Minimal-invasive surgical interventions are growing in popularity due to the benefits they offer to patients. Treatment in a minimally invasive way typically comes with less blood loss, smaller scars, earlier release from the hospital, and faster recovery. An increasingly growing branch of minimally invasive intervention makes use of natural human lumens to access deeply seated anatomic sites. Such lumens can be accessed through natural orifices such as the mouth, nose, ears, anus, or urethra. The vasculature or lymphatic system or examples where via small incisions lumens can be accessed to reach the heart or circulatory system. Instruments that want to take benefit of these speedy routes into the body better be flexible such that the travelled lumens remain intact and do not rupture. Controlling such flexible instruments is however close to art. It takes many years of experience and even then remains stressful and challenging. Robotic technology could be of help here.
The main problem is that robotics is quite complex. Robotics is a highly multi-disciplinary field that spans mechanics, electronics, sensing, software, and control. For surgical robotics (SR) human factors, anatomy, physiology, biocompatibility, and regulatory aspects add to that. When talking about flexible surgical robots each of these disciplines becomes even more challenging. For being successful in this field a Ph.D. may come in handy, but current doctoral training programs in engineering and SR fail to deliver sufficient broadly educated researchers, as they focus too much on single specific excellences. Companies that are active in the field need to restrict them to one single clinical discipline if they want to be successful in managing all the separate aspects. Because of that, they may fail in exploiting the commonalities that exist across intraluminal procedures. Techniques to navigate a vessel may turn useful when aiming to pass through the colon. Sensors that have been developed to visualize the kidney could find great use to observe the sinus and so on. Understanding and improving approaches to sense, model, control, and navigate flexible instruments could impact an entire spectrum of surgical/interventional fields.
The main ambition of ATLAS, which stands for “AuTonomous intraLuminAl Surgery”, consists of the development of a state-of-the-art training program to educate highly talented early-stage researchers (ESRs) in the broad set of techniques that are needed to control flexible surgical robotic systems. By targeting three surgical scenarios namely ureteroscopy, colonoscopy, and endovascular navigation, ATLAS forced its ESRs to consider the commonalities and differences across these fields.
ATLAS developed three platforms aiming at autonomous navigation through the respective lumens. By engaging in these ambitious research topics, participants were exposed to all aspects of robotics.
While contributing to the state of the art, they became proficient in building, modelling, testing, and interfacing; In short, in integrating basic building blocks into systems that display sophisticated behaviour.
While maintaining close collaborations with industry and healthcare institutes, the ATLAS ESRs understood how to keep both clinical and commercial needs and constraints into account.
Creating a European-wide doctoral program on Surgical Robotics, where participants receive the most recent know-how on intraluminal surgery and robotics, is urgently needed to create a bigger impact on healthcare and advance minimally invasive surgery.
While ATLAS is delivering 15 PhDs with unmatched expertise ready to reshape the field, their scientific publications will proceed with them. Through our dissemination, ATLAS already contributed to the state-of-the-art, showing how more sophisticated ways of steering medical instruments are within reach, and how improved treatment may be soon a reality.
