Surgeons in Hong Kong are no strangers to using robotics in their surgeries. During the period between 2010 to 2016, the number of robotic surgeries in Hong Kong has doubled from 505 to 1006. 

A robotic system that can reassemble itself inside the body to perform operations

One major milestone in Hong Kong's robotic surgery development is the Novel Surgical Robotic System (NSRS). This ground-breaking invention is the brainchild of researchers from the University of Hong Kong (HKU) and Polytechnic University (PolyU).

NSRS is the first robotic system in the world with arms having in-vivo motors that are both small enough and able to generate sufficient force to perform various surgical operations inside the human body. (Photo credit: PolyU)
NSRS is the first robotic system in the world with arms having in-vivo motors that are both small enough and able to generate sufficient force to perform various surgical operations inside the human body. (Photo credit: PolyU)

A sleek and motorized device, the NSRS enters the human body via natural orifices or a single incision. Combining the concepts in Transformers, NSRS is able to reassemble itself inside the body cavity. What makes this system even better is that it is in a portable design that can be relocated to any surgical tables. At the same time, it features up to three or more robotic arms that can be equipped with different surgical tools. This eliminates the need for bulky equipment and significantly reduces the traumatic risk to patients.

> Read more: Working with machines – How robotic arms have helped doctors achieve better patient outcomes in heart surgeries 

During the animal trials, NSRS has successfully removed a gallbladder from a live pig in under one hour. Now, the system is moving on for more complicated procedures. NSRS is earmarked for pelvic and abdominal surgeries. It is expected to be used in patients earliest in 2018.

We are delighted to note that this engineering innovation will help turn a new page in minimally invasive surgery, thus enhancing the well-being of patients,” said Prof. Yung, Professor and Associate Head of the Department of Industrial and Systems Engineering at PolyU.

‘Arthrobot’ - the world’s first surgical robot

Contrary to traditional surgeries where surgeons directly operate the instruments, surgeons can use a console a few feet away from the patient to manoeuvre the robot in a telesurgical system. These robots are designed to compensate the surgeons’ reduced visual field and limited range of motion inside patient's body. Additionally, robotic surgery enables higher precision, a superior 3-D visualization as well as quicker patient recovery times.

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It dates back to 1983 when the world's first surgical robot, named 'Arthrobot',was invented. Listening to voice command by the surgeon, Arthrobot can position patients' limbs during orthopaedic surgeries. Interestingly, according to Dr Brian Day, one of the researchers developing the technology, 'Arthrobot' could only recognise his voice at that time. To enable another surgeon to use the robot, 'Arthrobot' would need to be trained to recognise and respond to a new voice.

In 1985, the PUMA 560 was introduced in neurosurgical biopsies. Since then, the use of robotics in surgery has experienced an exponential growth. In 2000, the FDA in the United States licensed the da Vinci robotic system. The technology is now commonly recognised to perform minimally invasive surgeries all around the world. Currently in Hong Kong, five hospitals, one private and four public, have installed this system. Robotic surgery is most often used in genitourinary, cervical and colon disorders in the city. 

Can robots replace surgeons in the future?

Robotic surgery is anticipated to play a big role in the future of medicine. Surgeons can carry out remote surgeries despite long distances from their patients. Apart from geographical distances, advancements in technology may one day allow robots to replicate the tactile feel and sensation a surgeon experiences in traditional surgeries. Still, despite the powerful ability of surgical robots, surgeons dismiss the idea that robots may one day replace them.

> Read more: The battle of doctors vs. machines in clinical diagnoses

"We still need to talk to our patients. The robot is merely a tool, a very accurate and important tool,” said Dr Stephen Wing-Cheung Wu, head of the Department of Orthopaedics and Traumatology at Hong Kong Sanatorium & Hospital.

"Human beings are still the most important. The computer, yes, it is very good, but it still needs to be controlled by someone with a human brain," agreed Dr Wai-Man Tang, a fellow orthopaedic and trauma specialist in the same hospital. MIMS