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A Robo-Surgeon That's Both Master and Slave

Robots are moving up in the world. Evolving into something more than calculating machines or a nifty toys, some are actually making a name for themselves in the high-precision field of surgery. Two American robots called Da Vinci and Zeus are already used extensively around the world as surgeon's assistants. Today, roughly half a dozen are used in French hospitals, for example, playing an important role in endoscopic surgery.

In fact, the French, in particular, are so taken by the technology that they are now coming up with their own version of this state-of-the-art robot. Just a few months ago, the National Network for Health & Technology, or RNTS, announced the kickoff of Endoxyrob, a French competitor that will be used in various national laboratories. Financed partially by the state and created by the company Senters, the robot, which is expected to be cheaper and include features its American counterparts don't have, should be ready to go in just over a year.

The role played by these surgical robots is significant indeed. After the surgeon has made the preliminary incisions and inserted the endoscope -- a miniature camera allowing surgeons to see the zone being operated on -- two mechanical arms, at the end of which are placed surgical instruments, go into action. And the one controlling these arms, and therefore the instruments, is none other than the robot itself. But Etienne Dombre, member of the Endoxyrob project and researcher at the laboratory for computer science, robotics and microelectronics in Montpellier, or LIRMM, explains that "this follows a master-slave logic. The surgeon manipulates the two 'master' arms, which transmit their movements to the two 'slave' arms that belong to the robot."

FREEZING THE ARMS. But although surgeons command the robot's moves, they are not at all in physical contact with the patient during the operation. The robot, therefore, creates an interface between the surgeon and the patient. What's more, with the help of systems that can measure the pressure resistance of body parts, the surgeon can sense the instrument's contact with the patients organs.

Even more amazing is that the robot can actually correct a surgeon's mistakes -- making it less a 'slave' than one would initially think. If the surgeon, for example, applies a large amount of pressure during an operation, the robot won't just follow orders: It will minimize the move, thereby allowing for more accuracy during the procedure. And if the surgeon actually miscalculates a move completely, the robot will freeze the mechanical arms in order to avoid damaging any vital organs.

Etienne Dombre promises not only that the Endoxyrob robot will be cheaper than its American competitors -- which French researchers estimate at $930,000 to $2 million -- but that it will also have more sophisticated features. These will include a better orientation of the instruments within the body and more refined devices for sending back pressure signals. Endoxyrob is also expecting to eventually combine computer images with those provided by the endoscope, thereby showing body zones that may be inaccessible to the camera during surgery.

If it sounds like the next step is a complete robotic takeover of surgery, experts like Philippe Cravez, a researcher at France's Atomic Energy Commission, offer words of reassurance. "Whatever the technological developments in the field of medical robotics may be, surgeons will continue to play the central role during surgery, since they are the ones providing the intelligence." What a relief! By Stéphane Foucart

Translated by Inka Resch

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