This is a landmark paper that describes the development of a completely autonomous robot capable of performing an in vivo small bowel anastomosis.
They review their methodology, first using phantom small bowel tissue such as would be used in a simulation laboratory. They then progressed to a porcine model and they report the first 4 anastomoses performed by the robot with some human supervision. The robot was able to place 83% of anastomotic sutures autonomously. The average time for the robot to complete an anastomosis was 60 minutes.
This is a highly impactful article and a harbinger of what can be done in the future. It is now ready for clinical evaluation and would be a perfect case for applying the IDEAL Framework. Due to the use of machine learning in the development of their device, the upcoming DECIDE-AI guideline, inspired by IDEAL, would also be relevant.