Much of the technology humans develop has been and will be created out of the desire to go beyond our natural abilities. Computers, for example, were developed to automate mathematical calculations at speeds that far exceeded that which even the brightest brains were capable.
From this need to surpass what we were naturally born to do, the field of robotics has also developed. Originally created to automate processes in the manufacturing industry in the early 1960s, today industrial robots are used to assist and protect their human counterparts. Industrial processes that need extra strength and stamina, like handling and palletizing, or precision, like cutting and welding, or those in which humans could be harmed, like in the spraying of chemicals, are now in the realm of robots.
In the sixty years since robots have been a part of humanity, their original purpose has become specialized and spread to a number of different fields. Robots play roles today in agriculture, transportation, military and law enforcement, and consumer and household goods. Perhaps the greatest impact that robots are making on humanity, however, is their ability to assist in the treatment of humans in the field of medicine.
Types of medical robots
Robotics in healthcare and medicine nowadays extends far beyond where it began in the operating room more than 30 years ago. Today, robots can be found assisting in a number of medical areas:
- Surgical robots / robot-assisted surgery
- Robotics for radiotherapy
- Rehabilitation robots
- Laboratory robots
- Robotic prosthetics
- Hospital robots
- Social robots
Robots for medical use have been a reality since the 1980s, beginning with assisting surgeons in the operating room. Robots doing surgery has become an increasing reality in operating rooms today.
There are distinct advantages to supplementing surgery with robotics. Robots offer surgeons and surgical teams reliable and consistent intraoperative support. For example, in spine surgery, robots can hold instruments and implant components perfectly still and on target during screw placement for decompression surgery.
Beyond routine procedures, robotics can also assist by supporting the team during challenging approaches, for example with single position fusions, which often require unergonomic setups for the surgeon. When combined with surgical navigation during scoliosis surgery, robotics can also assist with the challenges of alignment the complex anatomy of these cases present.
This stable positioning of instruments not only allows for greater precision, it also frees up the surgeon and surgical teams’ hands during the procedure. Due to their reliability, robots also have the potential to reduce the overall procedure time of surgeries. During spine surgery without robotic assistance, a surgeon has to align the instruments and drill all while constantly checking and holding the proper alignment.
With the aid of a surgical robot, alignment and drilling are split into two sequential steps, reducing the mental load on the surgeon and potentially allowing them to complete drilling more quickly. Faster surgeries benefit the hospital, the surgeon and especially the patient, who would then be under anesthesia for a shorter period of time.
Robotics for radiotherapy
In the 1990s, robotics was introduced into the field of radiotherapy. The first system featured a linear accelerator mounted to a robotic arm that can travel around the body, treating tumors with precision in a range of locations.
Robotics have since been further introduced into radiotherapy and radiosurgery. Robotic treatment couches, for example, position the patient with precision before treatment begins. They also allow clinicians to reposition the patient remotely without having to enter the treatment room.
While the field of rehabilitation robots is relatively new, the concept of using machines to rehabilitate patients was developed as early as 1910 by Theodor Büdingen when he patented a machine to support stepping movements in patients with heart disease[i]. The first truly robotic devices devised for rehabilitation were based on the principles of continuous passive motion (CPM), which moves a part of the patient’s body for them while they relax.
One such application is gait rehabilitation. Compared with traditional physical therapy approaches, robotics deliver controlled, repetitive and intense training that can reduce the burden on the therapist and provide quantitative-based assessment of the patient’s progress.[ii] Robots are becoming more and more prevalent in rehabilitation due to these advantages.
For the last 30 years, robots have been a mainstay in laboratories. The types of robots found in labs are specially designed to either automate processes or assist technicians in completing repetitive tasks. Much like in the field of industrial robotics, laboratory robots often take care of tasks that involve chemicals and substances that are dangerous or harmful for humans. The automation laboratory robots offer provides increases in speed, capacity and accuracy by reducing human error.
This relatively new application of robots used for medical purposes focuses on providing their wearers with life-like limb functionality. While prostheses with robotic capabilities are already available on the market, they remain costly for patients as this technology continues to develop. One example of advancements in this field are neuromusculoskeletal prostheses, which are affixed to the bone and operated with bidirectional interfaces connected to the patient’s neuromuscular system with implanted electrodes in their nerves and muscles[iii].
With a pre-programmed layout of their environment and built-in sensors, hospital robots are already delivering medications, meals and specimens around hospitals today. As a result of the Covid-19 pandemic, the ability to complete contactless sanitization has become increasingly necessary for the health and safety of patients and hospital staff. Hospital robots are starting to take over responsibility for sanitizing rooms and areas, eliminating the need for hospital staff to come in contact with any potential pathogens.
In the hospital setting, social robots give patients, especially the elderly and children, cognitive support through their ability to socially interact, providing encouragement and demonstrating to patients how to perform certain motor activities.[iv] These more human-like robots are able to perform their tasks with considerable autonomy and do so while interacting naturally with patients and clinical staff. With hospitals all around the world suffering from nursing shortages, these types of social robots could potentially provide the social interaction patients may be missing.
The future of medical robotics
In all cases, the level of autonomy of robots in healthcare typically increases with the ‘distance to the patient’. For example, a surgical robot, which is very close to the patient, has no autonomy and is told exactly how to behave by the surgeon. Sanitation robots, on the other hand, which are quite removed from working with patients directly, have more ability to decide how to conduct themselves based on their environment.
Robots today have a variety of uses in healthcare, all designed to help humans go beyond what we can naturally and safely do ourselves. The applications of these types of robots continues to develop rapidly in surgery and other areas of medicine. Robots in operating rooms and clinics are already becoming the norm and are just one of many ways healthcare continues to push the boundaries of technology.
[i] Gassert R, Dietz V. Rehabilitation robots for the treatment of sensorimotor deficits: A neurophysiological perspective. Journal of NeuroEngineering and Rehabilitation. https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-018-0383-x. Published June 5, 2018. Accessed October 15, 2021.
[ii] Rodríguez-Fernández A, Lobo-Prat J, Font-Llagunes JM. Systematic review on wearable lower-limb exoskeletons for gait training in neuromuscular impairments. Journal of NeuroEngineering and Rehabilitation. https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-021-00815-5. Published February 1, 2021. Accessed October 15, 2021.
[iii] Middleton A, Ortiz-Catalan M. Neuromusculoskeletal arm prostheses: Personal and social implications of living with an intimately integrated bionic arm. Frontiers in neurorobotics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393241/. Published July 24, 2020. Accessed October 15, 2021.
[iv] Cifuentes CA, Pinto MJ, Céspedes N, Múnera M. Social Robots in therapy and care. Current Robotics Reports. https://link.springer.com/article/10.1007%2Fs43154-020-00009-2. Published June 29, 2020. Accessed October 15, 2021.