The Evolution of Medical Robotics and Predictions for the Next Generation

The iteration of robotic platforms that healthcare providers use today, such as CorPath® GRX, are fairly new technologies, but the ideas and motivations that spurred their development have been intrinsic to medicine for more than a century. Providers have long searched for ways to improve the quality of care by increasing efficiency, and even simplistic technologies have contributed to that cause.

Understanding the evolution of the tools throughout medical history that gave rise to modern robotic platforms can provide insight into what future generations might look like and the hurdles we must clear to advance the technology. Some of the inventions that preceded the sophisticated devices we know today and which can help shape future innovations are:

• One of the earliest instances of incorporating automation into medical treatment dates to 1912. Robert Herdner built an "automation nurse" called Mademoiselle Claire. Essentially a mannequin with gears, levers, cords and springs that enabled her to pass surgical instruments to a doctor, the device was designed to streamline tasks for physicians during a procedure. Many of the modern robots we use today share the same purpose as Mademoiselle Claire, but they now support countless functions for pharmacies, labs and nurses by automating repetitive tasks.
• In the middle of the 20th century, inventors introduced two devices built to improve physician training and diagnostic capability. Lumena was a transparent robot released in 1950. It featured 11 kilometers of cabling to depict veins, nerves and organs to help medical students learn the female anatomy. Sim One was the first android robot for training anesthetists. Developed in 1967, it could breathe, blink, open its mouth, respond to medication, and it even had a beating heart.
• Surgical robots first emerged in the 1990s to ease strain on physicians, but not replace them entirely. The ceiling for robotic capability raised significantly in 2001 with the Lindbergh Operation - the world's first remote robotic surgery, conducted from New York City on a patient in France.

The next frontiers for robotics

As robotic platforms have grown more sophisticated, they have also become more specialized. As an example, our team recently launched the CorPath GRX Neurovascular Robotic System, expanding the reach of the technology from cardiology interventions into the finer, delicate neurological part of the body that can benefit from the enhanced precision of robotic-assisted intervention. Focusing on more specialized indications allows innovators to think more granularly about individual disease states and combat them from an area of deep understanding.

Looking ahead further, the success of the Lindbergh Operation has yet to result in commercialized telerobotic procedures, but perhaps not for much longer. Dr. Tejas Patel used developmental remote technology in CorPath GRX to complete the world's first remote, in-human heart procedures in 2018, and in 2019, Dr. Ryan Madder performed the first transcontinental PCI simulations over 5G wireless, dedicated fiber and commercial public internet networks. Both instances proved the fundamental technologies needed to make remote procedures a common treatment modality already exist in available robotic devices and telecommunications networks. Additional factors such as network quality and human factors, as well as regulatory approvals, will also influence the success of this technology.

Automation also has come quite a long way since Mademoiselle Claire. The next phase of automation will be characterized as "high automation", meaning robotic systems will automate larger portions of procedures while always leaving the final decision and control in the physician's hands. Incorporating artificial intelligence could allow the system to "learn" from previous experience and adjust to new inputs. Our own technIQ™automated movements for cardiovascular interventions have been designed to arm physicians with more effective and efficient procedural techniques. By automating more of the procedure, there is the potential to make cases safer, faster, and more effective while reducing trauma on the patient.

The evolution of robotics saw a seismic shift from training and diagnostics to advancing treatment modalities over the last century. Within the next decade, they will likely see even more advances that make a tremendous impact on patient care by bringing expert care to all - particularly with new developments in remote technology and automation.

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