Mini-robots on wheels helping doctors perform surgery probably seem about as realistic as David Hasselhoff receiving counsel from his car KITT in "Knight Rider."
However, the University of Nebraska-Lincoln and the University of Nebraska Medical Center are on the verge of applying for Federal Drug Administration approval of 3-inch tall mobile robotic devices that could drastically alter the way surgery is performed in the future.
Dr. Dmitry Oleynikov, the director of education and training in the surgery department at UNMC, said the robots – which are equipped with a camera – would be inserted into a patient's abdomen to help surgeons better see damaged organs without having to make a large incision. The procedure is called a laparoscopy.
Shane Farritor, an associate professor of mechanical engineering at UNL, has been intricately involved in the project with Oleynikov since work began in fall 2002.
"The idea of putting robots into humans for medical purposes has been around for a long time," Farritor said. "But we will be the first to apply robots to laparoscopic surgery."
Farritor said the team – consisting of several doctors, professors and graduate students from both schools – has developed four prototype models.
"One robot has a pan, tilt camera," Farritor said. "We also have one that can move around inside a human and has a clamping device that can stop internal bleeding."
Farritor said the goal in developing the robots was to make surgery more proficient, safer and, in some cases, no longer dependent on large incisions.
"Twenty years ago, all surgery was done in an open way," Farritor said. "And these small incisions will cause much less damage, pain and recovery time for the patient."
Oleynikov said UNMC already uses the assistance of a much larger device, referred to as the daVinci Robot, on a weekly basis to perform surgery.
He said though the daVinci is helpful, the robot has its drawbacks because of its large size – a problem the new robots will remedy.
"These small prototypes will be immensely helpful," Oleynikov said, "especially in operations involving the repair of the abdomen or the chest cavity."
The team has already conducted successful veterinary experiments with their prototypes, performing gall bladder and prostate removals in dogs and pigs earlier this year, Farritor said.
They also have taken their robots on an out-of-state tour to other medical centers. A recent visit to the University of Rochester in New York was a success, Oleynikov said.
Although the group is preparing to apply for FDA approval, the mini-robots will not be on the market for a couple of years.
"In regards to FDA approval," Farritor said, "the best-case scenario we can hope for is to have everything completed in 18 months to two years."
Without FDA approval, researchers can't use the new robot technology in human surgeries in the U.S. However, the group hopes to conduct its first human surgery with the assistance of a mini-robot next year in the United Kingdom, which has different regulations and restrictions on medical practices.
"We will probably do a gall bladder removal for our first human case," Farritor said.
Farritor said in the future, more difficult procedures, such as heart valves and colon recessions, that typically require large incisions could be done using minimally invasive techniques.
Until the robots receive FDA approval for use in the U.S., Oleynikov said they will continue building new models and are planning to start a production company in Nebraska with the hope of making the state a leader in robotic technology.
Not only patients will benefit from this latest medical progress, he said.
"Our highly educated, motivated students tend to find more jobs today in Chicago or out-of-state," Oleynikov said. "And this will help make our graduates want to stay in our state."
Oleynikov doesn't feel robots will ever replace actual surgeons, but did say they soon will become an indispensable tool.
"I believe robots will do for medicine," Oleynikov said, "what computers did for office work."
