What if your future surgeon was a robot? – Living in Switzerland Guide



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From semi-autonomous “surgeon robots” to skin tissue resulting from bioengineering, some of the most promising innovations come from the “Silicon Valley of robotics”: Switzerland.

“Robotic surgery is the future of surgery. There is no alternative ”, declared Philippe Morel, surgeon and pioneer of medical robotics in the Alpine country, six years ago. In 2010, he performed the first gastric bypass operation in one of the University Hospitals (HUG) in Geneva using a robotic surgery infrastructure from the United States, the Da Vinci Surgical System.

Since then, technology has made great strides, marking a turning point in medicine, especially in certain fields. In the field of urology, for example, surgeries related to prostate cancer, kidney and even bladder cancer are now increasingly performed using the Da Vinci robot. Since 2015, more than 22 centers in Switzerland have been equipped with this type of technology.

Today’s robots are not only capable of performing complex operations, but also of assisting medical personnel in operating theaters. Bernese hospitals Klinik Permanence and Salem-Spital were the first in Switzerland to use the Mako robotic arm, also made in the USA, to allow surgeons to implant full or partial knee or hip prostheses with unprecedented precision. .

The next challenge is to make surgical robots autonomous, using many of the technologies that underpin autonomous cars and drones. Although we are still a long way from the daily use of automated “surgeon robots”, progress is accelerating, reports The New York Times in a recent article on the subject.

What do you think of the use of robots in the medical field? Do they inspire confidence or mistrust? Tell me what you think!

Switzerland, the Silicon Valley of robotics

Switzerland recently hosted a conference on medical applications of robotics, Medical Robotics Week. Georg Rauter, professor of biomedical engineering at the University of Basel who initiated the event, says it was designed to demonstrate Swiss leadership in the field. We met him through our collaboration with NCCR Robotics, and he told us more about innovation in medical technology.

SWI swissinfo.ch: Professor, where is Switzerland in terms of research and innovation in medical robotics?

Georg Rauter: Switzerland is a leader in the field of robotics and medical robotics and can create unique technologies. That’s why it’s called the “Silicon Valley of Robotics”. Swiss companies don’t just follow innovation, they actively pursue it.

SWI swissinfo.ch: What are the most promising future robotic technologies in the medical field? And which Swiss companies are at the forefront?

GR: Surgical robotics, which also includes optical and laser systems, is certainly very promising. Semi-autonomous precision surgical devices look like science fiction. But high precision is difficult to achieve in telesurgery [performed remotely by a surgeon]. Therefore, we expect that semi-autonomous and minimally invasive procedures performed by robotic devices will become available in the market in the coming years.

Swiss companies such as Cascination with their HEARO robot, the world’s first robot specializing in cochlear implants to restore the hearing system, or Aot with the first bone cutting laser called CARLO, were the pioneers of semi-autonomous surgery. Now, the next phase of robot-assisted surgery will involve agile, intelligent and minimally invasive procedures that will enable high-precision surgery.

SWI swissinfo.ch: What should patients expect from robotics in medicine? More personalized and precision healthcare or faster and more efficient healthcare?

GR: Certainly more security and more precise and personalized services. A major achievement of surgical robotics will be the personalization of treatment, training and operations. The execution of planned procedures by robots will bridge the gap between the digital and the physical worlds. This will prove very useful in the event of a health emergency, as the Covid-19 pandemic has highlighted, speeding up the deployment of robots. In contrast, speeding up interventions and increasing efficiency are less important when patient safety is at stake or when faster healing can be achieved through personalized precision medicine.

SWI swissinfo.ch: What are the limits of this technology?

GR: Data security is a major issue, especially in medical robotics. With the Internet of Things, hacker attacks can be particularly dangerous. Unlike other devices, a cyberattack on a robot can have very serious consequences in the real world. In the medical field, a robot that does not do what it was programmed to do could endanger lives or injure someone. This is why hospitals try to have closed computer systems and robots are not connected to the Internet.

SWI swissinfo.ch: Can we expect a future of totally autonomous “robot surgeons”? What are the dangers and what are the opportunities?

GR: I don’t see this as a possible scenario in the next twenty years. Ethics, patient acceptance, regulatory and legal aspects are not yet ripe for stand-alone operations. Humans are particularly good at grasping many aspects in difficult situations. Currently, operating room robots do not have as many perception channels.

AI-based decision-making algorithms are good at judging data they’ve already analyzed, but what would an algorithm do if faced with completely different information than it was trained for? Humans would at least act ethically even if the decision might not be the best.

New skin, new life

There are many other cutting-edge medical technologies that promise to revolutionize our lives, and some of them carry the “Made in Switzerland” label. A recent example comes from the Swiss start-up CUTISS, which last week presented a machine capable of “reproducing” skin tissue. My colleague Marc-André Miserez wrote an article on this extraordinary invention, which could give hope to millions of burn victims around the world. According to Marc-André, this is an absolute novelty in the field of skin grafting. Here is what he told us:
From a small sample taken from the patient, a new machine can generate an area of ​​“bioengineered equivalent skin tissue”, perfectly compatible with the donor, up to 100 times larger.

The technique has been researched at the Zurich Children’s Hospital for 20 years. Now the new skin, called denovoSkin, has been approved by drug regulatory authorities in Switzerland, the European Union and the United States and has entered the second phase of clinical trials.

But the big breakthrough is the machine, which will make it possible to go from expensive laboratory culture to mass production with minimal human intervention. Once Phase III is complete, the product could be on the market in 2023.

Do you have any comments, remarks or questions about this revolutionary medical technology or others? Let’s talk about it over a (virtual) coffee.

And coming in our next edition, don’t miss a special summer newsletter featuring the highlights of our next report on the Swiss scientific world! If you haven’t yet signed up to receive this briefing in your inbox, you can do so below.

with Marc-André Miserez

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