reinforce blood vessels on the verge of rupturing,
  • Repair damaged organs, or
  • Collect clinical data beyond that available via X-rays or magnetic
    resonance imaging (MRI) scans.

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References

    1-2 “Robotics." Techopedia, Inc. July 27, 2021.

    3 Pierre E. Dupont, Bradley J. Nelson, Michael Goldfarb, Blake
    Hannaford, Arianna Menciassi, Marcia K. O’Malley, Nabil Simaan, Pietro
    Valdastri, and Guang-Zhong Yang. “A Decade Retrospective of Medical
    Robotics Research from 2010 to 2020.” American Association
    for the Advancement of Science. 2021.

    4 Lauren Greenwood. “The Types of Medical Robots in Use Today
    and in the Future.” Brainlab AG. November 22, 2021.

    5 Pierre E. Dupont, Bradley J. Nelson, Michael Goldfarb, Blake
    Hannaford, Arianna Menciassi, Marcia K. O’Malley, Nabil Simaan, Pietro
    Valdastri, and Guang-Zhong Yang. “A Decade Retrospective of Medical
    Robotics Research from 2010 to 2020.” American Association
    for the Advancement of Science. 2021.

    6 “da Vinci Surgery.” Cleveland Clinic. 2022.

    7 “Robotics in Medical (2021) – Technology Trends.” GlobalData
    Thematic Research. January 6, 2022.

    8 “Global Medical Robotics Market, Size, Forecast 2022-2027,
    Industry Trends, Growth, Outlook, Impact of COVID-19, Company Analysis.”
    Renub Research. March 2022.

    9 Pierre E. Dupont, Bradley J. Nelson, Michael Goldfarb, Blake
    Hannaford, Arianna Menciassi, Marcia K. O’Malley, Nabil Simaan, Pietro
    Valdastri, and Guang-Zhong Yang. “A Decade Retrospective of Medical
    Robotics Research from 2010 to 2020.” American Association
    for the Advancement of Science. 2021.

    10-11 “Robotics in Medical (2021) – Technology Trends.”
    GlobalData Thematic Research. January 6, 2022.

    12 Dr. Liz Kwo. “Contributed: The power of AI in Surgery.” MobiHealthNews. November 23, 2021.

    13-14 Sara Castellanos, “Autonomous Robots Are Coming to the
    Operating Room.” Wall Street Journal. September 10, 2020.

About the Author

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James G. Barr is a leading business continuity analyst
and business writer with more than 40 years’ IT experience. A member of
“Who’s Who in Finance and Industry,” Mr. Barr has designed, developed, and
deployed business continuity plans for a number of Fortune 500 firms. He
is the author of several books, including How to Succeed in Business
BY Really Trying, a member of Faulkner’s Advisory Panel, and a
senior editor for Faulkner’s Security Management Practices.
Mr. Barr can be reached via e-mail at jgbarr@faulkner.com.

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