In four experiments on pig tissues, a robot performed one of the most intricate and delicate procedures in abdominal surgery — without a human hand guiding it.

The STAR — smart tissue autonomous robot — sutured two ends of intestine in what its designers at Johns Hopkins University called “a significant step toward fully automated surgery on humans.”

“Our findings show that we can automate one of the most intricate and delicate tasks in surgery: the reconnection of two ends of an intestine. The STAR performed the procedure in four animals and it produced significantly better results than humans performing the same procedure,” said senior author Axel Krieger, an assistant professor of mechanical engineering at Johns Hopkins’ Whiting School of Engineering.

According to an announcement from Johns Hopkins: “The robot excelled at intestinal anastomosis, a procedure that requires a high level of repetitive motion and precision. Connecting two ends of an intestine is arguably the most challenging step in gastrointestinal surgery, requiring a surgeon to suture with high accuracy and consistency.”

The surgery is delicate because even the slightest hand tremor or misplaced stitch can result in a leak that could be catastrophic for the patient.

The Johns Hopkins team gave the STAR specialized suturing tools and state of the art imaging systems for a more accurate visualization of the surgical field.

“What makes the STAR special is that it is the first robotic system to plan, adapt and execute a surgical plan in soft tissue with minimal human intervention,” said first author Hamed Saeidi, a visiting research scientist of mechanical engineering at Johns Hopkins.

Krieger said the use of robotics “will result in a democratized surgical approach to patient care.”

“Robotic anastomosis is one way to ensure that surgical tasks that require high precision and repeatability can be performed with more accuracy and precision in every patient independent of surgeon skill,” he said. The study was published recently in the journal Science.

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