This week I will be speaking at the Cheltenham Science Festival on use of robots in surgery, and I’m keen to increase awareness and support for this growing field, through festivals and my support of the "Science: [So what? So everything campaign]".
Since I helped to start this area, some 20 years ago, it has developed internationally and now has a major influence on surgery. As the world's first Professor of Medical Robotics at Imperial College, London, I developed a robot for prostate surgery called Probot, which was used clinically in April 1991, and was thus the first robot in the world, to be used to autonomously remove tissue from human patients. As a result of my experiences, it became clear to me that the surgeon needed to be an integral part of the procedure and not just be limited to observing what was taking place whilst his only activity was to keep his hands on the emergency-off button.
I then developed a concept of what I call "hands-on" robots in which the surgeon is an integral part of the activity. The surgeon holds a force-controlled handle at the tip of the robot and moves the robot around within the required region, whilst the robot actively constrains him to a safe and precise location. This synergy between the ability of the surgeon to be part of the procedure, whilst the robot provides accuracy and constraint, seems to be very acceptable to both surgeons and patients. The term Active Constraint ROBOT led to the formation, together with Orthopaedic Surgeon Professor Justin Cobb, of my spin-off from Imperial College London called the ACROBOT Company limited. Using the Acrobot robotic systems for orthopaedic surgery, ACROBOT have demonstrated that the robot gives a superior performance to that of the unaided surgeon for procedures that are difficult to carry out conventionally.
In my view surgical robots should not only have the surgeon in-charge, but be relatively simple and low-cost systems that conduct procedures which the surgeon finds difficult to undertake. There is little point in having a robot which performs tasks which the surgeon can perform reasonably well without a robot, since it will be difficult to justify the extra cost, and possibly time, required for the surgery. The reason that time is important is that, whilst we as patients may wish to have the most accurate surgery, the surgeons are under pressure to complete their surgical lists. Thus there is likely to be pressure on the surgeon from the hospital administration to sacrifice accuracy, whose benefits may be seen at a later date, for time-saving today.
Over the last decade, surgical robots have become smaller, simpler and dedicated to specific tasks. As sensors and computer-controlled systems have become more powerful, we are starting to see the emergence of smaller "intelligent tools" in the hands of the medical community as a whole, not just surgeons. These should be developed to provide the sensing and tool actions which the medical practitioner finds difficult, whilst allowing the medic to undertake tasks which he finds relatively straightforward. In this way, we hope to minimise the cost and complexity of robotic systems, whilst maximising their benefit to both the medical community and to patients. I may be biased, but I for one would trust my life with one of my robots.
Professor Davies is speaking at the Cheltenham Science Festival, 3-7 June