Speaker 1: In this video, we demonstrate enhanced autonomous laparoscopic anastomosis of the small bowel using the smart tissue, autonomous robot, small bowel anastomosis is a procedure performed over a million times each year using manual laparoscopic, a robotic techniques during this task, the surgeon stages and reconnects two loops of bowel by suturing adjacent tissue use using either running or interrupted stitch consistency of these stitches is critical for successful stenosis as even a single missed stitch can result in leak [00:00:30] with catastrophic complications. Autonomous robotic suturing can complete this task with more consistency and repeatability than that of an expert surgeon, the automation of such a excellent delicate task required the development of many innovations. These include the adaptation of surgical tools to robotic platforms. The combination of near infrared and structured like cameras for three dimensional imaging and robotic control schemes that generate surgical plans to autonomously, correct for tissue deformation and obstruction.
Speaker 1: We [00:01:00] now showcase these innovation by performing a small bowel anastomosis using the smart tissue autonomous robot, a loop of small bowels first detach from the surrounding tissue using manual technique. A surgeon applies a transverse cut to separate the bowel into equal halves. Trans abdominal stay sutures are placed in the right and left corners of the bowel. These sutures reapproximate and align the two halves of tissue and preparation for the anastomosis. The same stay sutures are then passed through the abdominal wall. So [00:01:30] tension can be adjusted from outside the patient. A third stay suture is placed on the front wall of the bottle and used to open the anastomosis near infrared markers are then manually applied to the corners of the bowel for robust tissue tracking as seen Star's imaging system detects and tracks the anastomosis site, despite soft tissue defamations and breathing artifacts. Furthermore star generates three dimensional point clouds of the surgical site and autonomously overlays optimized surgical plans for the anastomosis.
Speaker 1: [00:02:00] When a surgical plan is not consistent with the three to mention a point cloud is shown on the front wall of this tissue. The surgeon initiates a replanning algorithm to generate a new point cloud with corresponding surgical plan star creates an anastomosis by first performing a running suture along the back wall of the small bowel, a human assistant removes all loose thread from the surgical field to prevent the four of locking sutures during the anastomosis. Similarly star completes the [00:02:30] second half of the anastomosis by using a running stitch to close the front wall. Sutures are applied with uniform spacing as determined in the initial surgical plan. While robust tracking is enabled by the near infrared imaging system. At the end of the surgery, the anastomosis is manually inspected for MIS stitches and defects. Here. We highlight a representative anastomosis from one of the acute laparoscopic trials.