Bringing Surgical Robots Into the Mainsteam 73
The New York Times is running a story about how using robots to perform surgical operations has been transformed from a controversial dream to reality. Dr. Frederic Moll abandoned his residency for Silicon Valley and helped to revolutionize the industry. The lengthy article also discusses some of his innovations. We've discussed various robot-assisted medical procedures in the past. From the Times:
"'I was struck by the size of the incision and injury created just to get inside the body,' Dr. Moll says. 'It felt antiquated.' He took the idea to his employer, Guidant, a medical device company. Guidant decided that robotic surgery was too futuristic and too risky, so Dr. Moll rounded up backers, resigned, and in 1995, founded Intuitive Surgical. The company prospered by proving that robots could deftly handle rigid surgical tools like scalpels and sewing needles through small incisions in a patient's skin."
I bet... (Score:3, Funny)
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They are more like "remote control" surgeons than robot surgeons.
It's basically laparoscopic surgery taken to a new level of miniaturization.
analogous to fly-by-wire in planes versus old hydraulic connections.
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If that were the case, I would worry that our future robotic adversaries does, in fact, have detailed knowledge of how we work.
But for now the borg will have to wait - we are still in control.
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nice one!
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The robots are not a panacea - don't
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These machines don't have any knowledge of anatomy. They are more like "remote control" surgeons than robot surgeons.
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Its CPU is a neural net processor, a learning computer. The more contact it has with humans, the more it learns.
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I mean um.... Healing
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I would think that the combination of MRI tech and facial recognition type software could enable robots to see and "understand" the precise physiology of a patient. I don't know how well the triage process or dealing with non-standard problems would work without significant human help. More routine procedures might not be too far away, Lasik surgery is already half way there. I would thin
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Title typo: mainsteam (Score:2)
Sure sounds like a promising Anime scenario: robots, surgery, steam.
Just throw a few pretty high school girls in sailor suits and you have a winner.
The laws and open sore software (Score:5, Insightful)
Laws that say that only an MD is allowed to use a surgical robot, and that a manufacturer can sell them only to MDs, and that you can only sell/distribute software for them if you are an MD. This may seem paranoid perhaps, but consider the lawws restricting x-rays: You can buy an x-ray machine for checking welding seams or for x-raying dogs + cats, but you can't use it on humans.
Or there could be a much looser future, in which anyone can buy one, and anyone can program one. If I were having surgery done by a robot, I'd want one that was running open source software.
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I think I'd want every last movement checked, approved, monitored, and then rechecked by an MD.
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Re:The laws and open sore software (Score:4, Insightful)
Re:The laws and open sore software (Score:4, Insightful)
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Here's a tip: If your estranged wife dies unexpectedly and your lawyer advises you not to testify, don't testify.
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And no, I'm not talking about the quality of the coding. If a machine is going to start poking around in my body, whether it does what it's supposed to is going to be my overriding concern, not whether I have access to source code that perform functions that I don't understand.
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Aw heck who am I kidding, we'd all love that.
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Re:The laws and open sore software (Score:4, Informative)
An example is the defibrillator. It used to be that only medical professionals were able to purchase/use them. Now there are several such as the Phillips HeartStart that are sold on Amazon. The units are designed so that the average idiot can use them. Slap the pads on the victim's chest, hit the big button, and the unit figures out if the victim needs a shock, and if so gives it. Otherwise it doesn't.
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Re:The laws and open sore software (Score:5, Interesting)
I've worked with a lot of the surgical robots and voice control systems available in the past decade, and they're much more reliable and consistent in manual performance than whatever random surgeon happens to be on call that day. Sure, a doc always has to be driving the thing -- they're nowhere near autonomous (that's still decades away for even simple things), but the point of the robotics is not to remove the expert decision-making of the doctor, it's to eliminate the mechanical aspects of surgery where most things go unpredictably wrong. Just brushing your glove up lightly against the wrong piece of anatomy can cause major internal bleeding, not to mention how difficult it is to precisely control your hands for every split second of a 14-hour long procedure where doctors might have to trade off several times with all sorts of tools still inside the patient.
The robotics also make an unbeatable teaching tool. The surgeons in 50 years are going to be vastly superior to even the docs we have today, because they'll not only be able to watch from the chief's POV from day one of their residency, they'll be used to rehearsing every procedure in the simulator beforehand and handing off the controls to different specialists elsewhere for a few minutes whenever they need.
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I for one do not welcome our new surgery-performing overlords. I study to be a surgeon because it's a job that needs exceptional skill and dedication. I love the stress, the blood, the gore and the responsibility. If all this turns out to be equal to being a common technician and not about being as skilled and concentrated as humanly possible, if robotics allow every first year med student to perform as flawlessly as the highest skilled brain surgeon by compensating for their every mistake, then it's time to move to some third world country. Selfish? Absolutely. I still do hope, that robotic surgery will not be applicable to every single procedure.
I feed on difficulties, challenges and competition and my ego is, by this, most certainly bruised.
Your post rather frightens me... when I considered becoming a surgeon, I liked the idea of helping people, but it was the blood and gore that turned me off. Why is this a draw for you?
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if robotics allow every first year med student to perform as flawlessly as the highest skilled brain surgeon by compensating for their every mistake, then it's time to move to some third world country.
