Slashdot Mirror
Bringing Surgical Robots Into the Mainsteam
The New York Times is running a story about how using robots to perform surgical operations has been transformed from a controversial dream to reality. Dr. Frederic Moll abandoned his residency for Silicon Valley and helped to revolutionize the industry. The lengthy article also discusses some of his innovations. We've discussed various robot-assisted medical procedures in the past. From the Times:
"'I was struck by the size of the incision and injury created just to get inside the body,' Dr. Moll says. 'It felt antiquated.' He took the idea to his employer, Guidant, a medical device company. Guidant decided that robotic surgery was too futuristic and too risky, so Dr. Moll rounded up backers, resigned, and in 1995, founded Intuitive Surgical. The company prospered by proving that robots could deftly handle rigid surgical tools like scalpels and sewing needles through small incisions in a patient's skin."
They have detailed files on human anatomy.
+1 IDisagreeSoHeMustBeATrollOrAnAstroturferOrAShill
I wonder how far away fully automated surgical systems, the "autodocs" of Larry Niven stories like Crashlander , are. While there are no doubt many dangers involved, an automated system would be better for nothing when it comes to things like removing appendixes when the local human doctor is dead or incapacitated.
Bringing Surgical Robots Into the Mainsteam?
Sure sounds like a promising Anime scenario: robots, surgery, steam.
Just throw a few pretty high school girls in sailor suits and you have a winner.
I can forsee two possible futures:
Laws that say that only an MD is allowed to use a surgical robot, and that a manufacturer can sell them only to MDs, and that you can only sell/distribute software for them if you are an MD. This may seem paranoid perhaps, but consider the lawws restricting x-rays: You can buy an x-ray machine for checking welding seams or for x-raying dogs + cats, but you can't use it on humans.
Or there could be a much looser future, in which anyone can buy one, and anyone can program one. If I were having surgery done by a robot, I'd want one that was running open source software.
I've actually gotten a chance to play with a surgical robot once, they are amazing. The particular one I worked with had 2 cameras, and coordinating monitors/eyepieces to view through, so you have the proper depth perception to work with. Truly amazing.
I feed on difficulties, challenges and competition and my ego is, by this, most certainly bruised. Your post rather frightens me... when I considered becoming a surgeon, I liked the idea of helping people, but it was the blood and gore that turned me off. Why is this a draw for you?
These are not robots. These are medical telepresence devices. They have no artificial intelligence or autonomy at all; they are intended to provide the surgeon with tiny hands and eyes in places they could not otherwise reach.
They are cool machines, but they are not robots.
Early machines will *only* replace technicians. It will be a long-ass time before a machine is actually coming up with new surgical procedures and ideas.
Nerd rage is the funniest rage.
Your argument sounds like one that pilots would have tried when autopilots were first installed in cockpits. Just as autopilots changed aviation, just as imaging have changed aviation (radars, ILS) and medicine (x-rays, cat, pet and MRI scans) - high tech robotics can make new things possible in surgury. Less invasive, more precision, better outcomes - but these will all require more skill, not less from the surgeons. Do not confusing cutting of flesh skills (butchery) with modern medicine - Dr. McCoy's word come to mind - I'm a doctor Jim, not a butcher.
Hope is the worst of evils, for it prolongs the torment of man. -- Friedrich Nietzsche
if robotics allow every first year med student to perform as flawlessly as the highest skilled brain surgeon by compensating for their every mistake, then it's time to move to some third world country.
I kind of doubt it. This device is likely going to be mainly used to do things a surgeon is bad at, and is never going to be good at (nerve fibers in a prostate surgery), or tedious, time consuming things better left to a robot. It seems unlikely it'll put you out of a job.
What I _do_ hope though is that this device can lower costs by reducing complications, or having fewer assistants during a surgery, or perform more surgeries/day, etc.
AccountKiller
all hail our scalpel wielding robotic overlords.
Wow, you're quite an asshole. You hope that all of humanity remains in the dark so that you can have a job and feel important? You obviously don't really give a shit about helping people so why should we give a shit about your complaints? What would you do if you had both an HIV vaccine and an HIV treatment drug? Let me guess, you'd shelve the vaccine so you can get repeat business, make more money and feel in control.
You're a douchebag and I hope you slam your hands in a car door so you can never work again.
Robot surgeons? This is a really bad idea...
Have they taught them how to play a round of golf yet?
Welcome to MS Surgery 2008 (c) Microsoft 1983-1992
> run appendix
appendix is undefined.
> run "appendix"
appendix not found.
> run "Appendix"
- Appendix script started...
- Setup complete.
- Loading scalpel vector data.
- Reticulating splines.
- Blade initialized.
- Cutting...
[Message from AutoUpdater: an update for LifeSupport.sys is available and will now be installed.]
LifeSupport.sys has performed an illegal operation and was terminated.
Restart? Y/[N]
> y
Restart? Y/[N]
> Y
LifeSupport.sys failed to start due to error:
0000 - General error
Patient has terminated unexpectedly.
