Robotics in healthcare

Robotics and Innovation in Healthcare

Profound changes in medical treatments and research approaches have occurred over the past decade due to technological advances in robotics. While 1961 is widely considered the year that the first industrial robotic arm was used in a US manufacturing assembly-line, the application of AI in robotics has exponentially broadened robotic capacities in diverse areas. Moreover, AI has been a main driver for healthcare-related innovations within the past five years.

 AI-enabled robotics is helping doctors surpass longstanding obstacles to provide effective treatments and solutions, such as helping paralyzed people walk, improving prostheses for amputees, conducting surgeries despite long distances between surgeons and patients, and creating biotechnology products utilizing nanotechnology.

The following describes some different areas in which robotics has completely transformed treatment options aimed at improving patient healthcare outcomes.

Spinal Cord Injuries, Strokes, and Robotic Gait Devices

People who have experienced a stroke or mild spinal cord injury often experience leg weakness. Furthermore, only 7% of stroke patients discharged from an inpatient rehab unit are able to climb stairs or walk uphill. A robotic gait device is a cutting-edge tool that is now becoming more available in rehab centers to promote a more normal walking gait and increased independence in daily life.

As described in an article in Neuropsychiatric Disease and Treatment in 2017, robotic “exoskeletons” move hip, knee, and ankle joints. Generally, patients fitted with a robotic gait device are strapped into a body-harness on a treadmill, while the device moves the patient’s joints to align with proper walking for that individual. In this way, correct joint alignment is re-learned and leg muscles are strengthened.

A recent article in the Journal of NeuroEngineering and Rehabilitation notes that robotic gait devices are often used to increase the following:

  • Walking-speed capacity
  • Step length (as measured in inches)
  • Comfortable walking distance

Additionally, the article reports that robotic gait devices used in in the rehabilitation of people with spinal-cord and brain injuries can do the following:

  • Decrease sensations of pain upon movement
  • Decrease spasticity (involuntary muscle contraction)
  • Improve sensitivity to temperature
  • Increase nerve-transmitted electrical activity at the muscular level

Prosthetic Devices ─ Hand Movements

The usefulness of hand prostheses has been vastly improved by robotics. Robotics has enabled people who are hand amputees (or those born without a hand) to use a bionic prosthesis to move fingers to grip objects in similar fashion to a real hand. In order for this usage to be learned, electrodes are implanted into the arm, spinal cord, brain, and specific nerves to activate actions upon receipt of a neurally-transmitted signal of the “intent to move” (according to the National Institutes of Health in 2018).

Converted into digital commands, this enables the person fitted with the prosthetic hand to perform more complex activities such as the following:

  • Grasping a straw with two fingers
  • Catching a baseball
  • Peeling a grapefruit or orange

Meanwhile, study findings published in Science Translational Medicine in 2018 showed that the use of small robots to vibrate arm muscles in hand amputees improved the use of their bionic prosthetic hands. Notably, a case study of four study subjects showed that an improved sense of the spatial position of the artificial hand and its movements (innate kinesthetic sense) aided in utilizing the prosthesis for complex hand and finger movements.

Minimally Invasive Surgeries—Hysterectomies, Knee Arthroscopies, and Vein Treatments

The number of ambulatory surgical centers (ASCs) has increased enormously due to the possibility of undergoing surgery for a wide variety of disorders without the need for a large surgical incision (or a resulting stay in a hospital). From hysterectomies to shoulder, hip and knee surgeries and from varicose vein removal to corneal cross-linking for certain eye disorders—ASCs are the primary healthcare sites where these surgeries are performed.

The importance of robotics in enabling ever-more complex surgeries via minimally invasive approaches cannot be over-emphasized. For example, the use of a robotic catheter for minimally invasive injection therapy in the treatment of spider veins (or small varicose veins) is increasing. The advantage of undergoing a robotics-assisted procedure in an ASC (as opposed to a non-robotics-assisted procedure) is the greater potential for surgical precision, thereby reducing the likelihood of a mistake that necessitates hospitalization.

Armed Conflict Zones and the Use of Robotics in Long-Distance Surgery

Military surgeons in the US army performed the first robotic surgery in 2016, and it has been employed on service personnel in armed conflict zones (e.g., Iraq and Afghanistan) since that time. According to the Journal of Military and Veterans’ Health, 86% of battlefield deaths occur in the first 30 minutes following injury. Since surgeons are often not situated close enough to the battlefield to perform a necessary surgery, the capacity for telesurgery, or utilizing robotic arms attached to surgical instruments (guided remotely by the surgeon), can be lifesaving.

Whether military or civilian-utilized, robotic surgical systems (RSS) include three categories based on the level of surgeon involvement in the surgical procedure:

  1. Supervisory-controlled (exclusively employs robot to perform procedure);
  2. Telesurgical (surgeon remotely manipulates robotic arms to perform procedure);
  3. Shared-control (robot manipulates instruments for easier surgeon utilization of instruments)

Use of the daVinci Robotic Surgical System in Gynecology and Urology Procedures

Approved for use by the Food and Drug Administration (FDA) in 2000, the daVinci Robotic Surgical System was one of the first robotic surgical systems to obtain FDA approval. It has been used in more than 6 million surgeries across the globe. Two other early robotic surgical systems were Zeus and Aesop. All three systems were designed for use in laparoscopic surgeries, and the daVinci Robotic Surgical System was especially promoted for use in minimally -invasive gynecologic and urologic (prostate) surgeries.

A case study of a South Korean hospital in 2018 utilizing the daVinci Robotic Surgical System (involving 10,267 procedures) showed that 94.5% were for malignancies (cancers), and system malfunctions/failures occurred in only 1.8% of all performed procedures.

Meanwhile, nearly 90% of minimally-invasive prostate surgeries in the US are now performed utilizing a robotic surgical system.

Nanotechnology and Robotics in Medicine

Since nanotechnology operates at a molecular level, its application is revolutionizing diagnostic and treatment approaches in circulatory disorders (e.g., hardening of the arteries). Cell repair utilizing nanotechnology and robotics is in the early stages, and may enable the treatment of cancerous cells (per an article in Advances in Robotics and Automation). Additionally, improved materials used in surgical procedures (e.g., tissue adhesives) and lab-based medical research have been developed due to nanotechnology and robotic capabilities.

This combination of nanotechnology and robotic healthcare innovations may prevent heart attack, stroke, and blood cancers from causing permanent disability through earlier medical intervention than currently possible. That breakthrough year may actually not be so far in the future.

About the Author:

Gregory Miller is a writer with DO Supply who covers robotics, artificial intelligence and automation. When not writing, he enjoys hiking, rock climbing, and opining about the virtues of coffee.

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