I kind of doubt it. This device is likely going to be mainly used to do things a surgeon is bad at, and is never going to be good at (nerve fibers in a prostate surgery), or tedious, time consuming things better left to a robot. It seems unlikely it'll put you out of a job.
What I _do_ hope though is that thi
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I kind of doubt it. This device is likely going to be mainly used to do things a surgeon is bad at, and is never going to be good at (nerve fibers in a prostate surgery), or tedious, time consuming things better left to a robot. It seems unlikely it'll put you out of a job.
What I _do_ hope though is that this device can lower costs by reducing complications, or having fewer assistants during a surgery, or perform more surgeries/day, etc.
Your first paragraph is all wrong. This is nothing more than a fancy scalpel. Albeit one with tremor-dampening, and fancy haptics/cameras but still a tool nonetheless. If there is not a person with their hands on the controls, the Da Vinci will sit there and occasionally beep. It enables a person to do things like nerve surgery because it translates large scale, tremor-filled movements into small scale, absolutely smooth ones.
You are correct that it can possibly reduce complications, although there are no
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Your first paragraph is all wrong. This is nothing more than a fancy scalpel. Albeit one with tremor-dampening, and fancy haptics/cameras but still a tool nonetheless.
I'm sure you're right. My point is really that all these tools are going to be "surgeon assistants" rather than "surgeon replacements". I have a hard time believing any patient is going to want to trust their internist to do complicated surgery by a robot. Thus those kind of tools will not be developed (and it's likely not even possible).
An
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You're a douchebag and I hope you slam your hands in a car door so you can never work agai
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To fellow slashdotters, this guy represents only a (hopefully small) subset of the surgical mindset. Early on in medical school I met some a$$hole surgeons who threw tools in the OR and abused staff and residents, and have terrible stories I could tell. Nevertheless, it is far from univer
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When I read your comments I'm reminded a lot of Dr. Moon [nih.gov].
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Who do you want to perform your GABG, a mediocre altruist or an egocentric professional who is confident because he/she really is that good?
I'd prefer the guy who is good enough that he's not trying to prove something. You sound like a cowboy, and cowboys CAN perform miracles... but usually they end up falling down due to hubris and lack of planning. I want a professional who can make sure the whole process is done properly, not just some guy who may or may not do an excellent job depending on how many drinks he had the night before or how much his girlfriend is putting out or whatever decides whether he's feeling on form.
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Who do you want to perform your GABG, a mediocre altruist or an egocentric professional who is confident because he/she really is that good?
Ever consider that the "egocentric professional" might just be closer to Frank Burns than Charles Emerson Winchester III? When you think you're the best, it might just wind up hiding a lot of mediocrity.
As a software developer, I've seen little correlation between ego, and skill. Some of the worst code I've seen came from a guy with (reportedly, I never met him) a hug
Re:Soon being a surgeon will be worth nothing. (Score:4, Insightful)
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So you would rather open a hole in someone's abdomen large enough to get your hands in, just to remove the grape sized growth on their liver, rather than opening a pea sized hole and using a machine? Barbaric. I think you need to rethink things.
The decision to perform an operation laparoscopically versus open is not as straightforward as you suggest. The overriding goal is patient safety, but smaller incisions do not necessarily imply safer operations. Laparoscopic surgeries almost always take longer than their open counterparts, which means the patient might remain under the effects of anesthesia and numerous other drugs for 6 hours rather than 2 - this is not benign. Also, visibility tends to be greater during open operations, so vital struc
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I think you are exactly right - read Atul Gawande's book Complications, the bit about hernia operations. He talks about it in this interview - http://www.abc.net.au/rn/backgroundbriefing/stories/2008/2122487.htm [abc.net.au]
Hmm... also read about the checklist, also by Gawande - http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande [newyorker.com]
Both show that the mystery about doctors and medicines is somewhat misplaced... in many cases (and a growing percentage) robots rule.
These are fun (Score:2)
These are not robots. (Score:4, Informative)
They are cool machines, but they are not robots.
Telesurgery (Score:2)
These are not robots. These are medical telepresence devices. They have no artificial intelligence or autonomy at all; they are intended to provide the surgeon with tiny hands and eyes in places they could not otherwise reach. They are cool machines, but they are not robots.
That sounds good for all of the doctors in India and China and othe relatively poor countries. I'd expect their fees are much lower. When I need surgery, all I have to do is rent the machine, and hire one of them, and make sure that I have a very reliable connection so I can be assured that nothing goes wrong during the operatio..^%^*&(# NO CARRIER...
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Oh no (Score:2, Funny)
Yeah...but, (Score:1)
A day at the hospital (Score:5, Funny)
> run appendix
appendix is undefined.
> run "appendix"
appendix not found.
> run "Appendix"
- Appendix script started...
- Setup complete.
- Loading scalpel vector data.
- Reticulating splines.
- Blade initialized.
- Cutting...
[Message from AutoUpdater: an update for LifeSupport.sys is available and will now be installed.]
LifeSupport.sys has performed an illegal operation and was terminated.
Restart? Y/[N]
> y
Restart? Y/[N]
> Y
LifeSupport.sys failed to start due to error:
0000 - General error
Patient has terminated unexpectedly.
I have used some surgery robots! (Score:2)
As for anatomy, anatomy is different from person to person! some people have their heart on the wrong side! some peoples liver is much larger than others (hopefully mine is I drink l