Science

“Tomorrow, surgical robots will be fully autonomous like cars”

Scanners and MRIs, which cost several million euros each, are often inaccessible to developing countries. IRCAD, known worldwide in surgical robotics, is working on a low-cost ultrasound machine capable of automatically detecting and then treating tumors before they develop. A breakthrough made possible by the extraordinary growth of artificial intelligence, says Jacques Marescaux, president of IRCAD.

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In 2001, “Operation Lindbergh” carried out by Professor Jacques Marescaux had the effect of Thunder in the world of surgery. For the first time, a patient located in Strasbourg was operated remotely from New York using a robotic console. From the robot surgeons They have been developed a lot, but they are still limited in terms of possibilities. Another revolution that appeared a few years ago in health could turn everything upside down:artificial intelligence. Jacques Marescaux, President of IRCAD in Strasbourg, he tells us how he uses AI to develop a low-cost ultrasound capable of detecting and operating in you die before they grow up. The project, called Disrumpere, promises an unprecedented democratization of medical imaging.

Why did you seek to develop a low-cost ultrasound system?

In 2021, I came across a WHO report that 5 billion people had no access to any medical images. Then I saw another study that showed that 5.8 billion people did not have access to basic surgery. Here at IRCAD we work with state-of-the-art tools that cost several million euros. But in many countries, hospitals cannot afford to pay MRI or a scanner worth more than a million euros. By comparing, ultrasound has many advantages: it does not require a source ofEnergy and can be plugged in anywhere. In recent years, low-cost probes have appeared (around 400 to 500 euros). Therefore, they are ideal tools for developing low-cost medical images.

What exactly can these inexpensive ultrasound scanners do?

Of course, the image with such a probe is not as good as with a 100,000 euro ultrasound machine like the ones we use in the hospital. But this is where artificial intelligence comes in: our machine, which has been trained with thousands of ultrasounds, will transform a 2D black and white image into a 3D image in colour much more accurate. In this way, we can detect tumors less than 2 cm in diameter, that is, at a stage where they can be destroyed without major surgery. The AI ​​can also tell if the organ has been fully scanned, so no tumor is missed.

How is this artificial intelligence integrated into robotics?

When the tumor is still in an early stage, it can be destroyed without performing a complex operation, which as I said is not accessible to everyone. Percutaneous destruction is performed, which consists of inserting a needle into the center of the tumor by heat (radiofrequency) or by cold (cryoablation). The problem is that you have to be extremely precise to position the needle correctly. THE’automate Guided by artificial intelligence, it will place the needle in the right place, it will say how deep it should be inserted, and all that is needed is to validate the proposal of the machine to practice the gesture. We are working with the startup for this. Axilum Robotics, who developed inexpensive robotic arms.

Can we imagine a fully automated surgical operation tomorrow?

Absolutely. Tomorrow we will have robots autonomous surgical procedures in the same way as autonomous cars. Also, we could already perform the surgical procedure automatically, but very complex homologations are needed to allow a machine to pierce the skin with a needle! Today, we are only in the prehistoric era in matter from robotic surgical, which is mainly used for accompany the surgeon’s gesture. With the addition of artificial intelligence, the robot is able to accurately reproduce the gestures that it has learned during thousands of hours of operating video. The surgeon will practically “operate” on clones. digital, then the algorithm will retain the best possible procedure to practice a perfect gesture. In the future, the one who wins the robotic surgery competition is the one who will put the most artificial intelligence in their system!

Won’t this robotic medicine be reserved for an elite?

On the contrary ! As the example from our Disrupt project shows, AI can be used to democratize access to healthcare in developing countries. Even with us, it could revolutionize disease diagnosis. Today, a whole battery of examinations (MRI, scanners…) which are very expensive as well as prevention. If tomorrow AI allows such a reliable diagnosis to be made with tools 100 times cheaper, everyone is a winner.

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