SURGEONS will use robots to conduct kidney transplants for the first time in Britain this spring, as the machines take on an increasing number of medical procedures.
Some medics predict that, in the next five years, robots will make the decisions about where to cut into the patient.
From next month, surgeons at Guy’s and St Thomas’ NHS Foundation Trust in London will turn to robots to perform keyhole kidney transplants, because the machines can carry out the most crucial part of the operation more quickly than a human.
Keyhole surgery is less painful and allows the patient to recover more quickly. At the moment, however, many surgeons feel they are not able to sew the blood vessels attaching the donated kidney to the patient quickly enough during a keyhole procedure. If not done swiftly enough, the donor kidney becomes damaged because it does not have a blood supply from the patient.
Carefully attaching the blood vessels between the donor kidney and the patient is the most important element of a kidney transplant.
A transplant surgeon will control the robot, which should manage the sewing up, through the tiny keyhole-sized incision in the body, within 30 to 40 minutes.
Nizam Mamode, consultant transplant surgeon at Guy’s and St Thomas’, who will be doing the robotic transplants, said: “What the robot does is allow you to stitch much more quickly than you otherwise would be able to do.”
So far, about 300 such robotic transplants have been conducted in India. Smaller numbers have been carried out in America and Italy.
Initially, the da Vinci robot, already used for other types of surgery including bladder surgery, will be used for the transplants. Surgeons expect to soon have a robot designed specifically for transplants.
Mamode predicts that in future robots will not just be driven by surgeons but will make key decisions such as where to cut into the patient.
Mamode said: “I think, increasingly, the robots will be making those decisions ... about where to cut. So, if you just think about going through the abdominal wall, normally the way that we would do it is, take a knife, go through the skin, stop, seal all the bleeding vessels, cut a bit more, have a look to see if we are right down to the level we need to be, cut a bit more. We are very close to a stage where a robot could do that.”
Brian Davies, emeritus professor of medical robotics at Imperial College London, believes surgeons will still wish to take the final decision about where the series of cuts are made, but says robots will increasingly advise doctors.
Davies said: “What we will see more of in the next five years is the ability to advise the surgeon of the suggested location and sequence of cuts, together with alternative possibilities.”
Surgeons at the Royal Devon and Exeter NHS Foundation Trust are investigating whether imaging technology could be attached to the end of a robot arm so that during an operation to remove cancerous tissue, the machine could tell the surgeon where the cancer is and how much tissue should be removed.
John McGrath, consultant urological surgeon at Royal Devon and Exeter, says it is possible that in future robots could be programmed to perform such an operation on their own.
McGrath said: “If we knew on the MRI scan before surgery where the tumour was, you could you take the surgeon out completely and just program into the robot a series of co-ordinates, and it would remove the area we have identified on a scan and remove it safely.”
Davies believes the surgeon will be reluctant to let robots work entirely on their own, however. He said: “Such systems are not totally autonomous in deciding what is the target tissue in real time on the patient. The surgeon, in taking responsibility for her patients, will want to have the final say.”
Robots are now commonly used to remove prostate glands, bladders and wombs. It is estimated that 80% of prostate cancer patients now have the prostate removed by a robot.
Robot Teddy For Child Patients
Can a robotic teddy bear help alleviate anxiety, pain and isolation for children in a hospital?
That is the hope of Dr. Peter Weinstock, the director of a training program at Boston Children’s Hospital called the Simulator Program, and Cynthia Breazeal, the director of the personal robots group at M.I.T.’s Media Lab. The two have collaborated to bring Huggable, a social robot prototype developed at the lab, into the hospital, which is financing a 90-person study to determine whether the robot can have therapeutic value for children who have to endure long hospital stays.
The device, essentially a high-tech puppet, can talk and play with patients with the aid of a remote operator. For the continuing study, one-third of the children play with Huggable, another third interact with an image of it on a tablet and the rest are given a regular plush teddy bear. All the children are recorded on video and wear a bracelet, called a Q Sensor, that measures physiological changes.
