Tiny surgical robots, also known as miniature or microsurgical robots, are specially designed robotic systems capable of carrying out complex surgeries. These robots are fairly new on the scene, although their development has been part of the wider evolution of robots in healthcare.
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The idea of small surgical robots began to pick up speed in the 2000s when the benefits of using this technology to perform surgeries with high precision in a minimally invasive fashion became obvious. Over the last two decades, small surgical robots have been developed for use in a range of healthcare fields, including cardiovascular surgery, neurosurgery, ophthalmology, gastrointestinal surgery, and more.
Examples of small surgical robots that have been developed for microsurgeries include MicroSurge, the small surgical robot designed to perform precise eye surgeries, snake-like robots that are guided through the body’s natural openings to perform minimally invasive surgeries, and endoscopic robots designed to perform microsurgeries within the gastrointestinal tract, amongst others.
Examples of Recent Advancements in Tiny Surgical Robots
Research teams around the world are developing tiny surgical robots for use in various therapeutic applications for different disease areas. In the past year, progress has been made towards introducing novel surgical techniques with the use of tiny surgical robots. Here, we will review these recent advancements.
Already, tiny surgical robots are being used for numerous types of cancer surgery, including colorectal surgeries, gynecological procedures, prostatectomies, and more. Advances in tiny surgical robot technology are helping to expand the range of cancers that can be treated with this technique.
Recently, researchers at the University of Leeds, UK, developed a novel tiny surgical robot that resembles an ultra-soft tentacle that could revolutionize lung cancer treatment. The robot’s ultra-small, 2-millimeter-thick tentacles are controlled by magnets and can reach into the small bronchial tubes of the lung. The team’s investigations with the tiny surgical robot, which were published in the journal Nature Engineering Communications, describe the benefits of the robot, with its soft and magnetically controllable tentacles, which they believe will help to improve navigation in the lungs during biopsies as well as paving the way to less invasive treatments. The team is collecting further data on their innovation, which they hope will lead to in-human trials.
Phantom Lung – Navigation and Localization Using Magnetic Personalized Tentacles
Phantom Lung – Navigation and Localization Using Magnetic Personalized Tentacles. Video Credit: SciTech Daily/YouTube.com
A team of researchers at Maastricht University Medical Center, the Netherlands, recently published the outputs of their work, which significantly contributes to the advancement of microsurgical capabilities. The team recognizes the limitations of current tiny surgical robot technology, highlighting that most platforms are limited to the use of operation microscopes to enhance the visualization of structures of the human body.
With this in mind, they created a microsurgical robot with an integrated 4K 3D exoscope. The researchers leveraged the evolution of high-definition 3D cameras to improve magnification capabilities while preserving the ergonomic posture of the surgeon. The paper, published in the journal Life (Basel) in March 2023, details how the innovation was successfully used to perform reconstructive microsurgery in humans.
In 2022, University Hospital Zurich, Switzerland, reported the first-in-human use of the Symani surgical system for carrying out lympho-venous and arterial anastomosis for lymphatic reconstruction. The team reported the use of the microsurgical system on five patients, performing a total of 10 robot-assisted anastomoses.
The benefits of the microsurgical system, according to the researchers, included high levels of accuracy in placing the stitches. This level of accuracy was maintained even when stitching small and fragile vessels. The research demonstrates the efficacy and safety of the microsurgical system in performing microsurgery in vessels smaller than 1mm. A recent study supports the use of tiny surgical robots in reconstructive microsurgery.
More recently, in 2023, researchers at Careggi University Hospital, Florence, Italy, demonstrated the first-in-human use of a dedicated microsurgical robotic platform in the performance of free flap tissue reconstruction.
The team used the Symani Surgical System, a platform designed to perform microsurgery, to conduct robot-assisted microsurgical free flap reconstruction. In their research, the team showed that the platform was capable of performing anastomosis of veins and arteries that measured less than 0.8 mm in diameter. The findings illustrate the potential of tiny surgical robots in opening up new microsurgical applications that were previously inaccessible with conventional technology.
Future Directions for Tiny Surgical Robots
The field of tiny surgical robots is in its infancy. It has a huge potential to revolutionize healthcare. While more research is needed to develop microsurgical platforms and demonstrate their safety and efficacy, the literature so far suggests a bright future for tiny surgical robots in advanced therapeutic options for a wide range of diseases.
Currently, tiny surgical robots have numerous benefits compared with conventional techniques. For example, it offers a minimally invasive approach and is precise and accurate. In addition, it lends itself to remote and telesurgery, precise tumor resection, and image-guided surgery. In the future, we will likely see developments in the field that leverage these benefits - establishing platforms with capabilities in these areas.
Ultimately, it is likely that tiny surgical robots will become established within many treatment pathways. The benefits that microsurgery offers overcome some of the current limitations of conventional surgery. In addition, microsurgery platforms open the door to new treatments that are not possible with current technology. Therefore, the field of tiny surgical robots will likely see significant growth in the future.
References and Further Reading
Innocenti, M., et al. (2022) ‘First-in-human free flap tissue reconstruction using a dedicated microsurgical robotic platform’, Plastic and Reconstructive Surgery, 151(5), pp. 1078–1082. doi.org/10.1097/prs.0000000000010108.
Lindenblatt, N. et al. (2022) ‘Early experience using a new robotic microsurgical system for lymphatic surgery’, Plastic and Reconstructive Surgery - Global Open, 10(1). doi.org/10.1097/gox.0000000000004013.
Tiny surgical robots could transform detection and treatment of cancers [online]. Eurekalert. Available at: https://www.eurekalert.org/news-releases/996661
van Mulken, T.J., et al. (2023) ‘First-in-human integrated use of a dedicated microsurgical robot with a 4K 3D EXOSCOPE: The Future of Microsurgery’, Life, 13(3), p. 692. doi.org/10.3390/life13030692.
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