Robots groomed for cutting role in delicate surgery

CHARLES ARTHUR

Science Correspondent

A British team of surgeons and engineers has developed robots for prostate and knee surgery which they say work "as well as the best surgeon on his best day, every day". But one of the key developers of the new systems yesterday criticised government changes which have made it almost impossible to get public funding for the groundbreaking work.

All of the project's early work had to be funded by medical charities because "we fell between the many stools" of science funding, said Dr Brian Davies, of Imperial College's mechatronics in medicine group, who helped develop the system. The Medical Research Council said it involved too much engineering to qualify for a grant, while a science council rejected it because there was "no novel science involved".

The first of the systems, dubbed "Probot", has now been used at Guy's Hospital in London for prostate surgery on 12 patients in the past four months. The surgery is a two-stage process. First, the pieces of prostate requiring removal are identified by the surgeon, using an ultrasound probe inserted up the penis. These points are recorded by a computer attached to the robot.

Next, a heated roller like a tiny ballpoint pen is inserted, using a robot arm connected to the computer. The tissue is removed as the computer moves the robot arm and activates the heating element as required. This process takes about 15 minutes.

The second system, called Acrobot - for "active constrained robot" - will be used on knees in which the knee ends of bones of the thigh and lower leg have degenerated due to arthritis or sports injuries. These ends are usually replaced with metal implants. At present, the surgeon uses a cutter to trim the bone ends. The Acrobot will hold the cutter, which will be controlled by the doctor, but it will be programmed to allow movement only within a predefined space. This will prevent the cutter moving into areas where it might damage soft tissue such as ligaments and tendons.

However, Dr Davies said that getting funding had been a significant problem for the project, which began in 1989. Appeals to the Physical Sciences Research Council, Medical Research Council and National Health Service's research and development arm proved fruitless. "In the end we were funded from the start by charities, though there was some research council money towards the end - but only for the laboratory work rather than the clinical trials." However, the Department of Health is funding the Acrobot, which is due to be used on patients next year.

The funding barrier exists even though thousands of knee and prostate operations are carried out every year. But the team believes using robots could mean that patients suffer less damage to healthy tissues - reducing the time required in hospital - and that the operations can be performed faster.