Does one surgeon, two humanoid robots and a 10-minute gallbladder surgery spell staffing shortage solution?

“Scissors, please.”

As soon as Oh Nam-kee, a professor of transplant surgery at Samsung Medical Center, gave the instruction, an arm extended from his left and handed him a pair of surgical scissors. When Oh handed the scissors back after using them, the arm took them and returned them to their place.

Two other arms moved on his right: One hand illuminated the surgical site with a laparoscopic camera while the other pulled tissue with forceps.

The scene was seemingly no different from any ordinary operating room with assistants seamlessly working with the lead surgeon — except for the fact that Oh's assistants were neither residents nor nurses, but two humanoid robots dressed in blue surgical gowns.

The “orchestration” by the human-robot team successfully concluded in just over 10 minutes on the afternoon of Sept. 16 in a lecture room at the Samsung Life Insurance Building in Gangnam District, southern Seoul, as the team successfully removed the gallbladder from a goat liver.

The prospect of humans and robots standing together at the operating table as a team — rather than doctors simply relying on robotic surgical instruments — is becoming a reality. Expectations are growing that such Korean robotic surgical assistants could eventually help alleviate staffing shortages in essential medical services if commercialized.

"We have achieved the world's first demonstration in which two humanoid surgical-assistance robots powered by physical AI have been divided surgical duties with a human doctor," said Samsung Medical Center.

The humanoid assistant

The robots are being developed as part of the Korean ARPA-H Project, a government-funded health care research and development program, led by Samsung Medical Center. The government plans to invest 13.8 billion won ($10 million) in research and development funding over five years from 2025 through 2029 in a bid to keep pace as global competition to develop AI-powered surgical robots intensifies.

The demonstration was a showcase for interim results from the project's second year. The team performed a cholecystectomy — or gallbladder removal — on a goat liver, which has a structure similar to that of a human's. Oh was the sole surgeon, with humanoid robots assisting him on either side. Name tags on the robots' backs identified their roles as “surgical assistant” and “surgical nurse.”

“Follow,” Oh instructed, and the endoscopic camera held by a robot moved along with the surgical instrument.

“Much farther back,” Oh said, and the camera moved farther away, widening the field of view.

The robots responded within two seconds of voice commands. While they secured the surgical field and pulled tissue aside, Oh continued removing the gallbladder.

The robots achieved a 100 percent success rate in picking up five types of surgical instruments and a 98.7 percent success rate in handing them over during tests, according to the hospital, results that put their performance close to that of human doctors.

A growing mechanical trend in surgery

Robots entering the surgery room is no surprise anymore, but Korea is focusing on robot-assisted surgeries, instead of ruling human involvement out of the whole procedure.

The global surgical robot market is projected to grow rapidly from last year's $12.49 billion to $45.93 billion by 2034, according to the Korea Health Industry Development Institute. The United States and China are widely seen as leading the race in the enormous market.

A Johns Hopkins University research team in the United States announced in July last year that an AI-powered surgical robot had successfully performed eight cholecystectomies on pig cadavers without human intervention. A case was also unveiled in China in January in which a robot autonomously performed key steps in biliary surgery on a pig, including ligating and cutting the bile duct.

The Korean research team is concentrating on collaboration between humans and robots. The idea is to enable “solo surgery,” in which the surgeon focuses on judgment and delicate procedures while humanoid robots perform their respective assisting roles, allowing an operation to be carried out with only one human doctor. The team's “surgical orchestration,” which it described as a world first, is an extension of that concept.

“Korea has medical professionals with sophisticated surgical skills, robotics companies and AI researchers, which give us favorable conditions for advancing this research,” said Jung Yong-gi, a professor of otorhinolaryngology at Samsung Medical Center who is leading the research. “We will be able to take the lead in the global race to develop surgical robots.”

Robotics industry and medical field also on board

The development has also received a positive assessment from the robotics industry.

“Fully autonomous robots that operate on their own come up against numerous legal and institutional hurdles before commercialization, including questions over responsibility when accidents occur and issues surrounding control,” said robotics engineer Yeo Jun-gu, program director of the K-Moonshot AI humanoid project.

“As robotics powerhouses such as the United States pursue autonomous medical robots, it is a meaningful achievement that Korea has concretely demonstrated the potential for collaboration between medical professionals and humanoid robots.”

Korea's emphasis on a different approach from other countries is also closely tied to shortages of medical personnel. Residents' working hours have been reduced even as surgeries require multiple staff members to assist the surgeon.

“This research began with efforts to address feedback from the field that there simply aren't enough surgical personnel,” said Jung Kyu-hwan, head of Samsung Medical Center's Intelligent Medical Robotics Research Center.

Another advantage of the Korean robots is that they can be used without substantially altering existing operating-room layouts or surgical instruments.

The ultimate goal is to fill staffing gaps in essential medical services.

“They could provide standardized surgical assistance at regional hospitals suffering from staff shortages or during nighttime and emergency situations, helping narrow regional disparities in medical care,” Jung Yong-gi said.

Challenges still lie ahead

The remaining challenge is to bring the technology to a level of sophistication that allows it to be used in actual clinical settings. Because the robots would be entering operating rooms where lives are at stake, they must be able to perform with precision not only on goat tissue but also on humans.

The team plans to gradually expand the robots' duties, beginning with relatively simple assistance such as adjusting the position of an endoscope, with the first clinical trial targeted for 2029.

“We plan to conduct clinical trials at three hospitals for major procedures including cholecystectomy and pituitary tumor resection,” the research team said.

BY CHAE HYE-SEON, LEE YOUNG-KEUN [[email protected]]