Robotic Surgeon Makes Rounds in Orbit

Researchers at the University of Nebraska-Lincoln have created a small surgical robot that surgeons can operate remotely, even in space. Unlike most surgical robots that weigh thousands of pounds, this new robot, called SpaceMIRA (Space Miniaturized In Vivo Robotic Assistant), weighs two pounds and can be operated from Earth.

SpaceMIRA arrived at the International Space Station in February 2024. Six surgeons in Lincoln, NE used hand and foot controls to cut simulated tissue in an experimental showcase of the robot’s surgical capabilities. The ISS mission for the robot demonstrated that it could dissect tissue in space, for which it used a preprogrammed path.

A second mission was to establish a connection with the Earth-based team, which was a tad more challenging, but worked well, said Shane Farritor, who is the David and Nancy Lederer Professor of Engineering at the University of Nebraska-Lincoln and lead researcher on the project. The lag time between a surgeon giving a command and SpaceMIRA executing it was approximately 800 milliseconds. 

This experiment paves the way for performing surgery in space using the expertise of surgeons on the ground. Currently, when astronauts fall ill aboard the ISS, they must return to Earth for medical treatment. 

While SpaceMIRA may one day enable surgery in space, Farritor is more excited about making a difference here on Earth. The robot’s small form factor and remote operation capabilities may increase access to surgery for patients in remote or underserved areas.

 

Roots on Earth

Farritor’s original robot, MIRA, which is FDA-approved for use in medical facilities, provided the inspiration for SpaceMIRA. (The startup Virtual Incision, of which Farritor is co-founder and chief technology officer, makes MIRA).

SpaceMIRA is a modified version of MIRA with reduced size to enable it to fit inside storage lockers on the ISS. With funding from the U.S. Army and NASA, Farritor’s research group has worked on surgical robots for years. 

“Our small, portable robots lend themselves to crazy places,” such as space and very remote locations, Farritor said. All of these “crazy places” would interest the Army. 

Early surgeries, performed using handheld tools, required large incisions and long recovery times for patients. Today, minimally invasive laparoscopic surgeries complement traditional methods. Surgeons inflate a patient with air and make a few small incisions to insert a camera and surgical instruments. Smaller incisions let patients recover faster. A surgeon can view the camera on a monitor to view the surgery site.

Robots can help surgeons operate more precisely compared to manual tools. Equipped with surgical tools, a surgeon inserts the robot inside a patient, and directs it using specialized hand controllers and other mechanisms.

For its part, MIRA looks like a tube with two arms at one end. Each arm holds an instrument, such as a grasper or a pair of scissors. Between the arms is a small light and a camera that can look in any direction. The robot has potential for a variety of procedures, including hysterectomies, bariatric surgery, liver surgery, and more.

 

Expanding access to surgery

MIRA weighs two pounds and is 30 inches long. By contrast, most other surgical robots weigh thousands of pounds and fill an entire room. 

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MIRA’s size makes it faster to set up and move between operating rooms, potentially increasing the number of surgeries that can be performed in a day and expanding access to care with the same number of surgical staff. This may be a particular asset for remote clinics with limited staff. In the U.S., only about 10 percent of operating rooms have a robot in them, Farritor said. 

In addition, MIRA’s remote capabilities could allow surgeons to operate from another city entirely. While the experiment aboard the International Space Station had some lag, Farritor expects stronger connectivity between surgeons and MIRA on Earth, both due to smaller distances and stronger, often hard-wired network connections. 

This connectivity may enable specialized surgeons to perform operations in hospitals that don’t staff those specialties onsite. This is a particularly exciting opportunity for under-resourced or economically challenged hospitals, such as ambulatory surgical hospitals, rural areas, and Army hospitals.

For now, Virtual Incision is launching a first-access program where a few hospitals will have access to MIRA over the next 12 months. 

“We just want to get our device out there,” Farritor said. 

Poornima Apte is a technology writer in Walpole, Mass.