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Beyond Safety: Is Robotic Surgery Sustainable?

Hallie Siegel writes: The release last week of the study on adverse events in robotic surgery led to much discussion on the safety and effectiveness of robotic surgical procedures. MIT Sloane's Matt Beane argues that while the hope is that this dialogue will mean safer and more effective robotic procedures in the future, the intense focus on safety and effectiveness has compromised training opportunities for new robotic surgeons, who require many hours of 'live' surgical practice time to develop their skills. Beane says that robotic surgery will likely continue to expand in proportion to other methods, given that it allows fewer surgeons to perform surgery with less trauma to the patient, but no matter how safe we make robotic surgical procedures, they will become a luxury available to a very few if we fail to address the sustainability of the practice.

54 comments

  1. It will become a luxury? by Anonymous Coward · · Score: 0

    This is an idiotic idea, as it presumes that nowadays robotic surgery is somehow a commodity available to the masses.

    1. Re:It will become a luxury? by bill_mcgonigle · · Score: 1

      This technology will never work. It can never be improved. The only safe thing to do is to go back to the ancient ways. We should pay people in thinktanks to ponder such things.

      Gosh, I hope the new owner does something about this crap.

      --
      My God, it's Full of Source!
      OUTSIDE_IP=$(dig +short my.ip @outsideip.net)
    2. Re:It will become a luxury? by Anonymous Coward · · Score: 0

      Every technology can be improved. Hard drives got better by a factor of a thousand, therefore everything else will scale at exactly the same rate.

    3. Re:It will become a luxury? by Anonymous Coward · · Score: 0

      Whoosh...

    4. Re:It will become a luxury? by hawguy · · Score: 1

      This is an idiotic idea, as it presumes that nowadays robotic surgery is somehow a commodity available to the masses.

      I don't understand your objection?

      The premise of the article seems to be that if we don't train sufficient numbers of robotic surgeons, demand for robotic surgery will outstrip the capacity of surgeons. This will result in an increase in price for robotic surgeries, and when that price exceeds what insurance companies are willing to pay, only those that are wealthy enough to self-pay for robotic surgery will be able to have it.

    5. Re:It will become a luxury? by khallow · · Score: 2

      That's what markets are for. If there's a high demand for robot operators in the medical industry, then more people will sign up for the money. That assumes that the cartels controlling access to the medical professions don't block this.

    6. Re:It will become a luxury? by hawguy · · Score: 1

      That's what markets are for. If there's a high demand for robot operators in the medical industry, then more people will sign up for the money. That assumes that the cartels controlling access to the medical professions don't block this.

      Did you read the article? It's not a problem of having enough robotic surgeon candidates, but of making sure they can all be adequately trained.

    7. Re:It will become a luxury? by Anonymous Coward · · Score: 0

      The objection of the article is that safety concerns are blocking the necessary training, not a lack of people willing to train.

    8. Re:It will become a luxury? by bobbied · · Score: 1

      I think you are right... Time to start raising leaches again and bleeding for a fever.

      Maybe we can apply some leaches to the current owner until they get better?

      --
      "File to fit, pound to insert, paint to match" - Aircraft Maintenance 101
    9. Re:It will become a luxury? by moosehooey · · Score: 1

      Woosh...

    10. Re:It will become a luxury? by ThatsDrDangerToYou · · Score: 1
      Leeches, yes?

      Generally, I go with trepanation. Pretty much a cure-all. 94% of surviving patients agree!

    11. Re:It will become a luxury? by khallow · · Score: 1

      Did you read the article? It's not a problem of having enough robotic surgeon candidates, but of making sure they can all be adequately trained.

      In a country with the most massive education and training infrastructure in the world? I don't buy it.

  2. Sustainable? by penguinoid · · Score: 1

    We can't just keep digging up fossil robotic surgeons, that will only last another hundred years. It's time we started developing renewable robots.

    --
    Don't waste your vote! Vote for whoever you want, unless you live in a swing state it won't matter anyways
    1. Re:Sustainable? by NotQuiteReal · · Score: 1

      Yes, we may have of reached Peak Surgeons. Clearly they weren't talking about the doctors. What they meant was that the raw materials to create sustainable robots, should be hand gathered by indigenous peoples, using only organic ores from mines found in nature.

      --
      This issue is a bit more complicated than you think.
    2. Re:Sustainable? by khallow · · Score: 1

      I'll crank up my SUH (Sports Utility Hospital) for you. It does eight robotic surgeons per patient.

    3. Re:Sustainable? by bobbied · · Score: 1

      I'll crank up my SUH (Sports Utility Hospital) for you. It does eight robotic surgeons per patient.

      I here the SHUH (Sport Hybrid Utility Hospital) can do 12 now using regenerative technology...

      --
      "File to fit, pound to insert, paint to match" - Aircraft Maintenance 101
  3. No But.... by Anonymous Coward · · Score: 0

    The growth in the use of the word "Sustainable" is unsustainable.

  4. Sustainable? Yes, but... by Anonymous Coward · · Score: 0

    ... we have to follow Shakespeare's advice regarding lawyers.

