Purdue University is reporting that its researchers are trying to develop less expensive, more portable robotic devices for surgery. The research is being led by William Peine, an assistant professor of mechanical engineering. Purdue press office interviews Dr. Chandru Sundaram, an associate professor at the IU School of Medicine’s Department of Urology, and describes some interesting areas of robotics research:
“I think we have just touched the surface of robotic technologies for surgical assistance,” he said. “There is a huge amount of research and development that is going to happen in the future. The most complicated future roles will involve tactile feedback and image-guided surgery where you feed in information you have from CT scanners or ultrasounds or magnetic resonance imaging and the robot will accurately go to that particular part of the body and do whatever needs to be done.”
One future application for robotic surgery might be endoluminal surgery, in which a light source is part of a flexible probe that could be snaked throughout the body, perhaps gaining entry through the stomach, an artery or some other part of the body.
“If you have cancer of the stomach, doctors would go in with the instrument and remove that area of tissue,” Peine said. “Another possible application is fixing reflux disease. A new area that doctors are pursuing is trans-gastric surgery, where you go into the mouth, enter the stomach, make an incision in the stomach wall and then into the abdominal cavity. Once you are in the abdominal cavity, you can remove someone’s gall bladder, for example. Because you gain entry through the mouth, there is no scar.”
Taking endoluminal surgery a step further, surgeons want to use a technique called interventional radiology for robotic surgeries.
“With interventional radiology, doctors will use real-time X-rays, called fluoroscopy, to see what the probe is doing inside the patient,” Peine said. “Surgeons will be able to enter an artery near the groin area and navigate through arteries and into the heart, brain, to other major organs, snaking all through the venous system to perform surgeries in those areas of the body.”
Doctors now use catheters in arteries to gain access to the heart and blood vessels.
“They can inflate a balloon or insert a stent, but if you use a computer-controlled robot tip, you have the ability to manipulate tissue more carefully inside the heart, for example,” Peine said. “So you might be able to repair a valve without needing open-heart surgery. Compare the two: open heart surgery, where you stop the heart, connect tubes, split the patient’s sternum in half, or using a procedure where a catheter goes in and you are home the next day.”
In the area of tactile sensors, researchers are working to create devices that can relay the sense of touch to surgeons, said Peine, who developed such a palpation instrument while he was a doctoral student at Harvard University.
“One drawback of minimally invasive surgery is that you can’t get your fingers inside the patient to touch the tissue,” he said. “You can’t palpate, and palpation is used extensively in medical procedures and in diagnosis. A surgeon may find an artery by sensing the pulsations, or locate a tumor by feeling it. A tactile sensor would measure the same sorts of things. You could use a device like this, for example, to find small lumps in the lung during surgery.”
The sensor would relay information to a computer, where it would be displayed on a monitor as a color-coded “tactile map” that tells a surgeon what the probe tip is feeling, Peine said.
Peine, whose research involves creating both software and hardware for surgical robots, helped form a company called Pressure Profile Systems, located in California, which develops and markets tactile medical devices. He also is affiliated with Purdue’s Regenstrief Center for Healthcare Engineering at Discovery Park, the university’s hub for interdisciplinary research.
“The Regenstrief Center’s mission statement is to design, implement and sustain interdisciplinary solutions to transform health-care delivery systems,” Peine said. “We emphasize that solutions and new technology should improve the quality, efficiency, safety and accessibility of health care.
“Surgical robotics has the potential to do this because less expensive robots reduce costs and make the technology available to more hospitals, while the quality and safety of care would improve by including a computer in the loop with the surgeon.”