Medical researchers in London are working to create a robotic vagina, but not the kind you think.
Traditionally, medical students learn to perform pelvic exams using silicone plastic models and by practicing on consenting patients as well as teaching assistant volunteers who are trained to give feedback.
But new technology being developed could give students a much more precise education and help familiarize doctors with a wider range of possible subjects and conditions. The "robotic vagina" is created by 3D computer models based on medical scans of real subjects. Combining those digital models with robotic haptic technology, a kind of technology that recreates touch, doctors can get a virtual sense of different uterus shapes, cysts, and other vaginal structures before performing an exam on a real human.
Trainees can get experience not only with normal anatomy, but with abnormal and diseased anatomy.
Dr. Fernando Bello, the head of the team working on the project at the Imperial College of London, says there are a lot of advantages this new technology has compared to traditional methods. "We have an unlimited number of cases because we can have a large number of subjects scanned. That means trainees can get experience not only with normal anatomy, but with abnormal and diseased anatomy."
He also explains that the robotic system can give more refined feedback. The visual component of the technology helps students associate certain touch feelings with the appropriate body part or cyst, instead of feeling something and mischaracterizing what is being sensed.
"For example, if a trainee is asked if they feel the right ovary they might say yes, but might not be feeling that. This system can detect whether or not that's the case."
Bello says the system can give trainees warning if they are applying too much pressure, which might cause discomfort in patients, or if they are not applying enough pressure to actually feel the uterus and other structures in the pelvis. He explains that studies are simultaneously being performed to deconstruct how gynecologists actually become pelvic exam experts.
Pelvic exams present unique challenges to medical professionals, and developing the technology to teach doctors how to perform them has not been easy. One challenge is the diversity of the female reproductive anatomy.
"There's a huge amount of variability across subjects in terms of anatomy, so one challenge is really understanding the amount of that variability," says Bello. "How can we try to teach medical students to cope with that? We want to be able to understand how learning takes place and recreate that in the robotic system."
Another difficulty faced by those developing the system has to do with patient comfort. Because examining the pelvis is most commonly done by hand, doctors have to be educated as to how to make the process involve as little discomfort as possible. But given the anatomical variability, it can be difficult to have rules of comfort that apply across the board.
"You will find there is a large degree of normal variation in the human body," he said. "What happens with female anatomy is that it's all hidden particularly with exams being done by hand. So everything is examined without being able to see."
The idea though, is that this new robotic system will help doctors more accurately "see" with their hands to make pelvic exams not only less miserable for patients, but also more accurate at detecting early signs of disease.