  5. Possible solution. by jklovanc · · Score: 4, Interesting

    The issue seems to be that while conventional surgery requires help from students robotic surgery does not. It becomes very difficult for a student to do part of the surgery and thereby learn by doing. A possible solution would be better simulations so that a student can learn by doing. I think it is a very different than working on a cadaver or simulated patient using conventional methods. The main one being that there is already a separation from the patient by the machine. Every image and feedback that the doctor gets through the robotic surgery device can be simulated by software. It can be programmed to simulate problems so the doctor has to deal with more realistic issues. In effect a flight simulator for surgery.

  6. Will they Sustain? by st3v · · Score: 1

    Only if situated in the state's only "self-sustaining scallop farm". Now say that five times fast...

  7. Buzzword Saturation Limit Reached by pipingguy · · Score: 1

    Unprecedented and problematic!

    1. Re: Buzzword Saturation Limit Reached by bobbied · · Score: 1

      Do what the military does... Just convert all this to acronyms, mostly with 3 letters... Trust me, you will feel better in no time, just nobody will know for sure what you are talking about.

      --
      "File to fit, pound to insert, paint to match" - Aircraft Maintenance 101
  8. Hacker Team by PopeRatzo · · Score: 1

    How will we know the robotic surgeons have installed the most recent security updates? Will they be WiFi enabled so the teenager sitting in the hospital cafeteria can use them to play Operation and try to light up my nose while trying to take out my funny bone?

    --
    You are welcome on my lawn.
  9. wrong question by Gravis+Zero · · Score: 1

    the real question is when will we advance this technology far enough to not just be an assistive device for surgeons to actually being the surgeons?

    --
    Anons need not reply. Questions end with a question mark.
    1. Re:wrong question by demonlapin · · Score: 1

      The procedural parts of medicine are among the most automatably difficult tasks imaginable - people do not have standard sizes or shapes, they do not always have the particular problem that you wish they had, and improvisation is the name of the game. The Turing Test is many orders of magnitude easier than even the simplest surgical operation.

    2. Re:wrong question by Kjella · · Score: 1

      Honestly, I'd beg to differ. When you cut a human body open you're likely to find a relatively standard set of organs. Even with all conditions and permutations it is a whole less open-ended than say driving a car, where arguably a lot of odd conditions could happen at any time. In short, there's a few vital functions that that the body must uphold and if a robot surgeon does he's not making anything worse. He might not cure everything, but that's not the point.

      --
      Live today, because you never know what tomorrow brings
    3. Re:wrong question by Anonymous Coward · · Score: 0

      Clearly, I only operate on patients who are in standard shape, not the ones with congenital defects.

    4. Re:wrong question by SuricouRaven · · Score: 1

      Humans are squishy and flexible. Computers are not good with this - the only way to even simulate soft-body physics is sheer computational brute force. It's nightmarishly complicated just trying to predict which shame a blob of liver is going to assume if you poke it in a certain place.

    5. Re:wrong question by demonlapin · · Score: 1

      Beg away. I'm an anesthesiologist, I watch surgeons work five days a week. What do you do?

  10. Re:Animals by demonlapin · · Score: 3, Informative

    I'm not sure how this got modded up, but that was standard practice in the 1920s... not today. We have standardized procedures for damned near everything you can think of.

    I'm an anesthesiologist. I put people to sleep for cardiac surgery. My hospital does around 400-500 hearts a year... and we don't kill any dogs.

  11. Personal Expreience by sycodon · · Score: 4, Interesting

    Complete Adrenalectomy.

    Done at 7AM on Monday went home noon on Tuesday afternoon. Nothing but Tylonel, pain free by Wed morning. Dr. said less than a cup of blood was lost.

    Now I have 5 cool looking, little holes that I tell people were gunshot wounds.

    He used a Da Vinci robot.

    Alternative was open surgery, complete with a 6 inch incision and a week in the hospital.

    --
    When Fascism comes to America, it will call itself Anti-Fascism, and tell you to give up your guns.
    1. Re:Personal Expreience by ThatsDrDangerToYou · · Score: 1

      So... what did they do with that cup of your blood? These "doctors", did they shun the sunlight? You can't be too careful these days.

  12. A Waldo is not a robot. by jwbales · · Score: 0

    How do surgeons get away with calling a Waldo a robot? There is no such thing yet as a 'surgical robot.'

    1. Re: A Waldo is not a robot. by biobogonics · · Score: 1

      They are called robots for the same reason that radio controled fighting toys on television are called robots. Remotely operated devices that mimic the movements of their operators were once called slave devices. The term robot comes from Chech where it meant a slave laborer!

    2. Re: A Waldo is not a robot. by ACE209 · · Score: 1

      The term robot comes from Chech where it meant a slave laborer!

      I always thought it came from polish, meaning worker.

      --
      "we are all atheists about most of the gods that societies have ever believed in. Some of us just go one god further."
  13. No by Anonymous Coward · · Score: 0

    No, a robot surgery simulator could be made. Also, surgeons could get experience with simpler surgeries, such as plastic surgery.

