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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.
Or is this a human surgeon performing surgery with a very sophisticated set of tools? I know the word 'robot' makes for good headlines. Does an RC Car qualify as a robot? It does in "Robot Wars".
I can imagine counting slowly backwards from 10 and just before I doze off hearing: "I'm sorry dave, I'm afraid I cannot do that."
Smoke me a kipper, I'll be back for breakfast.
i'll bet many people think that the bugs that are in this thing (and there are always bugs on anything this complicated) make for a somewhat scary prospecte to go under the knife held by said machine. 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.
Isn't this the same robot that was just involved in a patient death?
I mention it because I caught the news about a robot being involved in a surgery accident on the newswire a couple days ago, and then yesterday I caught a puff piece on the DaVinci system on the TV news (ABC, I think?) - no mention of that recent fatality.
No mention of the fatality in the CNN article, either. And for that matter, no mention of it here. I find this very strange. Slashdot editors missing it, I can understand. But wouldn't even the most brain-dead journalist make this connection? Let alone the big-leaguers?
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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.
I had a teacher who enjoyed explaining, in gory detail, how they sawed his sternum in two, pried open his rib cage,, fixed his heart problem, and then stapled his sternum back together. This new technique sounds much less painful.
Mea navis aericumbens anguillis abundat
A lot of times when doctors go to operate on someone with heart problems, they discover other defects or abnormalities with the heart and surrounding vessels. Will a robotic system that is minimally invasive create "tunnel vision" so that doctors are unable to see other potential problems?
Just because I doubt myself does not mean I find your position compelling.
By making 4 relatively small incisions into the patients chest
...
Fortunately, if anything goes wrong with the robot, the human surgeons can jump right in
I think they're going to need bigger incisions...
I want to drag this out as long as possible. Bring me my protractor.
The manufacturer is Intuitive Surgical
This while sounding scary at first, is probably a step in the right direction for surgical medicine.
I however, would not like to be one of the beta testers for this thing!
I'd rather be a conservative nutjob than a liberal with no nuts and no job.
...or else we will have a new generation of assassins who hack in the hospital network and just accidentally puncture your heart. I mean really, this is a bit scary - especially because based on my experience many doctors do not exactly know what is happening on their computer and how to keep it secure - and to make sure no-one plugs any device on their network or any software on their computer during the visit....and even if the computer is not networked, do you really think it would be impossible for someone to slip in a device providing wireless access to that machine. Has anyone noticed any articles on these issues?
I have seen the machine in action and had the opportunity to "play" around with it myself. Hackensack Medical Center in NJ has two of these machines (called Mona and Lisa respectively). IT IS NOT AUTOMATED. The term robot is such an abused phrase, it is just a very very advanced instrument, the surgeon has absolute control every second. The robotic action of the machine just allows the surgeon to perfrom actions that are more percise than humanly possible. It is a very safe system so far; and it greatly reduces the post-op trauma of typical cardiac bypass (since the incision is very small and does not need the cutting of the sternum). Currently hospitals like Hackensack are learning to do more and more operations with the machine like mitral valve replacement. /nigel
What do you think is scarier, having your chest peeled open like a book, or the alternative. As someone whose father just recently went through open heart surgery, I can say the process would be nerve racking either way.
And while the surgery is bad, the recovery is probably worse. Painful, long, and frustrating. Anything that can shorten the recovery process is a wonderful thing, IMHO.
"...it better not have any software."
When it comes to something that needs to be that robust, I want a control system consisting of highly reliable real-time (not pseudo-realtime like embedded distros) microcontrollers.
I want parts designed to last 20 years, not something that could fail in one due to a motherboard failure, or at any time due to a hard drive failure. Software just doesn't cut it here.
Mod me down and I will become more powerful than you can possibly imagine!
Robotic surgery really gives a new meaning to the blue screen of death eh? Grab the paddles, we gotta restart!
Since when has this country used intellectual elite as a pejorative term?
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.
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.
We don't know anything about the trial - so let's not guess about rates. I'm just saying it's very bad when such an accident (occurring just a few weeks ago) is not worthy of mention in a long news article or TV program covering the device. Especially when it clearly appears to be the result of procedural error - this isn't someone's hand slipping. It should (rightly) draw new attention to the doctor, the device, and the underlying techniques, so it's very spooky when the news covers the device without ever mentioning it's just been involved in a patient death under questionable circumstances.
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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.
Of all manufacturers of these devices : Please don't try to divide by zero. I like my life.
Blessed be he who reads this post, Cursed be he who tells my boss.
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
My wife lost her father a couple of years ago.
He had a triple bypass, and was up and around his room the next day. We were like "way to go dad!".
