Robotics get to the heart of the matter

Babbage recently underwent a small operation to remove a benign intestinal polyp, and was most impressed by the surgical technology. He was not etherized, but merely under conscious sedation. Nor was any incision involved; the procedure was conducted entirely via a prehensile probe equipped with a fibre-optic camera and biopsy tools.

For more major operations too, the safety advantages of minimally invasive procedures are becoming well-known. In traditional heart surgery, a striking development is the so-called 'daVinci' machine now in some medical facilities. Akin to the Waldo remote manipulator, a daVinci probe works, within the chest of a patient, as the surgeon's eyes and inhumanly steady hands. The surgeon can operate, without fear of 'the shakes', from a non-sterile environment, while patient trauma is greatly reduced by the small 'keyhole' incisions rather than the usual single, massive sternum breach.

At present, daVinci is the size of a room, and only a tool. But the future implications are even more revolutionary. In a university prototyping lab, Babbage was shown an automated version - a shoebox-sized ‘daVinciette' - learning surgery. Its patients were eggs of plastic gel, each with a caseless clockwork watch for a heart, the surrounding gel skin embedded with wire mesh and red ink bubbles. Some watches were deliberately damaged, and the daVinciette's task was to mend these without interfering with the obstacles in the skin.

As Babbage watched, the daVinciette took each egg, and proceeded to identify its watch, penetrate the gel skin for an examination, then attempt repair when necessary. At each stage, it could refer the case for human attention. Finally it wound the mechanism, then classified the patient as dead (the watch not ticking, or ink in the works), alive, or to be referred. The daVinciette was not the best of surgeons: around a third of its patients died, and one in ten was referred. Nevertheless, its record was slowly improving, and viewed alongside other medical robotics advances, this brings the 'Aesculapius machines' and 'autodocs' of science fiction into the realm of likely futures.

Of the medical endorobotics experts Babbage spoke to, some foresaw automated surgery useful in battlefield or other hazardous environments. Others saw brighter prospects, a way out of resource shortages in a world of escalating clinical demand. But whatever the applications for daVinci and the daVinciettes, their increasing part in medicine seems to Babbage inevitable.