The robosurgeon will see you now

SMALL PRINT:A smart scalpel that knows when to stop cutting so that it spares healthy tissue? Zapping wounds with mini "lightning bolts" to help them heal? Welcome to the future of medical technology. Except it's already here – it just has to escape the lab and get into the wider world. That's according to Dr Richard Satava, whose insights help inform how the US army funds medical research and even occasionally how Hollywood makes sci-fi movies.

Satava will speak at MedinIreland, the medical and healthcare technology expo being run this week by Enterprise Ireland at Dublin’s Convention Centre. Satava, a professor of surgery at the University of Washington, is also a “technology harvester” who identifies new approaches developing around the world.

An emerging theme he sees is the smarter use of energy sources in surgery, such as cutting tissue with light rather than blades. “You can control it much better than you can control things like scissors, because you are able to do it at millisecond and microsecond speed, which you can’t do on human performance levels.”

He describes a prototype smart laser-based scalpel that can also “see” its surroundings in the body by sending out beams and analysing how nearby tissues reflect them. “There might be a blood vessel under the skin that the surgeon wouldn’t be able to see, but the scalpel can see it and can turn off and so not cut it.” This approach could even have applications in cancer surgery, he adds. “If you sample the cancer and you get its signature, then you put that into your smart scalpel and wherever it sees the cancer cells it will eliminate the tissue. But as soon as you come to a place where there is no cancer, it automatically turns off the laser.”

While it might sound cutting edge, the concept isn’t new. “These are the kinds of things we have been working on for about 10 or 15 years – they are pretty standard in the research area, but the hard part is getting them out of the laboratory.”

A more recent development is “plasma medicine”. “Plasma is like mini-lightning. When you charge between two electrodes it disrupts the air in between, and it creates all kinds of energy – free electrons, free radicals, UV light, near-infrared light, electromagnetic pulses. And when you make this little discharge – this tiny little cloud at the end of an instrument that’s about the size of a cigar – it allows you to turn on and off specific molecules in the human body.” It’s early days, but plasma might be able to help treat wounds, by reducing bleeding and encouraging the body to produce its own healing factors, says Satava.

He recalls how, when he worked as an adviser on Terminator 3(2003), such notions were still flights of fancy – "but now they are coming out of the laboratories."