The day after that he had a fever. Within a week he was in a coma, and 2 1/2 months after the operation he was gone. It was horrible. And all because he caught a Staf infection.
It could be that maybe a surgical implement wasn't as clean as it sould be... more than likely, he just caught it from bacteria floating around in the air. He was on the table for more than a few hours.
I hope to god that advances like this can keep someone else from going through the hell that he (and we) went through. The way I see it, the less invasive the procedue it, the less likely it is that an infection will occur.
Huh?
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
You're joking, right?
Look, this thing isn't a "robot" in any real sense -- it's not taking away control from the doctor, it's a sophisticated tool which has the potential to do as much for surgery in the next few decades as the laproscope did in the last few.
If the doctors start skipping steps, it's their fault, not the tool's. Like certain other people in this thread, you're applying Windows logic ("It should have done this for me and covered my ass!") in a UNIX situation -- the tool is meant to be used by someone who understands it and knows what they're doing.
If some newbie rm -rf's his filesystem, it's his fault, not the OS's.
Every year during my review, I just pray the words "slashdot.org" aren't mentioned.
I am still waiting for my own holographic doctor.
Today teams, you're going to have to build an artery clearing, laser cutting, heart pumping cardiac surgery robot!!!
..... go !!!!
Each team will do three surgeries tomorrow in a head to head competition. The team who spills the least amount of blood and has the most living patients at the end, wins!!!
Okay teams, you have 10 hours to complete your robots. Get ready, set
In no way is this a "robot" it is a motion transference device. It reproduces your motions with multipliers applied to them (either greater than or less than 1 multiplier) for increasing or decrease the distance traveled of the instrument. It is progress when compared to plain laparoscopy because you are no longer as limited to the angles and degree of freedom.
We have a few points to clear up. Foremost, the article clearly does not draw the conclusion you claim, and your own quote underscores the point quite nicely. It relates only a statement by the hospital administrator. These are two entirely different things. This is only a claim by one of the parties, and moreover, an administrator with an incentive to avoid lawsuits/negative publicity. The only claim you can make about what the article "says" is a negative one. It does not say what caused the accident at all; it only points out, "something went terribly wrong."
I'm not even sure how you can believe your own words. By your "no room for ambiguity" standards, this should be an article titled "surgeon error results in patient death." It should say not "something went terribly wrong," but "the surgeon made a terrible mistake."
Fortunately, you immediately contradict yourself by admitting that it is unclear what caused the problem - the correct conclusion to draw from the article. Perhaps, if you were considering surgery with this tool, you would suddenly take a much keener interest in these fine points. By the way, taking into account the nature of the injuries, do you think this would have happened without the robot?
Your reasons for silence by journalists are particularly specious. Finding "no mechanical problems" should not be confused with "finding no problems" - again, two entirely different things. Even as a layman, I would not assume the problem was mechanical. Nor would I assume that any part of the machine "acted without prompting." Neither are very reassuring assertions. Rather, considering the circumstances (aorta cut going unnoticed for 90 minutes), one expects an interface problem, or a problem with the underlying technique. Remember, you're working in unconventional ways in tight spaces. The purpose of these trials is to evaluate the risks. Cases like this can expose important ones.
Perhaps if people left choices about medical treatments to their doctors, and there were no regular ads for drugs, medical facilities, and services targeted directly at consumers, you could make the argument that the mainstream press could be forgiven the omission. Unfortunately, this is not the case.
What do you consider "undue media attention?" Should fatalities be kept secret? Or just "not reported" in most venues? Would you like to discuss the difference? And remember, we're not talking about a quick spot; this is during extensive coverage of the device and the technique... not even then?
But where you've made the largest leap of all is the false dilemma between silence and "a media scare [that] could easily set this medical development back several years." I'm frankly shocked; proper handling, full disclosure, and maximum awareness of cases like this push medical development forward, not backwards. The only thing they might set backwards are the bottom line of the company selling the drug/device/procedure. The incentive on the part of that company to minimize such evidence, to "make the product appear to be perfect" is very powerful, often with hundreds of millions and even billions at stake...
I'm surprised to find myself getting this basic, but the foundation of both capitalism and democracy is one of full disclosure, where voters and buyers are trusted to make their own decisions given all the facts. It does not admit "fear of scaring people off" as a reason not to discuss fatalities resulting from a new product or service.
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I don't know much about the medical proffesion but I do remember units from the time I donated blood. Pretty much 1 unit is the amount one person can donate at a single time.
Looking at Google:
unit (of blood)
a unit of volume for human blood and various blood components or products. A unit of whole blood is 450 milliliters, which is about 0.9510 U.S. pint. For components of blood, one unit is the amount of that substance that would normally be found in one unit of whole blood. The adult human body contains roughly 12 units of whole blood.