Traditional minimally invasive surgery is great because it gets the job done while giving the patient less pain, less scarring, less tissue damage and shorter recovery times. Now, researchers have improved it by creating a small robotic mechanism that acts like a tiny wrist.

In a study presented at the International Conference on Robotics and Automation, researchers showed that needlescopic surgery (a procedure that utilizes instruments as small as a sewing needle's diameter) can be improved by producing a small robotic wrist that boosts dexterity in surgery, most especially in areas that are tight.

Needlescopic surgery isn't actually new, in fact, it has been round since the ‘90s but it is so difficult to do (the procedure creates incisions so small surgical tape can be used to seal them) that not many surgeons can use it regularly. No thanks to tool limitations though, needlescopic surgery has been limited to cleaning away diseased tissues with curettes or burned away with heated wires or lasers.

Led by Robert Webster, a mechanical engineering associate professor from Vanderbilt University, the researchers developed a highly handy surgical robot fitted with steerable needles with wrists in an effort to improve dexterity never before seen in needlescopic tools. With improved dexterity, needlescopic surgery can be expanded for use in the brain, ears, throat and nose, with suturing and resections even more precise than before.

Adapting robotics to minimally invasive surgery was a field dominated by the Da Vinci Surgical System from Intuitive Surgical. The Da Vinci is a surgical system that can be used for various procedures as long as incisions are within a third of an inch to 3/16th of an inch. Specifically, it is great for abdominal surgery but its wire-and-pulley design makes it troublesome to downsize, making it not ideal for surgeries in smaller spaces like the neck and head.

To address this problem, Webster and colleagues developed a surgical robot using "steerable needles," a system of telescoping tubes made of nitinol. A "memory metal," nitinol makes it possible for tubes to be rotated, extended and retracted as needed by a procedure. However, it had limited reach, a problem addressed by adding a robotic wrist.

"This would allow us to do surgeries that at present require much larger incisions and may even enable us to perform operations that are not feasible at present," said S. Duke Herrell, a consultant for the study.

By the end of summer, the researchers hope to complete the interface and control surface that would allow surgeons to use the tiny robotic wrist in their procedures.