Drawing on advances in robotics and computer
technology, Johns Hopkins researchers are designing new
high-tech medical tools to equip the operating room of the
future. These systems and instruments could someday help
doctors treat patients more safely and effectively and
allow them to perform surgical tasks that are nearly
The tools include a snakelike robot that could enable
surgeons, operating in the narrow throat region, to make
incisions and tie sutures with greater dexterity and
precision. Another robot, the steady-hand, may curb a
surgeon's natural tremor and allow the doctor to inject
drugs into tiny blood vessels in the eye, dissolving clots
that can damage vision.
These and other projects are being built by teams in
the National Science
Foundation Engineering Research Center for
Computer-Integrated Surgical Systems and Technology,
based at Johns Hopkins. Launched in 1998 with funding from
the NSF, the center aims to transform and improve the way
many medical procedures are performed.
Working closely with physicians from the School of
Medicine, the center's engineers and computer scientists
are building robotic assistants intended to enhance a
surgeon's skills; devising detailed visual displays to
guide a doctor before and during a difficult medical
procedure; and planning digital workstations that would
give the physician instant access to an enormous amount of
medical information about the patient.
Because most of the new medical tools are linked to
computers, their work can easily be recorded. Later, these
records would be checked against data describing how well a
patient responded to the treatment. From this review,
doctors could learn which techniques and procedures were
most effective. "We could produce the equivalent of a
flight-data recorder for the operating room," said
Taylor, a professor of
computer science and director of the center.
The emphasis is on futuristic technology, but "we're
not trying to replace or automate surgeons," Taylor
insists. "We want to work in partnership with surgeons to
help them do their work more effectively. Human hands are
remarkable, but they have limitations. There are times when
it would be useful to have a 'third hand,' and we can
provide that. Sometimes a surgeon's fingers are too large
to work in a small confined space within the body. We can
help by building tools that act like unhumanly small and
highly dexterous hands."
One promising example is the team's snakelike robot.
Currently, a doctor performing throat surgery must insert
and manually manipulate long inflexible tools and a camera
into this narrow passageway. The snakelike robot would
provide an alternative. It could enter the throat with two
thin rods tipped with tentaclelike tools capable of moving
with six degrees of freedom. If directed, the tools can
bend easily into an S-curve.
During surgery, a doctor would sit at a robotic
workstation and peer into eyepieces that display a
three-dimensional view of the operating site. The doctor
would then maneuver the controls to guide the movement of
the robot. The prototype is made of nonmagnetic metals so
that it can be used safely near magnetic imaging equipment.
The tools' movements are nimble because sophisticated
software can make up to 100 adjustments per second.
The steady-hand system, also devised by the Johns
Hopkins team, was built to help with another challenging
task: microsurgery. At this scale, even the best surgeons
display some tremor in their hands. Yet the slightest
uncontrolled movements can be troublesome during surgery on
microscopic structures, such as tiny blood vessels in the
eye. To address this problem, the steady-hand robot can
grasp a needle and move it carefully in tandem with the
surgeon in a technique called cooperative manipulation.
In tests of the device, the researchers have
successfully injected a liquid into a chicken embryo's
blood vessels, resembling structures in the human eye. "The
steady-hand could allow a surgeon to make very precise and
accurate micro-movements without tremor," Taylor said.
Before they are used on human patients, both the
snakelike robot and the steady-hand system will require
perhaps five more years of lab testing and prototype
advancement. Still, Taylor believes both have a good chance
of eventually joining more traditional tools in hospital
operating rooms. "What makes this work particularly
rewarding," he said, "is that we have the opportunity to do
cutting-edge engineering that can help people in a very
A video showing some of this research is online at