What can AI do in robotic surgery?

Robotic surgery is undoubtedly one of the great advancements in medicine: robotic arms, usually operated by a surgeon, can mimic and even exceed the capabilities of the human hand.

This technology allows for smaller incisions, minimizes bleeding and scarring, and speeds recovery. Improved precision and visualization ensure greater accuracy, especially in complex surgeries such as brain tumor removal.

The impact of robotic surgery has also reached Bangladesh, where the first robotic-assisted surgery was performed at the National Cardiovascular Institute in January 2024.

One of AI's most notable capabilities is its ability to learn from extensive surgical procedure databases. By analyzing thousands of surgeries, AI systems can identify patterns and trends and discover new optimal techniques. Driven by complex algorithms, this deep learning can capture the subtleties of a surgeon's movements and provide precise control down to sub-millimeter accuracy.

In this age of AI, can integrating AI into robotic surgery increase the efficiency of surgery? “AI has the potential to revolutionize surgical robots by increasing precision, improving decision-making and providing real-time analytics,” said Enayet Ullah Khan, a pharmaceutical and medical device expert in Dhaka.

But at the same time, challenges have arisen, especially the high cost. We take a brief look at the potential uses of AI in robotic surgery, the existing market for robotic surgery, and more.

The Potential Role of AI in Robotic Surgery

Nearly every piece of technology available now incorporates AI in some form, and robotic surgery may be soon to follow.

While AI-enabled robotic surgery isn't a reality yet, Enayet said it could “assist surgeons by predicting outcomes, making recommendations and learning from massive data sets to continuously improve surgical techniques and patient care.”

One of AI's most notable capabilities is its ability to learn from extensive surgical procedure databases. By analyzing thousands of surgeries, AI systems can identify patterns and trends and discover new optimal techniques. Driven by complex algorithms, this deep learning can capture the subtleties of a surgeon's movements, improving best practices and precision control down to sub-millimeter accuracy.

For example, an AI-powered surgical robot trained in hundreds of brain tumor removal surgeries can learn efficient techniques from experienced neurosurgeons. During surgery, the AI ​​guides the robotic arm and navigates complex anatomical structures to remove the tumor with minimal tissue damage, ensuring a highly precise and effective surgery.

Training an AI-powered surgical robot is a lengthy and complex process, but it allows the robot to guide surgical procedures with extreme precision: the robot can correct any tremors or deviations in the surgeon's hands in real time, ensuring precise movements and reducing human error.

AI will also play a key role in pre-operative planning and intra-operative navigation, allowing surgeons to input patient-specific data to develop individualized surgical plans, which will lead to improved outcomes by taking into account the patient's anatomy, pathology and optimal pathways.

During surgery, AI ensures precise guidance of the robotic arm, further increasing the precision and effectiveness of surgery.

Robotic Surgery Market

Robotic surgery has revolutionized medical procedures for nearly 50 years, since its introduction in 1978 with the Programmable Universal Machine for Assembly (PUMA) 560. Dr. Yik San Kwoh performed the first robot-assisted brain biopsy in 1985. These systems have evolved.

The market for these devices has grown significantly from $800 million in 2015 to more than $3 billion by 2023. Leading medical institutions and innovative start-ups are continuously working to further advance surgical robotic systems.

The following big names have made significant advances in robotic surgery technology, including Intuitive Surgical, known for its Da Vinci Surgical System, and Medtronic's Hugo system.

Johnson & Johnson also offers the Monarch and Veris systems, which address specific surgical specialties such as urology and gynecology, as well as robotic bronchoscopy and precision knee replacement surgery.

Stryker manufactures the Mako system, a robotic-arm assisted surgical instrument that perfects the process of total knee replacement, total hip replacement and partial knee replacement.

The benefits of robotic surgery are manifold. It improves patient outcomes by minimizing human error and reducing recovery time and risk of complications. Firstly, the use of robotic arms in surgery provides extreme precision and makes the procedure minimally invasive. The system also allows for pre-operative planning and intra-operative navigation, allowing for more individualized surgical planning.

This has proven to be particularly effective in complex surgeries such as the removal of brain tumours.In the first case of robotic surgery being used in Bangladesh, stents were inserted in two patients with blocked heart vessels with the help of the robot at the National Institute of Cardiovascular and Vascular Research (NICVD).

Impacts and challenges

AI-enabled robotic arms can not only learn from a vast database of past surgeries, but also redefine surgical care.

“Right now, two-thirds of the world's population, roughly 5 billion people, lack access to appropriate surgical care, so our AI-based system can help close this gap by ensuring access to appropriate surgical care around the world,” Dr. Joseph Nathan, co-founder and chief medical officer at Foresight Robotics, told Forbes.

This will provide more physicians with the opportunity to learn from top models in their fields, empowering more medical professionals to perform surgery regardless of location or resources. Additionally, surgeons can use AI-based robots to expand their specialization and provide care to a wider patient population.”

AI can also recognize subtle differences and identify emerging trends by analyzing global data, but the high cost of AI-enabled robotic surgery remains a major challenge.

As of 2017, robotic surgery costs approximately $3,568 per session, or about $2,700 more per patient than traditional surgery over 13 years. The integration of AI will further increase these costs, making affordability a major issue, especially in developing countries.

“Bangladesh is increasingly adopting digital health technologies such as telemedicine and electronic health records, and has shown a willingness to integrate new technologies. This is promising for AI and robotics, but their high costs make them difficult to fund in a country with a limited healthcare budget,” Enayet concluded.