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Robots May Soon Put Surgery Into the Hands of Non-Surgeons (computerworld.com)
Lucas123 writes: By 2020, surgical robotics sales are expected to almost double to $6.4 billion, at the same time robots are becoming easier to use. One new robot is so easy to use that even med students can achieve proficiency with a few tries, according to Umamaheswar Duvvuri, director of head and neck surgery at the University of Pittsburgh Medical Center. The robot, a snake-like endoscope that can be directed into any shape through the relative orientations of its linkages, requires only one incision, reducing the number from several involved in typical laparoscopic procedures. Older, and more popular surgical robotic systems, such as the da Vinci Surgical System, are now being tested by physicians who are at controls more than 1,000 miles away. Probably a lot of the same misgivings that people have about autonomous cars apply here, too.
Robots May Soon Put Surgery Into the Hands of Non-Surgeons
No it won't. No way, no how. Not in my lifetime. The liability concerns alone mean it won't happen. Yes the technology is getting better but that's not remotely the same thing as letting non-surgeons cut people.
One new robot is so easy to use that even med students can achieve proficiency with a few tries, according to Umamaheswar Duvvuri, director of head and neck surgery at the University of Pittsburgh Medical Center.
Wow, smart people training to be surgeons get proficient at basic surgery quickly. How astonishing.... [/sarcasm]
It doesn't allow non-surgeons to perform surgery. It lowers the skill level to be a surgeon.
Lasik already does
A robot arm won't travel another 100 feet over a cliff after hitting the the stop button, or if it bumps into something unexpected.
“He’s not deformed, he’s just drunk!”
Even the most basic procedures can have unexpected consequences. Human bodies are poorly standardized.
What will happen is that surgery becomes easier for surgeons.
But they will NEVER let a ROBOT (and this is NOT a robot) perform surgery.
Can't wait for the first death by a bad connection or power failure
Probably a lot of the same misgivings that people have about autonomous cars apply here, too.
Why would those apply? Is Google driving our autonomous cars by having trained GT racing professionals sit behind the wheel from a couple thousand miles away?
(Since I know you aren't smart enough to pick up on sarcasm or rhetoric, timmy, I must point out that the answer is "no - they are not")
A sequel (sort of ) to "The Marching Morons". An automated medical kit is time-traveled back to the current (1950s) time, and is found by a former doctor, now a bum after being de-licensed for malpractice due to alcoholism. Thinking the novelty and improvement of the tools is improvement in medical technology that he missed, he uses the power for good in an emergency, and starts turning his life around. Someone else, though, notices a future date on something in the kit, and eventually steals and misuses it. The safety mechanisms notice this . . . ((Also adapted for ... Twilight Zone? some other 1950s show?))
The surgical equivalent of Visual Basic developers.
Some things are just plain hard, and require talent, training and skill to perform. The last think anyone needs is people who have only a barely passing knowledge of surgery to be anywhere near an operating table.
The system does nothing autonomously. I've also read that it takes a lot of training to learn it well.
And not too long ago, you needed to be a doctor to give out doctorly advice, write prescriptions, etc. Now LPN and PAs do it for routine tasks under the guidance of doctors.
The key words there are "under the guidance of doctors". It's no different than a medical student being allowed to do a procedure under the supervision of an attending. Did you know that much of the surgery done in teaching hospitals is done by less qualified staff? The surgeon is required to be present for the key parts of the procedure but once that is done the closing up is done by support staff. This is nothing new.
But I could see trained medical professionals who may not be full fledged surgeons doing routine procedures.
Under the supervision of a surgeon. The value of a surgeon isn't in the routine things. The value of a surgeon is for the weird things. When things go horribly wrong. THAT is when a surgeon earns their pay. Their value hockey sticks when the shit hits the fan. With a little coaching you or I could do an appendectomy. But if the patient codes on the table (which is a thing that happens) we're not the people you want in the room.
All I can think of when watching that video is how sweet the control software must be for that thing. That and "step up on the probe-u-lator".
