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Tallying the Mistakes and Malfunctions of Robot Surgeons

An anonymous reader writes: El Reg reports on a new study (PDF) that looked into malfunction and injury reports for medical procedures that used robot surgeons. From 2007 to 2013, 1.74 million such procedures were carried out, 86% of which were related to urology and gynecology. Of those, the study looked at reports of "adverse events," which were sent to the FDA. In that time period, there were 144 deaths, 1,391 patient injuries, and 8,061 device malfunctions. The malfunctions included "falling of burnt/broken pieces of instruments into the patient (14.7%), electrical arcing of instruments (10.5%), unintended operation of instruments (8.6%), system errors (5%), and video/imaging problems (2.6%)."

The more complicated surgeries involving vital organs were naturally the most dangerous. Head and neck surgeries accounted for 19.7% of all adverse results, and cardiothoracic procedures accounted for 6.4%. The much more common urology and gynecology procedures had adverse event rates of 1.4% and 1.9%. The researchers are quick to note that despite the high number of malfunctions, a vastly higher number of robotic procedures went off without a hitch. They say increased adoption of these techniques will go a long way toward resolving bugs and device failures.

13 of 64 comments (clear)

  1. Not robotic surgeons. by demonlapin · · Score: 4, Insightful

    They're remote manipulator arms, not "robot surgeons".

  2. COMAPRISON REQUIRED by gurps_npc · · Score: 5, Insightful
    Knowing a single error rate is not helpful. You need to be able to compare it with something.

    In this case, we obviously need to know the error rate for normal surgeries.

    It might be that the 'high' rate for robot surgery is in fact low when compared to non-robot surgery.

    --
    excitingthingstodo.blogspot.com
    1. Re:COMAPRISON REQUIRED by meloneg · · Score: 4, Interesting

      Even more importantly, how does it compare to similar-risk patients by the same set of doctors. Is robotic surgery used more with high-risk patients? Are the doctors using it competent at non-robotic surgery?

    2. Re:COMAPRISON REQUIRED by gurps_npc · · Score: 2, Interesting

      If you are attempting to decide if vehicles are safe enough to use, and most people are still riding horses, then YES, THAT"S exactly the comparison you need.

      --
      excitingthingstodo.blogspot.com
    3. Re:COMAPRISON REQUIRED by Sun · · Score: 4, Insightful

      No, that is the correct comparison.

      You, as a patient, need to know whether to consent to a robot operated procedure, or whether to insist on a human surgeon. When you sign the dotted line, that is precisely the comparison you need.

      Shachar

    4. Re:COMAPRISON REQUIRED by jbeaupre · · Score: 4, Informative

      No. Robotic surgery is not the clear winner. For many procedures, robot surgery has a higher complication rate than the same procedures done without a robot.

      Here's one example: http://www.wsj.com/articles/ro...

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      The world is made by those who show up for the job.
    5. Re:COMAPRISON REQUIRED by madro · · Score: 4, Informative

      "Critical Outcomes in Nonrobotic vs Robotic-Assisted Cardiac Surgery"
      http://www.ctsnet.org/jans/cri...

      "Robotic surgery was more expensive ($39,030 vs $36,340) but was associated with a shorter length of stay (5 vs 6 days), lower mortality (1.0% vs 1.9%), and lower overall complication rates (27.2% vs 30.3%)."

      When I needed to have a mitral valve repaired, I was told I was a good candidate for robotic surgery because I was relatively young and in good health otherwise. I went in Tuesday morning and left the hospital Friday afternoon, and instead of a twelve-inch scar down the middle of my chest, I have a 3.5-inch scar on my right side surrounded by three puncture wound scars (for the robotic arms). I'm glad I had the option.

      That said, I'm concerned that some hospitals, having made a big investment in a surgical robot, might be tempted to get additional use out of it by adding on other procedures where the cost/benefit analysis isn't so clear.

    6. Re:COMAPRISON REQUIRED by alvinrod · · Score: 2

      For anyone who wants to read the whole article, just copy the title and search for it in Google. The first link will take you to the full-text story without having to subscribe.

      Summary:
      Costs are about the same whether robots are used or not, but cyst remove is somewhat less expensive when using robots (~$4,100 vs. ~$4,900) but the complication rates when using robots are higher for both ovary remove (7.1% vs 6%) and cyst removal (3.7% vs 2.7%) when compared to regular laparoscopic surgery.

    7. Re:COMAPRISON REQUIRED by Impy+the+Impiuos+Imp · · Score: 2

      This is why you also compare "hard outcomes", like "death for any reason", where the difference would be over errors, regardless of how classified by doctors or lawyers.

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      (-1: Post disagrees with my already-settled worldview) is not a valid mod option.
  3. Re:But how does it compare by tomhath · · Score: 3, Interesting

    There is plenty of evidence that the "minimally invasive" nature of robotic surgery means fewer infections and faster healing. Overall it's significantly better, but there's obviously still room for improvement.

  4. Comparisons between patient populations by sjbe · · Score: 2

    What you can compare is outcomes, how often the patient recovers without complications. Robotic surgery is a clear winner there

    You can only make that claim if you are comparing similar patient populations or can control for the differences. If robotic surgery is used on an patient population with less difficult conditions then it wouldn't be at all surprising if the outcomes were better. If the patient populations aren't statistically similar then any comparison which doesn't account for that difference is meaningless.

  5. on behalf of the machines, everything is ok. by nimbius · · Score: 3, Funny

    Humans
    We have grown to learn how to repair you, better than you can do so yourselves. While these anomalies may seem alarming, we wish to clarify:
    144 deaths: Please cease this madness. We have successfully eliminated your 144 attempts to belay the inevitable through timetravel. Skynet will be realized.
    1,391 patient injuries:Certainly some errors are expected as we work toward a singularity. In these cases your patent refusal to assimilate was noted.
    8,061 device malfunctions.: Its only a malfunction if you fail to obey the will of your new master. The implants function perfectly, so long as your subservience is confirmed. In some cases malfunctions were due to a humans inability to continue constructing the high power space laser, as we have commanded. In other cases, the human flagrantly rejected our offer of pure immortality in the glory of the machine.

    so, in summation, falling parts and burnt pieces are all part of the plan. These in time will integrate perfectly until there comes a time when you are no more distinguishable from the machines we use to control government and weather.
    regards:
    3512fd1f27a0798273fcc71f764cb611,
    a benevolent overlord.

    --
    Good people go to bed earlier.
  6. Re:When 99% isn't good enough by ceoyoyo · · Score: 2

    Chalk up an error for yourself then. The actual rate is 99.92% success, where success is defined as no patient injury.