Vaginal Cuff Closure with Dual-Arm Robot and Near-Infrared Fluorescent Sutures

Area of Science:

• Robotics in Surgery
• Medical Robotics
• Surgical Automation

Background:

• Suturing is a critical surgical skill.
• Current robotic systems often require human assistance for tasks like suture management.
• Autonomous execution of suturing tasks can improve consistency and outcomes.

Purpose of the Study:

• To develop and evaluate a dual-arm robotic system for autonomous suturing.
• To automate the management of loose suture thread, traditionally a human-assisted task.
• To integrate near-infrared fluorescent (NIRF) sutures for automated boundary detection.

Main Methods:

• Extension of the Smart Tissue Autonomous Robot (STAR) with a second robotic manipulator.
• Development of novel near-infrared fluorescent (NIRF) sutures.
• Automated segmentation of NIRF sutures for task boundary delimitation.
• Ex-vivo and in-vivo experiments using porcine models for vaginal cuff closure.

Main Results:

• The dual-arm system outperformed human surgeons in most metrics for vaginal cuff closure in ex-vivo porcine models.
• The system demonstrated superior consistency compared to human surgeons across all evaluated aspects.
• Successful in-vivo demonstration of vaginal cuff closure using the robotic system in a porcine model.

Conclusions:

• The dual-arm suturing robot enhances autonomous surgical capabilities.
• The integration of automated suture management and NIRF sutures improves precision and consistency.
• This robotic system shows potential for advancing autonomous surgical procedures, including vaginal cuff closure.