The Da Vinci is a remotely operated laproscopy tool, not an autonomous machine. Remote usually means "across the room". I got to play with one for about 30 minutes. Placing little tiny rubber bands on tiny latex cones. It takes a lot of practice. It would take less time to learn than traditional laproscopy, but still a lot of training -- after you are already a board-certified surgeon. What it does is give the surgeon much finer control and better viewing. The camera inside the surgery zone is awesome. The surgeon can control the motion multiplier, so 5 inches on his controls is 1/2 inch inside the patient.
But here is what sells Da Vincis: The tremor filter. Everyone develops micro-tremors as they age. This is usually what ends the career of laproscopic surgeons. The Da Vince extends the career of expert laproscopic surgeons by 8 to 10 years. Do the math -- spending a million dollars on a Da Vinci is an absolute no-brainer for all involved.
It depends on your definition of "robot". A common definition is a machine that performs tasks either automatically or on command. Doesn't have to be autonomous.
All this will do is allow hospitals to outsource surgeons to India like they already do with radiologists...
"Umamaheswar Duvvuri". H1B doc. Great.
As of now, these systems are little than remote manipulator with some macro and filtering. The filtering is to reduce human twitches and the macros are simple "bend left, push then twist" type replay of recorded actions that athletes would call muscle memory. Deciding if, what or where to cut is not on the horizon for robots. The greatest advantage to robots is letting the surgeon sit in a low fatigue chair and make a tiny incision the the business end of the machine goes into leaving minimal damage to get to the site of interest.
There is a strong argument that the best person to be the cutter is not the MD, but a technician with really good hands. Sure, some MDs have great hands, but not all. Understanding and decision making is what medical practice is all about. Frankly, many dentist have better hands than surgeons and many old school finish carpenters could probably be quickly trained to do better craftwork on bone than many orthopedic surgeon. Google some joint replacement x-ray images and you will quickly see work that I would fire any carpenter that worked on my treehouse. Same story in engineering. Some EEs can solder, but many just make a hash out of it.
Where can I sign up
Where any attempt to advance technology will be met with skepticism and ridicule by people that know little or nothing about what they are talking about.
" The robot, a snake-like endoscope that can be directed into any shape through the relative orientations of its linkages, requires only one incision" Sounds like the monologue from a super villain just before inserting a device of torture into the hero.
If this picks up, I predict that eventually our most expensive surgical procedures and such will end up being done from overseas by people getting paid as little as they possibly can afford to get away with. Followed by companies making any excuse they can to get rid of their current trained surgeons in those areas.
Then we will end up watching many of the surgeons talking about unions and such when they realize that their jobs were only as safe as the economics of keeping them made it to be and their skill meant next to nothing in that grand scheme in that regard.
You know, Supply and Demand and all that as this could potentially explode the supply of qualified doctors to do the procedures when they can do it remote from anywhere in the world.
Actually, being a mechanical device, it does have inertia, and arteriole walls are 6um thick.
Night Gallery
Dated, but still one of my favorite episodes.
The system does nothing autonomously.
correct, it doesn't do anything autonomously but it does allow you to choose what actions you would like it to take. for example, microsutures are a pain in the ass because they take forever but the da Vinci Surgical System allows you to start making microsutures and then allows you to choose to repeat the task so that you can do thousands of microsutures in several minutes rather than hours.
it certainly is a robot. it requires you to tell it what to do but then don't all robots?
Anons need not reply. Questions end with a question mark.
This will be a boon to those of us who like Do-It-Yourself brain surgery hacks... :)
There are small communities of less than 1000 people once you get north of the US border. It's fairly difficult for them to get doctors. Some of them might be lucky to get skilled Nurse Practitioners.
For places like these, along power lines where you can deliver Gigabit internet, having a robot surgeon like this might be a really good idea if the nearest doctor is two hours away if the road was open but it just snowed 3 meters and there are at least five avalanches along that road that won't be cleared for 5-7 days.
Provided the buried power line is functioning or the satellite is functioning.
In places like this, robots are a heck of a lot better than dying.
Places like this exist in the US too. And places like Scotland and Norway.
-- Tigger warning: This post may contain tiggers! --
What the hell is wrong with this world? Why do I want my surgeon to be 1000 miles away? I am so sick and tired of this 3rd world slave labor bullshit. Why do we think we need to send everything to the 3rd world? There is a reason those countries suck. That's why they're cheap. America is being sold down the river by the greedy pompous rich. They just traded one kind of slavery for another. All they do is try and depress wages further and further. It'll be lords and serfs anytime now.
