The operating theatre is about to get new advances that may reduce healing time, and might even eliminate complex surgery altogether. The art of surgery was first discovered as far back as 12,000 BCE, and the procedure that was performed was trepanation. Modern surgery was pioneered by John Hunter in the 1700s. Since then, the invention of the da Vinci surgical robot was a game changer in the fields of surgery. Here we take a look at what the future would hold for surgeries, with the introduction of many innovative tools that would aid doctors and patients alike. 1. Machine learning for surgery outcome prediction Catherine Mohr, vice president of strategy at Intuitive Surgical Unsupervised said: “Pattern matching algorithms would aid doctors in recognising when a sequence of symptoms results in a particular disease,” and added that medicine is just essentially excellent pattern matching. Predictions of patient outcomes undergoing therapy and surgery are fundamental to medical practice. Machine learning recently was applied to predict surgical outcome retrospectively and was found to exhibit a high surgical outcome prediction accuracy of 95%. In another independent research involving 1,442 patients, machine learning outperformed current clinical methodologies by almost 13%. With the better predictive abilities of surgical outcomes as facilitated by machine learning, doctors are able to tap on this emerging technology to prescribe the best form of treatment for the patient. This would enable patients to receive a better quality of care, and shorten the post-surgery recovery period. 2. Second generation surgical robots Think the da Vinci system is advanced? Then welcome Verb, a second generation surgical robot, the result of a collaborative effort between Google Life Sciences and Johnson & Johnsons. The maker of the first generation surgical robot, da Vinci, had welcomed competition, saying, “We look at competition really as just confirming that the robot-assisted surgery market will continue to grow. It’s something that we believe, and clearly that people who are entering and recognising and realising they can’t stay on the sidelines now,” in an interview affirming the future of robotics in surgery. Other second generation surgical robotic devices for surgery have introduced new features, such as haptics, as current robotic surgical systems are crucially absent of such features, but the ALF-X robot promises to change this. As TransEnterix CEO Todd Pope explains, “Today with robotics, there is zero feel. They are only looking at a screen, and they have no sensation of the tissue or bone. Our systems are going to have haptic feedback. When they run into tissue, they are going to have force feedback. They’re going to have a much more natural surgery experience with ours.” Verb would also leverage on big data, advanced imaging, machine learning, while other systems in the works would enable surgeons to look under tissues, and have a rotatable the surgical table. 3. Micro robotics for micro surgeries Tiny robots, only 200 nanometres thick – which is about 1/400 of a human hair - would soon be deployed to perform microsurgeries throughout the body. The de facto surgical approaches for blocked arteries are angioplasty and bypass surgery now. This innovation involves small microbeads that form a corkscrew shape, able to navigate vascular system. These microbeads are externally controlled by magnetic fields, would attack the hardening plaque, and would biodegradable after releasing anticoagulant drugs into the bloodstream to prevent future plaque accumulation. The Nobel Prize committee, recognising the nanomachines’s potential in the fields of drug delivery and microsurgery, have awarded the 2016 Nobel Prize in Chemistry to the trio of Fraser Stoddart, Jean-Pierre Sauvage, Ben Feringa “for the design and synthesis of molecular machines". The Nobel Prize committee explains in a statement that, “In terms of development, the molecular motor is at about the same stage as the electric motor was in the 1830s, when researchers proudly displayed various spinning cranks and wheels in their laboratories without having any idea that they would lead to electric trains, washing machines, fans and food processors.” 4. Next generation laparoscopic (keyhole) surgeries Current laparoscopy requires four to five entry points, each measuring one to three centimetres around the surgical area. The next generation of laparoscopy requires just one incision that would measure less than 6.5 cm in belly button in which one small camera and miniature surgical tools are placed. This single incision keyhole surgery, currently only used for gallbladder removal and gynaecological procedures, is the last step before the holy grail of surgeries: Natural orifice surgery, requiring no external incision. The innovation of single incision techniques in surgery has enabled the development of a new invention, in-turn inspired by an octopus’s arm. This innovative tool can perform one of the most crucial maneuverers of surgery – safely manipulating organs to perform the retraction task. Before this, surgeons would be required to use additional instruments to move and secure the organ away from the operative site. The inventors hope that with this innovation, surgeons would be able to easily access remote and confined regions of the body and to allow them to manipulate soft organs safely. 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