So you would rather open a hole in someone's abdomen large enough to get your hands in, just to remove the grape sized growth on their liver, rather than opening a pea sized hole and using a machine? Barbaric. I think you need to rethink things. Sure, surgery requires skill and dedication. It will for quite some time to come. But in the end, it is a common technician type of job: Cut, remove, splice, stitch.
When our name is on the back of your car, we're behind you all the way!
I kind of doubt it. This device is likely going to be mainly used to do things a surgeon is bad at, and is never going to be good at (nerve fibers in a prostate surgery), or tedious, time consuming things better left to a robot. It seems unlikely it'll put you out of a job.
What I _do_ hope though is that this device can lower costs by reducing complications, or having fewer assistants during a surgery, or perform more surgeries/day, etc. Your first paragraph is all wrong. This is nothing more than a fancy scalpel. Albeit one with tremor-dampening, and fancy haptics/cameras but still a tool nonetheless. If there is not a person with their hands on the controls, the Da Vinci will sit there and occasionally beep. It enables a person to do things like nerve surgery because it translates large scale, tremor-filled movements into small scale, absolutely smooth ones.
You are correct that it can possibly reduce complications, although there are no studies as of yet saying so and it is much more expensive.
Yes, I have used a Da Vinci.
Yes, I do feel important, no, you don't have to give shit about my complaints. I wouldn't shelve the vaccine. I'm not evil and I have nothing against patients getting better and being happy. Quite the opposite. Money does not interest me quite so as recognition. I just seem to prioritise myself over everything else and so far that has only done me good.
I'm sorry for stirring you up, that was just my ugly
P.S. There might be surgeons here that really do the job so they can help people and nothing more and consider me an asshole as well. In that case I apologise for the stereotyping, feel free to mod me down as well. I only speak of what I have encountered.
Somehow robots with guns that have uncommanded movements are something that should never be done because it could never be perfected, but robots with knives that are required to have delicate touch lest they kill someone accidentally is considered something that should be no problem to get working... yeah, that makes sense...
My word, this guy brings shame to the profession. I hope I never run into you professionally if you are indeed a surgeon. Where are you located (region is ok) -- I am interested to know how you have such cemented views.
To fellow slashdotters, this guy represents only a (hopefully small) subset of the surgical mindset. Early on in medical school I met some a$$hole surgeons who threw tools in the OR and abused staff and residents, and have terrible stories I could tell. Nevertheless, it is far from universal. Some of the best surgeons I met and know are great people, who are definitely not in surgery for money or "prestige," and who were ivy-league educated (as I am) and could have gone to a more lucrative and "prestigious" investment banking job on wall street.
I trained at MGH (Boston) almost a decade ago and there was the entire gamut -- true terrible assholes who felt that they were so good that they had to be assholes, and good surgeons that were good people. I have never really seen a strong correlation between the two as the poster above suggests. There are always the straw arguments that he presents (e.g. would you rather go to a good asshole or a bad nice guy?) Well, how about a good, nice surgeon? Fortunately, they do exist. Even as such, I'm sure my pedigree is better than this poster (I don't have to prove myself and am not obviously as obsessed with "prestige".) Funny thing is I bet I have seen him before as the CT surgery world is not that big and I've presented at major meetings in the past.
Since moving on to a private practice hospital affiliated group, I like to think of myself as having elite skills and the fortune of not being a jerk. All of the guys in my group are people I would (and have) sent my relatives, or enjoy a round of golf with after work.
So, don't fuel any negative views with this guy's flamebaits. Surgeons are people - some good, some not so good, in both skill and attitude.
I'd rather have a surgeon who is humble enough to be worried about doing a good job and confident enough to use every tool available to him than some crazy ego-driven jackass who thinks he can't make a mistake.
Prima-donna aholes are never as good as they think they are, and I've worked with a lot of them over the years.
I appreciate your honesty, and understand where you are coming from. It's good to have a drive for personal excellence. However, I hope you outgrow your attitude somewhat, because acting like an elitist asshole is ultimately counter-productive. It alienates people, and will give you a blind spot caused by caring more about yourself and unable to accept legitimate criticism.
When I read your comments I'm reminded a lot of Dr. Moon.
Rampant carbon sequestration destroyed the Dinosaurs' tropical paradise. I'm here to help repair the damage.
Who do you want to perform your GABG, a mediocre altruist or an egocentric professional who is confident because he/she really is that good?
Ever consider that the "egocentric professional" might just be closer to Frank Burns than Charles Emerson Winchester III? When you think you're the best, it might just wind up hiding a lot of mediocrity.
As a software developer, I've seen little correlation between ego, and skill. Some of the worst code I've seen came from a guy with (reportedly, I never met him) a huge ego. I see little reason why any other profession is any different in this respect.
Douche bag egocentric surgeons certainly are the stereotype we've seen on TV and movies. If it's actually true my guess is it really has more to do with being a defense mechanism against fucking something up than actual skill. If I mess up, someone is inconvenienced for a little while before I fix it. If a surgeon screws up, people can die. One way to deal with this is to believe you're perfect, or at least "the best", and no one could have done better than you did.