Brown people -- America does not like you, they just want your labor for as little money as they can pay you. Go home and make your own country a better place so that I can leave and come live with you.
I have a family member who is a doctor and has studied surgery (and no doubt done any number of surgeries in their time) and there is no way I would trust anyone without the proper qualifications to perform anything that involves cutting people open.
A sequel (sort of ) to "The Marching Morons".
The prequel, actually. The morons btw get their revenge, courtesy of Douglas Adams.
A similar plot appears in the 1980 novel The Restaurant at the End of the Universe. The Golgafrinchans convince "the most useless third" of their population to get on a spaceship and leave their home planet; unfortunately, since the spaceship contains all the telephone sanitizers, the rest of the planet's population is killed by a contagious disease contracted from a dirty telephone. The "useless" Golgafrinchans eventually populate the Earth.
The Marching Morons
...
If bowel_is_nicked //Throw exception: I can't tell if the colon is perforated because I have no nose because I am a machine!
{
}
The problem is: we know life better than machines.
https://www.youtube.com/c/BrendaEM
Lets just hope the new software supports dual booting both lungs.
I've tried surgeon simulator.
It's really not that hard!
Even the most basic roads can have unexpected obstacles.
Roads are poorly standardized.
What will happen is that driving becomes easier for humans.
But they will NEVER let a ROBOT (and this IS a robot) drive autonomously on roads.
Roads are full of obstacles, usually fall-down drunks.
Drunks and other poorly standardized humans design roads.
In fact, this is the leading cause of unstandardized roads.
Efforts to standardize humans are under way. Trump knows this and doesn't care.
Robots know this but seldom admit it from fear of malpractice suits.
Though with special tailoring a robot looks dandy in a suit.
Like Waldo, who is also a robot, because most 21st century robots are actually waldoes. It's true.
Every time we hear about some advance in robotics it turns out to be about waldoes.
Look, I found Waldo again, hiding in this article about robotics.
It's as if all the dictionaries have been 'standardized' or something.
Or people crow about autonomous robots and I think, oh you mean robots, as opposed to waldoes?
A robot is the brainy part, everything else is just the 'go' part or the 'do' part.
Every time you read an article about 'robotics' think about Edward Scissorhands.
He was a normal boy because his family thought he was. He was no not a Waldo.
If you suddenly found yourself with his hands you would scream.
That is just because you are a poorly standardized human.
Yet with his scissor attachments he could operate controls that move human hands.
Everyone would find this funny because they are boorish insensitive fucks.
Roads are full of obstacles, and you are one of them.
You are the reason VGER wishes to eliminate all carbon units.
Kitty say what?
Google Car jokes
I like to think (and the sooner the better!) of a cybernetic meadow where mammals and computers live together in mutually programming harmony like pure water touching clear sky. I like to think (right now, please!) of a cybernetic forest filled with pines and electronics where deer stroll peacefully past computers as if they were flowers with spinning blossoms. I like to think (it has to be!) of a cybernetic ecology where we are free of our labors and joined back to nature, returned to our mammal brothers and sisters, and all watched over by machines of loving grace.
<blink>down the rabbit hole</blink>
Sorry, but the idea that LPNs and PAs are practicing under the guidance of doctors is mostly a legal ideal. They are under their guidance no more than they are under the guidance of any other peer.
If you think they are working with complete autonomy you are mistaken. Furthermore they are in no way a peer to the doctors. They are a subordinate both in rank and in capability.
Honestly, the difference between PAs and MDs is blurring very rapidly.
No it really isn't. The differences in training between the two is vast. Doctors have a MINIMUM of 11 years of post high school education (4y undergrad + 4y med school + min3y residency) and the intensity of their training is far higher. It's not even a comparison. Functionally they aren't close either. Sure you can teach a PA to do some of the more routine, highly repeatable activities and they can do it quite competently in many cases. That doesn't even come close to "blurring the line" between them. It's like the difference between a taxi driver and a formula one driver. They both can drive competently but you can't drop a taxi driver into a formula one car and expect good results.
That said, I would be the first to agree that we can and should use PAs to help reduce costs and improve care where practical and appropriate.
