Location, location, location. And I’m not talking real estate.
When it comes to serious disease, location is an often underappreciated factor in mapping out treatment. This became a sobering fact of life when my mom, while in her mid-50s, was diagnosed with stage IV ovarian cancer in the latter half of 2024.
At stage IV, there is little time to waste. Thankfully, after the initial diagnosis, my mom was able to get into surgery in just two weeks through the Dana-Farber Cancer Institute in Boston, Massachusetts, one of the best cancer hospitals in the world. I asked her what it meant to be able to get into surgery so quickly. She said: “It helped relieve the fear to tackle it right away instead of waiting while it continued to spread. It took the fear out of me.”
Following the surgery, which went remarkably well, she completed chemotherapy and is now in remission. Still, this wasn’t quite the end of the road.
Her type of cancer carries a high risk of recurrence, and she remains on Lynparza, a PARP inhibitor designed to reduce or delay the risk of disease progression or recurrence. Because Lynparza can come with taxing side effects and regular recurrence testing remains necessary, so does ongoing monitoring. On a regular basis, she and my dad wake up around 3:30 a.m., drive to Boston before work for testing, and return to Rhode Island to head to work for the day. Up in Boston, she gets same-day results and, in turn, more peace of mind.
This isn’t their first rodeo. My mom first had a different cancer earlier in life. Dana-Farber doctors saved her life then, as my mom puts it. She feels comfortable there and trusts their facilities. Had they been further from a state-of-the-art cancer hospital, the speed, quality, and routine of treatments may have looked very different.
Not everyone lives in such close proximity to world-class medical facilities like Dana-Farber. An experimental, AI-powered breakthrough in surgical procedures may be laying the groundwork for making geography matter less.
2022 marked the first time autonomous robotic surgery was performed on a live animal. It was carried out by the Smart Tissue Autonomous Robot (STAR), a device developed by roboticist Axel Krieger. The laparoscopic surgery, involving reconnecting two ends of the small intestine, was no small feat. It is described by the 2022 report as being particularly challenging because soft tissue moves and deforms, unlike rigid anatomy including bones.
Impressively, STAR autonomously completed the surgery on four live pigs, and, according to Krieger, “produced significantly better results than humans performing the same procedure.” Still, STAR came with its limitations. It required marked tissue, worked in a highly controlled environment, and was guided by a predetermined plan. Just three years later, in July 2025, Krieger’s work in surgical robotics demonstrated a break from many of these limitations with the AI-powered hierarchical surgical robot transformer (SRT-H).
SRT-H, trained on videos of surgeries, is described by a Johns Hopkins report as an evolution from robots being able to merely execute surgical tasks to being capable of adapting, making quick decisions, and self-correcting in real time. Krieger compared STAR to teaching a robot to drive along a carefully mapped route. He compared SRT-H to “teaching a robot to navigate any road, in any condition, responding intelligently to whatever it encounters.” Characterized as incorporating the same “learning architecture” as large language models (LLMs), SRT-H can additionally understand and respond to spoken commands.
To prepare SRT-H for surgery, researchers trained the robot on 17 hours of recorded surgical demonstrations performed on 34 gallbladders. For testing, SRT-H was then given eight ex-vivo pig gallbladders (gallbladders removed from dead pigs) that the robot had not been previously trained on. Without human intervention, it achieved a 100 percent success rate across the eight cases, completing all 17 surgical tasks. This included identifying and grasping ducts and arteries, placing clips, and making necessary cuts, all part of a key phase of cholecystectomy, or gallbladder removal surgery. Notably, cholecystectomy is a surgery the study points out as “a common laparoscopic procedure performed over 700,000 times annually in the United States.”
Researchers even deliberately introduced SRT-H to conditions requiring adaptability. “The robot performed flawlessly across anatomical conditions that weren’t uniform, and during unexpected detours—such as when the researchers changed the robot’s starting position and when they added blood-like dyes that changed the appearance of the gallbladder and surrounding tissues.” And while it did not conduct the surgical tasks as fast as a human surgeon, the Johns Hopkins report states that the results were “comparable to an expert surgeon.” Jeff Jopling, a co-author on the study, compared this to surgical residents mastering their craft at different paces.
The implications of these advances in AI-powered robotics are not going unnoticed. In an announcement just this week, the Defense Advanced Research Projects Agency (DARPA), an independent research and development agency within the U.S. Department of Defense, is betting millions in hopes of accelerating the technology.
The DARPA announcement notes traumatic injuries, particularly in combat operations, as a critical threat, making the point that otherwise survivable injuries can end fatally simply because service members may lack access to specialized surgeons. The competition seeks to “spur the development of robotics systems that can act as skilled, reliable partners to human surgeons.” In March 2027, it will award $1.5 million for capabilities in surgical collaboration, $1.5 million for capabilities in surgical independence, and $500,000 to be “distributed to top performers in the individual sub-component capabilities.” And lacking access to specialized surgical care is not a problem confined to the battlefield.
DARPA rightfully recognizes the civilian benefits of propelling this technology too, remarking that the agency “expects the technologies developed under this competition to offer profound dual-use benefits for civilian healthcare—from expanding specialist access in rural communities to bolstering disaster response capabilities.” And there is research to back up the need for better access to specialized care.
A 2025 JAMA study found that in 2020, nearly 60 percent of rural Medicare patients undergoing high-risk surgeries traveled over an hour for care. This could mean long, burdensome drives to reach necessary medical expertise not available closer to home. In natural disasters, it can be even more difficult to reach essential care. After Hurricane Helene hit North Carolina in 2024, washed-out roads cut off both patients and hospital staff from Mission Hospital, then the only Level II trauma center in western North Carolina. The resulting disruption reportedly led to surgical delays.
But what if it were different?
Innovative, AI-powered robotics like those demonstrated by SRT-H could eventually mean a very different future for those lacking ready access to specialized surgical expertise today. While this kind of technology has not yet been tested on humans and it will likely be some time before that happens, it is nevertheless rapidly advancing. In just three years, Krieger’s robotics work evolved from following a predetermined surgical plan in a controlled environment to demonstrating adaptive autonomy in executing a complex, critical phase of surgery across eight cases. If this can be extended across procedures, and eventually be used on people, it could be scaled to fill in critical gaps in places that need it most.
Instead of requiring patients to travel long distances for surgical expertise, a robust, autonomous surgical robotics industry could mean specialized care traveling to patients and their communities. It could mean rural hospitals and emergency trauma centers becoming equipped with certain specialized surgical capabilities when a human specialist is not physically present. Realizing that potential will require continued experimentation, investment, and development.
We are not there yet. My parents are lucky enough to be able to fit the early-morning trips to Boston into their schedules. In a world where this technology progresses from the laboratory to widespread human use, future families may not have to be.
Ed Tarnowski is the Founder and Editor of The Compute Optimist. He is also a Resident Fellow, Technology and Innovation at the R Street Institute, a Senior Contributor at Young Voices, and the Washington, DC Regional Director for America’s Future. All opinions expressed are his own.