Medical robotics and related technologies are booming. At UCL, engineers and doctors are working together to meet the technical, human, ethical and financial challenges of future medical practice.
Until recently, medical and surgical robotics was the stuff of science fiction. Today it’s reality. In recent years, several Belgian hospitals, including Saint-Luc University Hospital, have acquired robots or computer-assisted surgical systems. Examples:
- The da Vinci© Surgical System, the most famous, is a telesurgery system. It doesn’t take the surgeon’s place but helps him or her work in a less invasive way via endoscopy, without sacrificing dexterity while inside the body. This guarantees steady, accurate movement.
- Zeego© is a scanner mounted on an articulated arm that revolves around the patient during surgery in order to generate real-time medical imaging. This confers added precision and safety to surgical movements. Other medical imaging devices and technologies (ultrasound, magnetic resonance, etc.) can also be used during surgery.
- The endoscopic pill is a large ingestible pill that contains a miniature camera. While travelling the entire digestive tract, it delivers intestinal images that are impossible to acquire via traditional endoscopy.
Other robotics examples
Other technologies under study:
- bionic arms and legs;
- 3D printers and biocompatible materials to produce implants and custom cutting guides;
- rehabilitation assistance robots, such as REAplan for patients suffering from motor disorders (often resulting from brain injury).
There’s also a robot that, unassisted, can remove a tumour by using a sonogram to direct intense, focused ultrasound pulses. In short, the medical robotics sector is advancing rapidly, which means keeping up with it and training in these technologies are paramount.
CRAS: European surgical assistance workshop
At the European level, some 100 laboratories, universities and research centres are very active in medical robotics and related technologies. In recent years they’ve been meeting annually. In 2015, UCL and KU Leuven organised the fifth Computer/Robot Assisted Surgery (CRAS) Workshop.1 Many subjects were addressed: flexible robotics (by endoscopy or catheter), miniaturisation, the role of virtual simulation in the learning process and doctor training, etc.2
Technologies that raise questions
Aside from its technological prowess, medical robotics raises ethical, safety, clinical practice and legal questions. ‘Research has made great strides, but few devices have made it to market’, observes Benoît Herman, coordinator of Louvain Bionics. ‘Because of precaution, for better and worse, medicine is a slow science. Developing medical and surgical robots and especially using them on patients takes years. This is normal: the least error of calibration on a medical robot can have severe consequences. Manufacturers, doctors, health authorities—nobody wants to see a robotics-related scandal. Society wouldn’t forgive us.’
The dawn of robot doctors?
Such issues helped drive the 2014 creation of Louvain Bionics, supported by a Pierre de Merre bequest via the Fondation Louvain. This centre of interdisciplinary expertise aims to promote new medical and paramedical technological collaboration among UCL engineers, doctors, physiotherapists, psychologists and philosophers. ‘By promoting synergies and stimulating research in this sector,’ says Mr Herman, ‘we hope to help patients benefit sooner from these technological advances, even if some of them have yet to prove their clinical advantages. Da Vinci©, for example, helped make possible more minimally invasive surgeries, thus reducing the duration of hospital stays and even costs to the community. But to say it’s revolutionised surgery—let’s not exaggerate. These new technologies aren’t close (yet) to replacing humans. They’re tools that serve the human doctor, who remains the sole decision-maker when it comes to medicine.’
(1) In 2016, the CRAS workshop took place in Pisa (Italy). More information at www.cras-eu.org. (2) Scientific presentations at the fifth CRAS Workshop are available at www.cras-eu.org/organisation/Workshop/past-editions/Proceedings_CRAS2015.pdf.