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The State of Robotic Surgery
kkleiner writes "Robotic surgery is experiencing explosive growth in America's operating rooms, and the unquestioned industry leader in this field is the DaVinci robot, made by Intuitive Surgical. Only 14% of prostate surgeries in the US last year took place not using the DaVinci. Installations have grown from 210 systems seven years ago to 1,395 today. Although typically used for smaller surgeries like prostate removal and hysterectomies, the system was recently used for a kidney transplant, and more complicated procedures are expected in the future. The DaVinci is really just the first wave of robotic surgery as technology continues to push clumsy human hands out of the operating room." The article mentions some of the downsides, or perhaps the growing pains, of DaVinci robotic surgery: "According to a large study of Medicare patients, robotic prostate surgery led to fewer in-hospital complications, but had worse results for impotence and incontinence ..." Another company makes a simulator to train surgeons on the DaVinci. Embedded in the article is a 2009 TED talk on DaVinci by a surgeon.
They're remote manipulation systems, also known as "waldoes". Robots operate under the control of a stored program, not the direction of a human operator.
-jcr
The only title of honor that a tyrant can grant is "Enemy of the State."
As a qualified surgeon (albeit junior), I'd like to offer my $0.02 if I may.
To be honest, there aren't many parts of the body that are inaccessible to modern surgery. Closed boxes such as the thorax or skull are a couple, but in these cases the main problem is not physical access but the fact that the cancers themselves are often aggressive and deeply embedded. Brain tumours (particularly GBM) are notorious for sending out stray single-celled metastases before the main tumour even shows itself. Small-cell lung carcinoma is another. Basically, by the time the cancer has revealed itself, it's all but too late to do anything about, and no amount of cutting out the primary will remove distant microscopic spread, even with the best tools for the job.
Fortunately, these 'black book' cancers are the rare ones. Common cancers such as bowel, breast and prostate tend to be slower growing and based in parts of the body that are relatively easy to access.
The main use of robotic surgery is not so much to improve physical access, or to 'remove more', but to reduce surgical trauma, and thereby speed patient recovery and reduce peri-operative complications.
And interestingly, we all know surgery for early or localised tumours is the best chance for 'cure', but did you know that radiotherapy actually cures almost the same proportion of cancers? Together they account for nearly 90% of all cancer cures, but where does all the money go? Chemo - because it's sexy. Well, I guess we're also trying to replicate Erlich's 'magic bullet' theory which applied in the early days of antibiotics but unfortunately it's still a way off.
-Nano.