Human-machine technologies increase patient safety

At Johns Hopkins, the partnering of humans and machines creates a natural bridge between engineering and medicine, expanding the capabilities of both in terms of healthcare, specifically in surgeries.

“Sometimes as humans, we just have limitations on what we can do,” says Amit Jain, MD, Med ’12, chief of Minimally-Invasive and Outpatient Spine Surgery and a William F. Rienhoff, Jr., MD, Scholars Award recipient. “The idea is that a surgical robot is an extension of your mind and is able to accomplish tasks that are essentially going to improve patient care.”

“We can have the ability to do things that we would otherwise never have thought possible without these augmentations, without this intersection,” according to Muyinatu Bell, PhD, the John C. Malone Assistant Professor of Electrical and Computer Engineering, Biomedical Engineering, and Computer Science.

As founder and director of the Photoacoustic and Ultrasonic Systems Engineering Lab, Bell leads a team working on innovative biomedical imaging systems.

For example, Bell has developed software and signal processing techniques that remove the artifacts, reflections, and other forms of visual noise that can make ultrasound images difficult to interpret. One technique involves evaluating the amplitudes of different ultrasound waves over time, to measure their spatial coherence. Comparing how these waves bounce off objects can help provide more detailed information about what is being scanned.

“When we look at spatial coherence, we are able to detect differences such as whether a suspicious mass contains fluid which is typically benign, versus being solid content which might be indicative of a cancer,” Bell says.

Bell and her team are also working on a way to attach light sources to the tips of surgical instruments, so that through photoacoustic imaging — combining ultrasound imaging with light and optics — a surgeon can have a better indication of a tool’s proximity to structures like critical blood vessels hidden by tissue.

“Metal surgical tools and blood both have higher optical absorption than surrounding tissues and, therefore, can appear more clearly in a photoacoustic image,” Bell explains, adding this advancement will increase patient safety during surgeries.

“Spine surgery is very intricate. It’s very delicate,” says Jain, who partners with Bell and others at the Whiting School of Engineering to work on the next generation of surgical robots. “So, can robots help us do it more precisely, more accurately, and more reliably, and basically reduce the footprint on the patient’s life?”

One invention in development is an autonomous surgical robot with a continuous dexterous manipulator to help perform complex spine surgical procedures. “We can design things like a steerable instrument that can get into small nooks and crannies of the body where the human fingers or traditional tools may not be able to go,” Jain says.

Surgeons will be able to manipulate the device by remote control, but also pre-program it along pre-set routes to perform parts of the operation autonomously, adds Jain, who is collaborating with engineers at Whiting’s Laboratory for Computational Sensing and Robotics on this project.

In addition to being an associate professor of Orthopaedic Surgery at the School of Medicine, Jain also works with colleagues at the Carey Business School and the Bloomberg School of Public Health, to use statistical analysis and algorithms to tackle problems like the surgical backlog caused by the Covid-19 pandemic.

“Ever since the beginning of the institution, Johns Hopkins has had an incredible legacy of surgeon thought leaders and hopefully what we are creating, both in terms of advancing value-based care in surgery, engineering robotics, as well as predictive algorithms and analytics, can advance some of that legacy and really leave a mark on the field of surgical care,” Jain says.