Robots

I like robots. They're cool. They're slowly making their way into medicine. The Da Vinci robot shown above is a surgeon-controlled robot that allows minimally invasive procedures such as prostatectomies. It acts similarly to laparoscopic instruments; the robot controls the tools and camera which allows a surgeon at a console to operate. The system translates the surgeon's movements into precise, fine instrument commands, filtering out tremor, and allowing greater range of motion. Safety features reduce operator mistakes. The surgeon experience may be better, allowing more ergonomic maneuvering than traditional surgery. Importantly - and often this is confusing for patients or the public - the robot never acts on its own; it's simply another type of instrument for the physician.

The data is equivocal; robots are expensive, robotic surgeries take longer than regular surgeries, and outcomes don't show that robots are superior. So I'm not sure how I feel about robotic surgery presently. Nevertheless, I think there's potential for robotic surgery and I think it adds to the repertoire of surgical skills. For example, laparoscopic instruments make me think of long arms that only operate at the elbows; in contrast, robotic instruments can have a wrist to allow rotation, flexion, and extension within the body. I also think that the safety mechanisms can improve patient care; obviously, surgeons with a mild tremor cannot operate now, but with a robot, would they be able to? Lastly, like telemedicine, could robotic surgeries allow surgeons to operate remotely? Certainly, we would not want this commonplace, but what if someone needed surgery in Antarctica? or the space station? (How a robot would get there, I'm not sure).

Image of the Da Vinci Surgical System made by Intuitive Surgical shown under GNU Free Documentation License, taken from Wikipedia.