Althouse: About those robot surgeons.

April 10, 2013

About those robot surgeons.

"There also have been a few disturbing, freak incidents: a robotic hand that wouldn't let go of tissue grasped during surgery and a robotic arm hitting a patient in the face as she lay on the operating table...."

25 comments:

Anonymous said...: Think....HAL.

'Nuff said.; 4/10/13, 9:48 AM
kentuckyliz said...: Re the patient who got hit in the face: did she deserve it?; 4/10/13, 9:49 AM
Nonapod said...: A few incidents out of hundreds of thousands of surgeries. I wonder how that compares to human surgeons? How many errors per do humans make in surgeries per hundred thousand versus these machines?; 4/10/13, 9:49 AM
Scott M said...: and a robotic arm hitting a patient in the face as she lay on the operating table...."

kentuckyliz said, "Re the patient who got hit in the face: did she deserve it?"

Nope. All she was doing was eating Cheetos.; 4/10/13, 9:51 AM
rhhardin said...: For eye surgery you dial the laser back from "destroy tank" to "delicate," somebody remarked. Maybe Likeks.; 4/10/13, 9:59 AM
edutcher said...: The Blonde notes the number of return trips to the hospital after robot surgery.; 4/10/13, 10:06 AM
Dear corrupt left, go F yourselves said...: I was scheduled to have my ATM machine remove some moles today. Perhaps I should re-think. ObamaCare exchange was going to pay for it, so I wanted to take full advantage.; 4/10/13, 10:47 AM
Bruce Hayden said...: The problem for the Luddites is that this is the wave of the future. Machines can do a lot of things that humans cannot do alone. So far, we are just talking extending our own capabilities - just at a smaller and smaller scale. Smaller incisions, smaller repairs, etc. and I expect that we are still a bit away from the limits of this technology. Which should ultimately lead to more positive outcomes as the surgery becomes progressively less invasive.

What is going to be interesting is when and how we can replace human surgeons completely. My guess is that it will involve starting by automating standard actions - such as maybe some suturing, tying them, maybe making some cuts, etc. Or maybe even replace some of these with techniques that aren't so closely related to our physical capabilities and history.

Interestingly to me, a client of mine is a nuclear oncologist. Already the completely program a lot of their procedures, then simulate them until they get them right. Need to accurately lock the body part in place, of course.

Should be interesting.; 4/10/13, 10:54 AM
Eric the Fruit Bat said...: Sure a sex robot will go haywire every now and then but you'll never have to buy it jewelry.; 4/10/13, 10:57 AM
Nonapod said...: What is going to be interesting is when and how we can replace human surgeons completely. My guess is that it will involve starting by automating standard actions - such as maybe some suturing, tying them, maybe making some cuts, etc. Or maybe even replace some of these with techniques that aren't so closely related to our physical capabilities and history.

Interestingly to me, a client of mine is a nuclear oncologist. Already the completely program a lot of their procedures, then simulate them until they get them right. Need to accurately lock the body part in place, of course.

This is the real reason I'm optimistic about healthcare in the future even with the looming disaster of the Affordable Healthcare Act. Because of technoloy to improve and greatly reduce the costs of diagnostics along with more and more automation removing humans at different points in the workflow, healthcare will gradually become cheaper, better and more personalized. I know it's unlikely that we'll remove human doctors completely (until with have strong AIs) anytime soon. Humans are expensive and make many errors compared to machines.; 4/10/13, 11:07 AM
Amexpat said...: Good news for malpractice attorneys, now they can sue the manufacturer of the robot in addition to the surgeon and hospital every time a surgery is not successful.; 4/10/13, 11:11 AM
Jeff said...: Of course the FDA knows better than the surgeons do whether or not using the robot system for a particular operation is a good idea. In fact, they can make this determination without even meeting the patient!

My wife recently underwent surgery that was, in part, exploratory, using the DaVinci system the post is referring to. The problems the surgeon found and corrected were only found because the robot system has high-resolution stereoscopic cameras that gave the doctor a much better view than she could have gotten from conventional laparoscopic tools.

If it weren't for the robot, my wife would still be in great pain. I thank God she was able to get it fixed before the activists and lawyers make it impossible.; 4/10/13, 11:48 AM
Christy said...: I had a Da Vinci surgery four months ago. I lost three tablespoons of blood, more than hoped for, and was out of the hospital in 24 hours. Took one Tylenol for pain that night and never opened the oxy bottle. My five incisions have healed nicely.

