doctor's in

Look: A dime-sized robot wants to burrow into your stomach — for science

The doctor will see you now.

Blank, expressionless eyes stare at your exposed abdomen — and then pop! The tiny silver, black machine burrows into your warm flesh, extending its claw-like arms and flipping on its headlights like a car pulling onto an empty highway.

It’s a spine-tingling piece of film — but this video is not the first scene of a horror movie. Rather it is a video of a piece of cutting-edge medical technology that its creators, Vicarious Surgical, believe will be a major player in making a healthier world.

Human healers are the gold — really the only — standard for medical care and have been for millennia, but some scientists believe robotic alternatives may offer a just-as-good or even better option. This could be especially true for delicate surgeries like abdominal explorations that can carry a high risk of complications. But other analysts suggest the promise of robotic surgeries may be overblown at best, a criticism that plagues new-age robotic “solutions” to human problems.

What does the video show?

Puppetiered by a human surgeon several feet away, the video from Vicarious Surgical, run by CEO Adam Sachs, shows how the dime-sized robot crawls its way into tiny spaces and then pokes around with precision. On a human, this equates to the robot creeping into a tiny incision in your abdomen, evaluating, and extracting whatever mass the human controller directs its unflinching gaze toward.

Throughout the process, the robot mirrors the surgeon’s expert movements — so you still need a human at the helm.

See it in action for yourself:

Sachs tells Inverse that he and his collaborators originally hatched the idea based on concepts stolen from sci-fi cinema.

“Shrinking the surgeon down and beaming them into the patient via robotic technology — that vision was inspired by sci-fi,” Sachs says. “Specifically the movie Fantastic Voyage.”

Vicarious Surgical’s robot hasn’t quite graduated from med school and is still in the development and testing phase. This means that this tiny robot is not being used on humans yet. Instead, it practices on less precious materials — in the video above, the robot can be seen grasping and twirling minuscule plastic rings similar in shape to those you might have dived for as a child.

The robot has also been tested and validated using synthetic and cadaver models.

If a surgeon could crawl inside you to complete a procedure, would you let them?

Vicarious Surgical

The entire premise is based on the idea that while steady hands and expertise are critical skills for a surgeon, being human is not. But all this begs a fundamental question: If a bug-sized, robotic surgical device could be made to crawl in you and then move around to remove parts of your flesh — would you let them?

How robot surgery works

Surgery robots are not new. The most popular of these systems right now is called ‘da Vinci,’ and the way it works is that surgeons control articulating arms on a human-scale robot from afar using a console not dissimilar to a gaming controller. In some studies, researchers have shown surgeons can use these systems from miles away to operate on people successfully.

In addition to providing surgeons better visuals of the surgery site, the main advantage of these systems is that it allows surgeons to do more laparoscopic surgeries — that is, surgeries through small incisions — versus “open” surgeries which need larger cuts to get to where the surgeon needs to go in the body. The small cuts mean improved recovery time for patients.

A drawback of these kinds of robotic surgeons, according to Sachs, is that they don’t have a human surgeon’s agility or flexibility. The robots’ arms often are designed with only one joint — at their “wrist” — instead of multiple points of movement like a real human arm — the wrist, elbow, shoulder, and so on. Vicarious Surgical has all three built into its bot.

The idea is that human surgeons would don virtual-reality headsets and operate the robot within the body as if they themselves were in there waving their arms around instead. In all, Vicarious Surgical’s robots can squeeze themselves through 1.5 centimeter-sized incisions, and then, Sachs says, open up to a full length of 20 centimeters — that’s longer than half a foot.

What are the benefits of robot surgery?

Sachs says that there are several huge benefits of robot augmented surgery, including:

  • Reduced complications
  • Reduced procedure time
  • Ability to operate on more patients
  • And increased revenue for hospitals

But an analysis published in a 2020 Nature report and a subsequent 2021 meta-analysis published in the Annals of Internal Medicine found that this technology doesn’t equate to any better long-term outcomes for patients compared to human-led surgeries. Each da Vinci system costs $2 million — and together with the lackluster real-world results, that cost has doctors questioning whether or not robot surgeons like da Vinci or Vicarious Surgical’s bot are really worth it.

Similar concerns have been voiced about the utility of A.I. in healthcare, too.

“Just because something’s new and fancy doesn’t mean it’s the better technique,” Naila Dhanani, a surgical resident at UT Health in Houston, says in an interview with the New York Times from August.

“Yes, robotic is safe, we’ve proven that,” she adds. “But we haven’t proven it’s better. There were four studies that showed a benefit with robotic surgery, so that’s quite modest. Forty-six showed no difference at all.”

Small and agile enough to climb through a dime-sized incision, Vicarious Surgical’s robot is poised to transform operating rooms.

Vicarious Surgical

What’s next — Vicarious Surgical has made waves with more than its compelling visual demonstrations — it has “Breakthrough Device Designation,” a status that puts it on a fast-track to approval under the auspices of the Food and Drug Administration, the federal body in charge of medical device and drug approvals in the United States. It hopes to be fully approved by 2023, Sachs says.

To reach that goal, it is now focusing on finalizing and validating the robot’s surgical features as well as ironing out its manufacturing logistics. But an open question is how truly useful this robot will prove to be to humans. For example, Vicarious Surgical’s robot doesn’t yet have a market price, but it’s unlikely to be cheap.

“We’re incredibly excited,” Sachs says. It remains to be seen how excited patients and physicians may be about the potential tech.

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