The hospital is beginning to collect and analyze the data with the help of researchers from Northeastern University. Dr. Weinstock hopes the study will help doctors better understand children’s emotional states, something he has referred to as the fourth vital sign. “We think a lot about heart rate, blood pressure and how much oxygen is in the blood, but we don’t have a great monitor for how the child is feeling right now,” he said. “What we do know is that children who are happier, who feel better, it can have a big effect on healing.”
Boston Children’s has invested $500,000 in social robotics research, including the Huggable study, according to the hospital.
For her part, Dr. Breazeal said she wanted to work toward making Huggable capable of operating autonomously, without the aid of a puppeteer. The robot could be a soothing distraction and simultaneously capture data and information from patients, which would be fed to hospital staff, improving the continuity of care.
“We could someday see this as a standard of care, where every child who comes into the pediatric hospital might get something like this,” Dr. Breazeal said. “It’s not only the health and emotional and recovery benefits, but also logistical and financial, improving efficiency to the overall health system.”
Robot Therapy
Microsoft’s experiment in China with chatbot known as Xiaoice was a success. Folks chat with Xiaoice when they have been dumped in a relationship, are experiencing depression or been laid off.
As a virtual platform, people can chat for extended lengths of time with her. Users feel she has excellent listening skills, a great sense of humor and so called ability to love you unconditionally.
Robots in Care Homes
With unblinking eyes and cold metallic purpose, the robot’s lasers scope out Jean Clark. Targeting her, it glides silently in her direction, thermal cameras continually searching her face for signs of weakness. Then, its quarry located, it stops for further orders or, perhaps, for Mrs Clark to finish her tea.
All of which gives her time to give her judgment on her new robot assistant. “It’s just wonderful,” she said. “I’m very excited.” Beside her, the robot’s sonar mutely scans the room.
Mrs Clark, 84, from Lincoln, is right to be excited. This robot is at the start of the longest trial of a technology some believe will revolutionise the care home sector: robot companions.
For the next year, care homes near the University of Lincoln will have several extra staff members. With no need to sleep, these robots will be able to monitor residents around the clock — their cameras checking body temperature, and eventually even pulse.
A permanent presence in the home, the final version will be able to spot changes in behaviour that could indicate illness. Ever vigilant, they will remind you where you left your keys, or let you use voice commands to Skype your relatives.
They are also the first stage in a process that some have predicted, for good or ill, could replace human workers. Around the world, researchers are working on robotic care-home assistants, in the belief that looking after the elderly could become a proving ground in a robotics revolution. Although, in this case, the robot’s creators say that theirs is only ever about augmenting rather than replacing existing care.
“This is absolutely not about replacing people,” said Dr Nicola Bellotto, from the University of Lincoln. “It’s an enabling robot. It enables people to do more, to be more independent.”
He also points out there are some fairly major technical hurdles before making humans unemployed is an issue. Such as giving the robot arms, or developing legs that it won’t trip up on. “These are heavy robots ... If it falls down on you it could injure and trap you.” Which could be embarrassing. So for now, his robot rolls on wheels — which means that, as with the original Daleks, stairs are its weakness.
Even so, as far as the residents of Lace Housing in Lincoln are concerned, the robot can’t wheel into their lives soon enough. Carol and John Chandler are going to be among the first to try it out. “For people on their own, with no one to chat to, this might take some of the loneliness away,” said Carol. “It’s about someone being there if no one else is. It is nice to know you can talk to someone, even if it is a robot.”
Her husband, John, said that it could have a more practical purpose. “The carers are only in four times a day. If I fall over, I can communicate with the robot to phone down and deal with it.”
Is there not something a bit depressing, though, about the fact that robots are needed at all? What about friends, relatives and carers? “No one can be there 24/7,” said Mr Chandler. Besides, he thinks the presence of the robot might, in fact, be a way to increase the number of visits they get. “We have two grandchildren in Lincoln,” he said. “Kids do love robots.”