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."

Comments

The laws and open sore software

[Harmonious Botch]

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.

Re:The laws and open sore software

[nametaken]

I think I'd want every last movement checked, approved, monitored, and then rechecked by an MD.

Re:The laws and open sore software

[Idiot with a gun]

Of course. But at the reliability rate of current proprietary software, I wouldn't want some company saying "It works, we tested it, trust us!"

Re:The laws and open sore software

[Have Blue]

Surgery is just about the last place anyone who isn't a trained expert should be involved.

Re:The laws and open sore software

[Harmonious Botch]

Surgery is just about the last place anyone who isn't a trained expert should be involved. It is exactly that athoritarian mindset that concerns me. It should be the patient's decision. It's my body; it should be my choice. ( hmmmm, what does this do to the abortion issue? )

Re:Autodocs

[Original Replica]

I wonder how far away fully automated surgical systems, the "autodocs" of Larry Niven stories like Crashlander , are.

I would think that the combination of MRI tech and facial recognition type software could enable robots to see and "understand" the precise physiology of a patient. I don't know how well the triage process or dealing with non-standard problems would work without significant human help. More routine procedures might not be too far away, Lasik surgery is already half way there. I would think an autodoc that could procedures that are not life or death like plastic surgery or setting a broken bone would be possible in the next ten years if there was a well funded organization with that as the goal. But I would be surprised to see a robot that could diagnose and treat serious trauma in less than 50 years.

Re:Soon being a surgeon will be worth nothing.

[maxume]

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.

Re:Soon being a surgeon will be worth nothing.

[TXISDude]

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.

Re:Soon being a surgeon will be worth nothing.

[Vellmont]

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.

Re:Soon being a surgeon will be worth nothing.

[camperdave]

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.