  14. Comment removed by account_deleted · · Score: 1

    Comment removed based on user account deletion

  15. Re:Animals by imboboage0 · · Score: 1

    I'm with the guy above me... you're really gonna need citations for this one.

    --
    Honesty may be the best policy, but by process of elimination, dishonesty is the second best policy.
  16. Hackers can now HACK their victims during surgery by Anonymous Coward · · Score: 1

    Now you'll have to worry about the surgeon's wifi access point
    with cleartext passwords that are never changed from the default. :(

    The malware will be called Hack and Slash (for obvious reasons).

  17. Re:Animals by scrote-ma-hote · · Score: 1

    Just to add in, to make sure everyone is aware that this poster is full of crap. I’m a paediatric anaesthesia fellow, I go to cardiac surgery on a regular basis. The surgeons DO NOT practice on live dogs before operations. This is just bizzare, made up fantasy!

  18. Re:Animals by Ungrounded+Lightning · · Score: 1

    I'm an anesthesiologist. I put people to sleep for cardiac surgery. My hospital does around 400-500 hearts a year... and we don't kill any dogs.

    So maybe I'm not up to date, or things are/were different in research hospitals.

    My personal info was based on stories told by my mother, in about the '60s, when she was a special duty RN at the University of Michigan hospital, often handling cardiac recovery.

    My favorite was the one where the UofMich hospital cafeteria, which had been purely open seating, established separate rooms for the staff to eat after an incident where patients' families overheard, and were traumatized by, a cardiac surgeon's response to a question. Asked how his operations the previous day had gone (referring to his experimental and/or practice surgery on a collie and another dog), he said "The blonde lived but the old bitch died."

    The kids and adopted dogs story was from my wife. The surgeon in question was Dr. Albert Starr in (at least) the '60s through '80s. He was at St. Vincent's and also flew, with his team, to operate at a number of other west coast hospitals, university and otherwise.

    --
    Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
  19. Re:Animals by Anonymous Coward · · Score: 1

    So maybe I'm not up to date, or things are/were different in research hospitals.

    My personal info was based on stories told by my mother...

    And thus spoke every ill informed "expert" on the Internet. Research hospitals aren't different to this extent. Kindly desist from spouting your fellatious (sic) brain farts from the comfort of your arm chair.

  20. Worst summary ever. by guises · · Score: 1

    Nothing to do with sustainability, nothing to do with robotic surgeons: worst summary ever. Not that I blame the submitter for this, it's the article which says "robot" when it really means remote controlled instrument, and "sustainability" when it's really talking about inadequate training. This is ridiculous though. I had this brief vision of robotic surgeons operating via some machine learning algorithm and... sustainability something... I hadn't worked out how sustainability factored into it before my illusion was dashed. Maybe they were running out of humans or something.

  21. maybe not now... by SuperDre · · Score: 1

    Well, maybe it's not yet ready for regular use, but in the end when the robots have been refined, it will be the ONLY way one still wants a surgery.. It's not like regular surgeon doesn't make mistakes, it sadly happens too often, but that no wonder, they are only human too..

  22. If the GOP get back in then most healthcare luxury by Joe_Dragon · · Score: 0

    If the GOP get back in then most healthcare will be come a luxury.

    And good luck paying for that when there are X3 more H1B's and maybe even no min wage.

  23. well by Anonymous Coward · · Score: 0

    I, for one, welcome our new knife-wielding robot overlords.

  24. Re:Animals by demonlapin · · Score: 1

    And the first grafts for aneurysm repair were hand-sewn by DeBakey's wife, but in the intervening fifty years the process has changed. You want to tell old stories, heard secondhand, go right ahead - but tell them that way, not as "current practice".

  25. What hospital is that? by Ungrounded+Lightning · · Score: 1

    I'm an anesthesiologist. I put people to sleep for cardiac surgery. My hospital does around 400-500 hearts a year... and we don't kill any dogs.

    What hospital is that? I'll want to avoid it if I ever need heart surgery.

    Seriously: How does your cardiac unit's mortality and morbidity rate stack up against those of hospitals where practice surgery on live animal, models, at least where the surgeon is new to the procedure, is more common?

    --
    Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
    1. Re:What hospital is that? by demonlapin · · Score: 1

      Ah, you're simply insane, or trolling. Call literally any surgery residency program and ask how it works in the real world.

  26. Re:Animals by Anonymous Coward · · Score: 0

    My personal info was based on stories told by my mother

    My mom used to tell me stories too, but you don't hear me regaling everyone with the how presents get delivered to all the good little boys & girls on Christmas morning, do you?

  27. Re:If the GOP get back in then most healthcare lux by Anonymous Coward · · Score: 0

    Well, instead of voting for establishment GOP politicians, people could try voting for right-wing populists instead. Problem is, the populists aren't big fans of amnesty. And certain people view that the same as being racist. (Of course, these populists might also end the H1B visa program...)

  28. "robotic" by Anonymous Coward · · Score: 0

    I was halfway through tfa before I realized that a "robotic surgeon" is actually a human, because in spite of being called robots these devices cannot do anything on their own. What does this mean for our "robotic overlords"?