Guys, seven years ago I spent 6 months taking care of a sister who had the same surgery done conventionally. Trust me. Thrilling is the only word for robotic surgery.; 4/10/13, 11:51 AM
Saint Croix said...: ISRG has been an awesome stock for us.; 4/10/13, 11:54 AM
Peter said...: I don't know why they call da Vinci a robot when it's not. A robot can perform autonomous actions. Da Vinci is an example of teleoperation.

And while this instance may or may not be flawed, this type of surgery can be used toperform procedures that would be all but impossible to do directly.

It can, for example, simply change the visual and tactile scale of things- what is actually tiny may feel and look relatively large to the surgeon. Thus enabling microsurgeries, and generally multiplying precision.

The bottom line is increased capability and reduced risk. Things like this are surely not going away.

Perhaps what's really happening is, the word "robot" is coming back to the idiots who marketed the thing as a robot. "Robot" may sound futuristic but (because it implies some degree of autonomy) also conjures images of machines gone amok.; 4/10/13, 12:09 PM
Lem Vibe Bandit said...: Whats the robot side of the story?; 4/10/13, 12:16 PM
Jane the Actuary said...: The Da Vinci robot may be wonderful, but you just know -- from how agressively it's advertised -- that this is yet another way in which our heathcare costs are out-of-control due to third-party payors. When a patients weights the DaVinci vs. traditional surgery, they see shorter recovery time and smaller scars at little to no additional cost to them (becasue the insurer picks it up).

Same with Proton Therapy for prostate cancer. I have no idea whether this is an exceptional advance over other treatment options, but it sure is marketed heavily. There was an ad in the paper today: "women get prostate cancer, too" -- meaning that women are affected by the side effects their husbands experience, so they should tell hubby about the ProCure Proton Therapy.

And knee replacement -- there was a radio commercial that the local hospital ran for quite a while, promoting their surgery as so superior to the other hospitals that their patients resumed their active lives in no time at all.

It may be that all these people experience better quality of life -- but at a cost that no one acknowledges.

For that matter, many of these treatments are not backed by controlled studies documenting that they're superior in the first place.

Oh, well -- at least we're not discussing missle strikes in Korea. Looks like it's a big nothing. (And CNN.com is full of editorializing on gun control today, after they gave up on the NORKs doing anything newsworthy.); 4/10/13, 12:26 PM
Jane the Actuary said...: Here's a thought experiment: imagine that the insurance company charged the incremental cost for the robotic version of a surgery to the patient. Both outcomes are identical, except that the robotic version has virtually no recovery time, and the standard version has, say, 3 days of incapacity (in bed, not necessarily in the hospital) and a further 2 weeks of "ow! that hurts!"

How much extra, out of pocket, would you pay to avoid the "ow! that hurts!"?; 4/10/13, 12:32 PM
Saint Croix said...: MAKO, another robot stock we hold, has not done well. Their robot does surgeries on hips and knees, which is a huge market. But Obamacare has been brutal to them. New tax on medical devices, pushing up the costs on the robot.

Mako has yet to achieve profitability and its entirely possible the Obama administration will send them into bankruptcy before they can establish their business. (Or, more likely, they will be acquired by ISRG).

Boy, socialism is stupid.; 4/10/13, 12:34 PM
William said...: I have read that many patients prefer robot surgery because it is cutting edge technology (heh). However, I would be interested to know if juries award greater or lesser damages for cases with bad outcomes to surgeons vs robots. it would only take a few huge awards to destroy this promising technology, and I do not think it would be that difficult for an attorney to caricature the robot as the Terminator.; 4/10/13, 12:34 PM
Scott M said...: Good news for malpractice attorneys, now they can sue the manufacturer of the robot in addition to the surgeon and hospital every time a surgery is not successful.

And the ISP. And the router manufacturer. And...; 4/10/13, 12:51 PM
Christy said...: Jane, I'm self-insured. I am paying the difference myself.; 4/10/13, 1:23 PM
Michael K said...: Just as in the early days of laparoscopic surgery, the early adopters have better hand eye coordination. That is critical for laparoscopic surgery because you are looking at a TV screen and there is no three dimensional vision. The da Vinci operates the same way. You sit at a monitor and operate the arms by grasping controls like a video game. As more and more surgeons adopt this machine, the less skilled will inevitably screw up a few times.; 4/10/13, 2:55 PM
cacchip said...: I had Da Vinci in August 2011 to remove my Prostate. I'm am cancer free and fully functional. I know others who had conventional surgery and they have all kinds of side effects. Give me the robotic option.; 4/10/13, 8:19 PM
Alina said...: Absolutely indited written content, Really enjoyed reading through.
eye surgery; 4/13/13, 8:19 AM