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Robots Approved For Cardiac Surgery
An anonymous reader writes "CNN has an article up on
a new robotic heart-surgery system. By making 4 relatively small incisions into the
patients chest the da Vinci
Surgical System, guided by real surgeons, uses its pencil sized "tools" to conduct
several different heart procedures including closed-chest coronary bypass surgery. By
operating on a patient with their chest closed, patient recovery times have reduced
from weeks to just days. Despite the robotic surgery taking longer than traditional
operations, this reduced recovery times makes the robotic surgery cost less
overall than traditional open heart surgery. Fortunately, if anything goes
wrong with the robot, the human surgeons can jump right in and pick up where the robot
has stopped. Already the robot (in place in over 130 hospitals world wide) has been
FDA approved
for Mitral Valve repair surgery. More insightful info on the da Vinci System here."
It's not the first such system, either.
But who will the overly litigious American peoples sue if something goes wrong? The doctor, who is, for all intents and purposes, not there? At any rate, while I am clearly attempting to facetious (sp?), this is really a very big step forward. I just don't want it working on me until they've worked out the bugs.
Doc
We should take care not to make the intellect our god; it has, of course, powerful muscles, but no personality.
but think about it, how many times have you screwed up a math problem? now how many times has you TI83? i'll take a robot's steady hand to a live doctor any day.
I would argue that a robot capable of performing heart surgery is slightly more complicated than a TI83. Let's all remember that the number of errors in a system typically goes up with the complexity.
it depends largely on where the aorta is cut. If you're talking about the major section of the aorta, near the aortic and mitric valves, then yes - the internal bleeding would be catastrophic, and the patient would die in a matter of minutes.
it sounds like this article is describing a cut in the aorta farther away from the heart than you're thinking. that would cause significantly less bleeding, and since imaging of such a location would be a secondary consideration, a complication in that area could go unnoticed for some time.
at any rate, a surgical system like the da Vinci could one day save many, many lives. I've got Marfan's Syndrome, and suffer from leaky aortic and mitric valves, as well as an aorta within 5mm of dissection. Closed-chest robotic surgery of this kind, which causes almost no damage to the heart and its effected connective tissues, would almost eliminate the need for me to undergo open-heart surgery one day.
Systems like this should be adopted cautiously, but i think that their introduction would lead to a dramatic drop in complications post-op, which is one of the the leading causes of death among open-heart surgery patients. Even those that survive the surgery are often left with drastically diminished cardiovascular capacity, due to the degree of trauma inflicted on the heart during the surgery. This was my father's case - he underwent open heart surgery twice to replace his aorta. The repeated surgery left his heart on a hair's trigger - the result of complications non-invasive surgery could have prevented.
pardon the soapbox, but this is a fairly close-hitting topic for me.
-WarbleVX
===== Warble://VX
Here is a link to CSTAR, which is a national centre in Canada for robotic surgery. The page talks about a few of the systems mentionned in the article.
They seem to have quite a few robotic surgery firsts. Pretty neat stuff.
Apparantly so... but how many patients die due to surgeon error while on the table? Or afterwards due to complications from surgery?
Complications include things like having your chest split open again a few hours later. Yes, it happens. I've had to pick up 12 units of blood for a patient that had this happen (and at one of the best cardiac hospitals in the US too, not some random place). Those 12 units lasted long enough to get him from ICU to surgery. No idea if he survived or not - I was just a gopher.
Will the robot be flawless? Seriously doubt it. But you don't reject a new tool just because it has flaws -- as long as it has fewer flaws (or, hell, even more predictable flaws) than the tool or method that preceded it.
I'm very sorry for the person that died, as well as their families, and I hope that whatever situation caused that will be analyzed and fixed so that it doesn't occur again.
This bodes well for our men in uniform, who don't have the sterile environment and the number of skilled doctors available in a hospital. As one who has worked on 3D visualization projects for Army Surgeons, tele-medicine and robotic surgery are major concerns. Army medics are incredible people who put their lives on the line and their backs to the bullets to save other people ... but they don't have the necessary skills.
