Even though robotic surgery may have become more and more common in today’s healthcare, surgery is still quite invasive and often a traumatic experience for the patient. By using flexible and robotically-steered instruments, surgical interventions can be performed while minimizing patient trauma. One step further, and these flexible instruments can even be used to deliver microrobots that can do a biopsy, for example. This resembles the ‘swallow the doctor’ vision of Richard Feynman and his student Andrew Hibbs. We are closer to this than we may think, according to Prof. Sarthak Misra in his inaugural lecture as a Professor of Surgical Robotics at the University of Twente, on 29 November, 2018.
Surgical robots like the Da Vinci system have become mainstream: In The Netherlands alone, 26 hospitals have one or more robotic systems like this. They assist the surgeon in interventions like prostate surgery or removing intestinal tumors. But despite all progress, surgery is still a very traumatic experience for most people, Misra says. The next step in robot surgery is about snake-like robots and flexible needles that will be able to reach difficult places in the body. “We are at the stage where we can start pre-clinical trials with our needle steering systems, and this is really an exciting time in the lab”.
These flexible instruments will be able to move around sensitive and healthy tissue to reach the diseased region within the body. The starting point for Misra is developing a pre-operative plan, a ‘navigation system’ for the intervention. The robot systems he developed in his group can, therefore, even be used inside a CT or MRI scanner. Another promising development are snake-like ‘continuum robots’ consisting of flexible and magnetically-steered elements, continuously bending. For example: Misra’s group demonstrated a flexible catheter that can be steered using ultrasound and can be potentially used for replacement of the mitral valve.
Needle steering robot that can be used inside an MRI scanner
Swallow a doctor
Misra’s vision goes beyond that: “What I really hope is having miniaturized microrobots that can perform personalized and targeted diagnosis and therapy.” Back in 1966, the science fiction movie ‘Fantastic Voyage’ already was about a miniature submarine that moved through the human body. Around the same time Andrew Hibbs – doctoral student of Richard Feynman – called it ‘swallow a doctor’. We are not so far away from this, according to Misra. His demonstration of ‘magnetosperm’ already got a lot of attention: magnetically steerable minirobots swimming like sperm cells. Another example is a star-shaped microgripper that will be able to perform biopsies. For the newly appointed Professor, a dream is that even minimally invasive surgery can be made less invasive. “I foresee micro- and nanorobots that will be injected into the body and perform personalized interventions in deep-seated regions.”
Misra's research is an example of UT's research theme 'Improving healthcare by personalized technologies'.
Prof Sarthak Misra is Professor of Surgical Robotics at the University of Twente. He also works at the University Medical Center in Groningen (UMCG). His inaugural lecture ‘Surgical Robotics: The happy accident in my life’, takes place 29 November, 2018 at 4 pm. More details on Prof. Misra research is available at the Surgical Robotics Laboratory website (www.surgicialroboticslab.nl). The full text of his lecture is available on request.