AccountKiller
Your first paragraph is all wrong. This is nothing more than a fancy scalpel. Albeit one with tremor-dampening, and fancy haptics/cameras but still a tool nonetheless.
I'm sure you're right. My point is really that all these tools are going to be "surgeon assistants" rather than "surgeon replacements". I have a hard time believing any patient is going to want to trust their internist to do complicated surgery by a robot. Thus those kind of tools will not be developed (and it's likely not even possible).
Anyway, if this guy really wants to worry about being replaced, he should worry about being replaced by a human in India, China, or Thailand. Patients are flying their to hospitals with skilled surgeons that do these procedures at a fraction of the cost.
AccountKiller
Clearly you've never taken care of surgical patients. The hallmark of a good surgeon isn't his technical ability. It's his ability to make quick decisions under less than ideal circumstances without all the available data at hand. The human body isn't a computer or a car. You can perform a technically perfect operation and still have disasterous complications for no apparent reason. And trust me, they can come up just like that without any warning. When that happens, no one cares if your hands are good. What they care about is your ability to get the patient through it.
If I were having surgery done by a robot, I'd want one that was running open source software.
College-Pages.com - Online Colleges, Degrees, and Programs
My word, this guy brings shame to the profession. I hope I never run into you professionally if you are indeed a surgeon. Where are you located (region is ok) -- I am interested to know how you have such cemented views.
That's interesting. Most people I know seem to think quite the opposite. The fact that I may consider what I do superior to other fields does not mean I go around insulting people or constantly telling them off. I actually get along with reasonable people quite well. My views have always been like that and I can't say they've ever failed me. I work in Europe, I'd rather not be more specific.
To fellow slashdotters, this guy represents only a (hopefully small) subset of the surgical mindset. Early on in medical school I met some a$$hole surgeons who threw tools in the OR and abused staff and residents, and have terrible stories I could tell. Nevertheless, it is far from universal. Some of the best surgeons I met and know are great people, who are definitely not in surgery for money or "prestige," and who were ivy-league educated (as I am) and could have gone to a more lucrative and "prestigious" investment banking job on wall street.
In that case I apologise to you as well. This is not what I have seen. Yes, I've also met the tool-throwers you mention but not among skilled surgeons. Self-control is something that is well valued around here. I also don't abuse anyone. Nevertheless all the good surgeons I know still have a mindset similar to myself. Those that do not, remain mediocre or change specialties. Again, this is what I see. Money and prestige? You can keep the money, but prestige is really something that I aspire for. This motivates me to do my work better which in turn saves lives.
I trained at MGH (Boston) almost a decade ago and there was the entire gamut -- true terrible assholes who felt that they were so good that they had to be assholes, and good surgeons that were good people. I have never really seen a strong correlation between the two as the poster above suggests. There are always the straw arguments that he presents (e.g. would you rather go to a good asshole or a bad nice guy?) Well, how about a good, nice surgeon? Fortunately, they do exist.
This may seem like a straw argument but I can say this honestly. I've never seen a great surgeon who is not arrogant, egocentric and doesn't consider himself/herself to be the greatest thing since sliced bread. We have to be overconfident in ourselves. There is no room for doubt in the OR. I would personally never let myself be cut open by someone who is not 200% sure that he is the best man for the job. The fact is, you can't afford to be cocky and arrogant If you aren't good. Kill a couple of patients because you overrate yourself and the respect and career are gone.
Even as such, I'm sure my pedigree is better than this poster (I don't have to prove myself and am not obviously as obsessed with "prestige".) Funny thing is I bet I have seen him before as the CT surgery world is not that big and I've presented at major meetings in the past. Since moving on to a private practice hospital affiliated group, I like to think of myself as having elite skills and the fortune of not being a jerk. All of the guys in my group are people I would (and have) sent my relatives, or enjoy a round of golf with after work. So, don't fuel any negative views with this guy's flamebaits. Surgeons are people - some good, some not so good, in both skill and attitude.
This is all nice but I still disagree. I'd never recommend a surgeon to someone on the basis that he/she is a nice person. I would re
I took part in a demo of a surgery robot (actually a remote control, not a robot). It was really intuitive! In seconds, I learned how to manipulate all the controls, everything felt very comfortable, I was able to move small rings, and place them over spikes, move and rotate in different directions and angles. It was sweet!
As for anatomy, anatomy is different from person to person! some people have their heart on the wrong side! some peoples liver is much larger than others (hopefully mine is I drink like it anyway...) This may work for simple things like stitches though!
A robot could / should not be doing surgery w/o some way to image and KNOW what the anatomy is that they are working on. I don't see robots replacing humans in this aspect for many many years(10 years after decent true AI). There is too much liability, the one time there is something different, OOPS... lawsuit)
How much is your data worth? Back it up now.
>Cut, remove, splice, stitch.
I think you are exactly right - read Atul Gawande's book Complications, the bit about hernia operations. He talks about it in this interview - http://www.abc.net.au/rn/backgroundbriefing/stories/2008/2122487.htm
Hmm... also read about the checklist, also by Gawande - http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande
Both show that the mystery about doctors and medicines is somewhat misplaced... in many cases (and a growing percentage) robots rule.