Over the last several years we have witnessed an intense interest in autonomous technology—self driving cars, autonomous delivery drones—among other applications. Once limited to the imagination and science fiction, we are seemingly on the cusp of such technology becoming reality, even commonplace.

Autonomous Robotic Surgery—Future or Fantasy?

While performing a radical cystoprostatectomy is much more complex than driving to the grocery, it is likely a matter of time before artificial intelligence enters the operating room in the form of autonomous robotic surgical systems (ARSs). Time will tell whether robots ever fully replace humans in the performance of complex operations. More likely, they will accentuate human performance or perform portions of procedures with close human oversight—akin to a car changing lanes or parallel parking with a driver’s eyes and hands ready to adjust or assume control.

This year at the American Urological Association in New Orleans, the annual meeting of the Engineering and Urology Society has dedicated its program to exploring the ongoing research that is helping to bring such future autonomous surgical robots to life (May 15, 2022).

The program will begin with Dr. Louis R. Kavoussi exploring the potential value of ARSs and why this goal is worth striving for. He will argue that we will realize such systems in the relatively near future. Dr. Jamie Landman will explore the limitations of autonomous robots and whether such technology is only to be realized in the far distant future. The various classification systems that describe robots—with respect to levels of autonomy and degrees of human oversight—will be reviewed by Dr. S. Duke Herrell. The ethical and legal considerations of ARSs will be explored by Dr. Sammy Elsamra. The program will then dive deeper into the nuts and bolts of autonomous robotic systems—the various technological components necessary to create such machines.

Building Blocks

For robotic systems to autonomously perform complex operations, such systems require imaging and registration abilities to recognize tissues and structures, as well as their own position in space. This is particularly challenging for soft tissues, as compared with fixed and rigid tissues, and will be discussed by Tom Calef. The properties of normal and abnormal tissue must be defined for robotic systems to safely interact with various organs, and current research in this area will be presented by Dr. Lauren Poniatowski. Real-time tracking and navigation is necessary as structures move during live surgery and the robotic effectors themselves move as surgery is performed, as will be explored by Dr. Brad Wood. Dr. Carla Pugh will discuss the extensive planning and skill modeling that is required. Dr. Andrew Hung will tackle intelligent control in the form of artificial intelligence, complex computational modeling, neural networks and fuzzy logic. Significant technological advancements with respect to end-effectors are also required, and Dr. Danyal Fer will describe his research in this arena. The state of the art with respect to each of these elements, and the status of ongoing research, will be explored. The current status of autonomous robotic systems, both in industry and in the clinical medical environment, will be reviewed by Dr. Michael Hsieh. The future of miniaturization—microbots, nanobots and micro—electromechanical systems will be explored by Dr. Sijo J. Parekattil.

This program will be followed by moderated poster sessions where teams from across the world will share their work at the intersection of urology and engineering. Best papers will be awarded by Engineering and Urology Society cofounder Dr. Dan Stoianovici. Please join us for an exciting and dynamic morning where we peer into the future of urological surgery!