Back in 1985, the best robotic surgeon we had was the Puma 560, a manipulator arm just barely more advanced than Rocky Balboa’s robo-butler. Just barely. The Puma was nevertheless revolutionary. It was the very first mechanical operator, progenitor to steady-handed robo-surgeons like the DaVinci system. But in the near future, robots will no longer be cutting into us — from the outside, at least.
Even as the current generation of robotic surgeons continues to shrink, with minuscule pincers and malleable toolsets capable of curling their way through our innards, the medical community is working to develop robotic surgical devices capable of operating autonomously, or at least remotely. This is due in part to expected shortages in qualified doctors, nurses and medical technicians over the next decade or so.
“By 2030, we estimate we’re going to need another 40 million health workers and we may be 15 to 18 million health workers short,” professor David Watters, head of surgery at Barwon Health, told Australia’s ABC.net last May. “The fact that we can get skilled procedures remotely to a patient will be of tremendous advantage to rural and remote communities and also low-income countries and low-middle-income countries that are struggling to train enough health workers to service their populations.”
Luckily, robots like the Smart Tissue Autonomous Robot (STAR), developed by a team at Johns Hopkins University, are already matching and exceeding the capabilities of their human counterparts. The STAR recently demonstrated its superior stitching abilities in both ex vitro operations and on live (albeit porcine) patients. But in the future, surgeons may not need to worry about closing up entry wounds at all — mostly because they’ll already be inside us when they get to work.
Ingestible cameras, such as the PillCam from Given Imaging, have been around for more than a decade. In fact, the technology was approved for use in some 80 countries before it earned FDA acceptance in 2014. These cameras send a series of high-speed images to doctors during their roughly eight-hour journey through the digestive system. What’s more, the PillCam can be guided — its course even halted and reversed — via an external magnet so that doctors can linger and better inspect anything they find.
But cameras are only the start. Last May, MIT CSAIL debuted a similar device except, instead of a camera, the robot carries a small magnet. Designed to be ingested orally, the device is constructed from folded, dried pig intestine. After the pill casing dissolves in the stomach’s acids, the robot unfurls itself and rattles around the gut, hopefully attracting and clinging to any loose batteries or other miscellaneous magnetic items that you may have swallowed. Given that Americans alone manage to eat upwards of 3,300 button batteries each year, these devices are sure to become a staple (or at least catch a few) at doctors offices in the near future.
A similar device from Rani Therapeutics doesn’t pick items up, but rather drops them off. See, large proteins are routinely destroyed by the stomach’s acids. That’s why drugs like insulin have to be administered intravenously rather than orally. The robotic pill from Rani is sheathed in an inert polymer and equipped with a carbohydrate-based “needle.” The pill is designed to protect its payload from stomach enzymes until it reaches the intestinal tract where it can be delivered. Unfortunately, the pill has been awaiting human trials since at least 2014, and doesn’t appear to be entering them any time soon.
If you are in need an ingestible endoscope — one capable of punching out a small portion of your stomach lining for biopsies — researchers at the physical intelligence department at Max Planck Institute in Germany have you covered. Like the CSAIL origami-bot, this too contains a small magnet which enables doctors to control it from outside the body. However, unlike MIT’s device, this one is built to withstand the rigors of the human body’s interior and deliver its potentially cancerous cargo completely unscathed after it passes through the gut. Officially known as the magnetically actuated soft capsule endoscope for fine-needle aspiration biopsy (B-MASCE), this device is undergoing in vitro trials.
The quest for edible robots is an international one. Researchers from Switzerland’s EPFL are working on a soft robot that doesn’t need to be guided by external magnets or mechanizations. Instead, this gelatinous device relies on liquids and air that react to an onboard supply of chemicals to activate its inchworm-like movements. The device is still in early development so don’t expect it to be crawling through your digestive tract anytime soon.
And speaking of crawling, the Rentschler Research Group has created a robot capable of traversing your colon. But rather than waste a workday traveling through the length of your intestines, this robot takes a more direct approach. Yes, through your butt. Just as with the EPFL’s creation, this device scrunches its way through your rectum like a worm in search of cancer.
But for as promising as these futuristic medical devices appear, they are almost unanimously unready for the trip through your innerspace. Even as other fields in robotics move towards full autonomy, medical devices have been slow to incorporate that feature. As Wired points out, doctors tend to be reluctant about handing over control to machines. So until these robots can prove that they can abide by the Hippocratic oath, don’t expect to see them worming their way through you anytime soon.