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.

Comments

These devices are not robots.

[jcr]

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

Re:These devices are not robots.

[janek78]

That's a valid point. Also, every technology - and medicine is no different in this - has it's phase of enthusiastic adoption, eventual disappointment when it's found out it's not as good as previously hoped, and then a phase of rational use in indications where it makes sense. I remember the time when surgeons would do 6-hour laparoscopies because it was IN. Later they realized that a 2-hour open surgery is actually better for the patient and laparoscopies were limited to cases where they make sense.

I am a doctor in a university hospital and I recently went out to have beer with a friend of mine from the urology department. He's the chief "robot operator" for our hospital and he hates the machine with a vengence. No only are the operations several times more expensive (and longer), but to get the money they paid for the machine back, the hospital forces him to use the robot even on cases that would be much better done hands-on. Patients with more complications and longer hospital stay are no exceptions. To me this still seems like a technology we are yet to learn to use properly. Use it for remote operations where the surgeon is not physically available, use it in indications where it makes sense, but don't believe in all-saving robotic future of surgery. It's not here yet. The adoption cycle of many older technologies should serve as a warning.