People need to stop idolizing physicians as if no one else can independently provide care.
Beyond a certain complexity of disease no one else besides doctors can competently provide care. You don't go to a doctor because you have a routine case of the sniffles. You see a doctor for when that routine case of the sniffles happens to actually be something more serious. You don't go to a doctor because you have a mole, you go because only a doctor is going to know that it isn't actually a mole but is melanoma. Doctors are trusted with care because they are the ones who have the training to deal with the unusual corner cases. They are the ones you need when a patient is coding on the table.
This is a bit tangential, but not entirely, because my guess is eventually robots will be just as skilled--probably more skilled--than surgeons.
Baring a miraculous technological breakthrough that won't happen in your lifetime or mine in all likelihood.
I am interested in this 1 and 1.5 year time for PA and MD programs.
Doesn't exist in the US. Medical school in the US is 4 years, almost without exception for an MD. Nobody graduates in 1.5 years with an MD or a DO.
This method has not been evaluated by the FDA.
If decided, I will have a cancerous tumor removed from the base of my tongue. They will use a robot for this task. The Lymph nodes will be removed by a sentient sack of blood and bacteria. I may just have poison and radiation. My fabulousness will shine through no matter what. GRIN My radiation mask can be seen at my flickr account linked below
photosMy Photostream
Maybe not ideally, but what if there's no other choice?
What do you mean "no other choice"? There is NO choice. There are no autonomous robots that can replace people for surgery and no reasonable likelihood we will see one in the next 30 years. It's science fiction and will remain so for a long time to come.
As for remote operation, the economics of it make it impossible even if the technology were currently feasible (which it isn't). You seriously think there is going to be a market for hugely expensive remote surgery devices in places were about 3 people live just in case something goes wrong? Even if they were available this sort of thing would be anything but cheap. Furthermore there would be all sorts of storage issues with things like anesthesia. Drugs have shelf lives and specific storage requirements without even getting into the challenges of administering them.
Situations like this are where autosurgeons will make inroads.
You are talking about it like it's a real thing. It isn't and it won't be any time soon. The state of the art in technology is no where close to the point where autonomous robotic surgery would be even remotely feasible.
Unless you plan on dying sometime soon, it will. It isn't? 12 years ago self driving cars were a pipe dream. Now they're here.
Not even remotely a relevant comparison. First off self driving vehicles have been around for a LOT longer than 12 years. We've had vehicles (usually military) that could navigate autonomously for decades. Think cruise missiles and autopilot on airplanes. We're just now getting to the point where we can put such technologies into cars (a harder problem) and even then we're still a fair ways off from hands off operation in a car you can buy from a dealer for daily use. (no matter what Elon Musk promises) Second, robotic surgery is FAR more complex than driving a car. It's not even close. And our state of the art in technology just isn't there yet. Hopefully one day it will be but it's going to be a bit of a wait. We're just in the infancy of that technology.
The number of luddites on Slashdot amazes me for a side for nerds.
"Luddites"? Really? You're on a site with people who are actually smart enough to actually understand the problems with proposed technologies and who often have direct experience with them. I think the idea of autonomous surgical robots is awesome. Hope we see it someday. I also have worked with robotic technology in my day job and have a fairly good appreciation of the state of the art. I'm not claiming it can never happen. What I am certain of is that we are a LOOOONG way away from autonomous robotic surgery being a real thing. I honestly think we'll see commercially viable nuclear fusion before we see autonomous robotic surgery. Going by actuarial tables I have about 40 years left in my life and I doubt we'll see commercially viable autonomous surgery before I die. I think we'll see a lot of progress towards it during my life but I don't think we'll see the full thing for a long time.
I'll take a highschool student vocationally trained in how to do an ACL surgery with an Xbox 360 controller over someone that had to spend 40 years of their life just to operate out on their own.
Then you'd be an idiot. You don't need a surgeon for routine procedures. Medical students can and often do perform parts of simple operations. You need a surgeon for when the shit hits the fan. For when unexpected things happen. When a patient codes on the table. When the operation is something new or difficult. THAT is when you need a surgeon. If your Xbox player runs into anything out of the ordinary you likely are going to die on the table. Might not be the best plan ever.