/.ers are sitting behind our computers screens (assumedly) close to a medical center, our men in uniform don't have the luxury. This can provide solutions to save lives, where previously they would only be put on a morphine drip to ease their last moments.
This is definitely only the beginning, while most of us
Sig Nazi- "No Sig for you, come back 1 year."
Robot Insurance? Yep, it's not a laughing matter for some people.
For when the metal ones come for you...
Dacels Jewelers can't be trusted.
It sounds great to me. Less recovery time, less trauma, more precision, etc. It probably won't be long till it's faster. Similar systems will probably start to provide all sorts of services. Eventually, you might begin to carry such things on capital ships and cruise liners, have "emergency stations" at rest stops that can repair heart attack damage instantly, etc.
Just like Star Trek. Which brings me to my concern. I can't really envision Dr. McCoy jumping in there. Once such systems are commonplace, will the doctor eventually become a mere medical technician? In 50 years, will the guy watching the surgery know what to do when MS Surgery blue screens?
Not that the percentages might be better, humans make mistakes too, but I'd hate to see the profession suffer. If nothing else, it will decrease the demand and even the perceived need for highly skilled surgeons (well into the future, of course). This could cause a shortage in which it really is just a sys-admin watching Dr. Roboto tinker with your innards, ignorant of what the hell is going on.
There was a recent article in the JAMA which reported that there was a decrease in cognitive ability in people how had major cardiac surgery.
They thought it might be due to the time spent on the heart-bypass machine or that time spent with the body cooled might be affect the brain in some unknown way yet. Thuse when reading this article and it stating that the surgery takes much longer but the hospital stays are shorter might in fact be hiding the fact that the rate of cognitive damage might go up and not be detected until months afterwards.
Sigs are dangerous coy things
The article mentions a group of patients who underwent atrial septal defect repair had ~3 day recovery hospital stays vs. 7-10 days for conventional surgery of this type.
My wife underwent conventional surgery for the same thing (they sew up the hole between the two atria) in fall of 2001: checked in the hospital Tuesday afternoon, rolled in to surgery Wednesday morning, was walking around Thursday afternoon, and I drove her home Friday evening. The surgeon earlier told us she'd be hospitalized only 2-3 days afterwards.
I wonder where they got the 7-10 day figure - sure doesn't match our experience. My market-speak detector is going off...
Well, to quote the article,
The hospital and Intuitive Surgical Inc., which manufactures the da Vinci Surgical Systems robot, evaluated the machine and found no mechanical problems. [Hospital president Isaac] Mallah said the robot did not cause the problem. It does not act without prompting and is always controlled by a trained surgeon.
There really isn't room for ambiguity in that statement; the hospital president says flat out that the robot was not the cause of the problem.
As I just said elsewhere, it's unclear how the accident happened, obviously, but with something like this I consider both the underlying technique as well as the user interface potential risk factors. Of course, it could just have been human error, but that's the whole point of risk factor analysis; the line between "human error" and a false expectation or a design problem does not actually exist.
Yes, it is unclear how this happened, but I stand by my statement that the machine should not receive undue media attention at this time, especially in light of the fact that 1) the investigation is young, ongoing, and under the auspices of regulatory agencies; and 2) the machine was found to have no mechanical problems.
A media scare could easily set this medical development back several years. Doing so prematurely on and little evidence would be a terrible disservice to those who could benefit from this type of surgery.
Obliteracy: Words with explosions
Cracking the sternum is a strange way to remove a kidney.Seems like you're a bit out of the way and all. Ho hum, I'm not a surgeon though, I just read the article.
Are you thinking of staph or strep? Streptococci are routinely present in the throats of healthy individuals. Some strains of staph are skin commensals, that is to say they live on the skin without causing any problems under normal conditions. Staph are a common sauce of post-operative infections, and are the culprit in MRSA, or Methicillin Resistant Staphylococcus Aureus, the antibiotic resistant hospital 'superbug' now seen throughout the world. They are frequently carried into hospitals by patients and visitors.