Are robots the future of the healthcare sector?

The da Vinci system is a surgery system used by surgeons operating a robot in order to create small incisions. The system provides a 3D high-definition vision system and tiny wristed instruments. Although these robots help to save lives, the view has been posed that there are many cases where patients have incurred injuries and deaths as a result of these operations. Accordingly, the question arises: Is it moral to put our lives in the control of robots rather than human surgeons?

For da Vinci surgery system

It has been said that surgeon robots are able to outperform even the most highly skilled and experienced of surgeons. Indeed, using common sense, with precision up to microns and flexible movements, these robots can perform more advanced surgeries than normal human beings as the latter induce errors, such as through the slight shaking of the hand, whereas a robot is able to ensure its robotic arm remains completely still. With the better rotations of robotic wrists, different angles can be reached. This clearly shows the greater efficiency and benefits achieved through the da Vinci system.

davinci-surgical-system

It has been said that the number of surgeries have been increased due to its benefits from lesser blood loss, shorter hospital stays and less reliance on postoperative medication, and the cosmetic benefit of no big scars. Indeed, as shown in Figure 2, the use of robotic surgical procedures on a worldwide scale has exponentially increased each and every year throughout 2000–2012.  In relation to these facts, people should put trust in the development of new technology as, in the future, technology will be the factor prolonging our lives.

robotic_surgeries.jpg

The benefits of the system do not stop at the duration and effectiveness of operation; in fact, post-operation patients have shown a decrease in the risk of infection and bacterial infection to the wound. Hence, the system provides a faster recovery time after every operation.

As a result, the applications of robotics surgery are expanding rapidly into many surgical disciplines. A study from Cadierre proved the feasibility of the robotic surgery on 146 patients and 16 different procedures by the da Vinci robot.  All patients recovered well and no robot-related morbidity occurred.

In another case study, there has a 50 in 100,000 failure rate, which has led to deaths. A 99.95% chance of success on an operation is realistically more than enough to ensure the safety of a person; the deaths of the 50 people have not been in vain as it drives people to do better in the future so as to prevent more deaths.

Besides, overworked surgeons have recently raised the desperate concern pertaining to patient safety. A study has shown that ‘at least once a month they have to take more patients than they could safely handle’. This proves that having a robot that can work tirelessly would benefit society. This is particularly clear when considering the potential outcomes stemming from a stressed, tired and overworked surgeon who is prone to making mistakes. With this being said, the increased use of the da Vinci system should be ensured in surgeries around the world. 

Against da Vinci surgery system

Robots can malfunction. Due to low adaptability in surgery, the da Vinci systems was responsible for 71 deaths and 174 non-fatal injuries in February 2013.

In regards the two cases that led to death:

  1.     1. A patient was suffering from prostate cancer. As a result, the da Vinci system was used. The camera attached to the robotic arm was damaged, causing cardiac arrest, organ failure and severe infection, which led to death.
  1.     2. A father undergoing a normal prostate surgery, which is a relatively common operation that most men undergo, ended up in the surgery room for 13 hours due to a technical fault. The post-surgery effects caused by these technical issues were kidney and lung injury, which led to a stroke causing death.

The use of surgical robots also has raised public concern on economical aspect. It costs approximately £1.5 million for a standard da Vinci robot, without considering the annual operation costs of £100,000, maintenance and training fees. A study published in the Journal of Urology found that, ‘a hospital needs to do at least 520 surgeries a year with the robot to bring its costs in line the traditional surgery. Smaller hospitals can barely meet that’.

Meanwhile, there is no strong scientific evidence or any analysis to prove that the use of surgical robots provides better outcomes than traditional treatments. It is felt that all the money invested into these robots has been wasted; there is nothing wrong with traditional surgery, and all this money could have been reinvested into training more doctors or in medicine to help save more lives.

The effects of the use of surgical robots to professional ethics are taken into account. Evidences have shown that the robots are controlled by poorly-trained surgeons: ‘We would not be regulating these things. We don’t run training courses because the equipment is so expensive’, as stated by the representative of the Royal College of Surgeons. This is a critical situation as there is proof that no training has been given to the operators of the system. This is negative when considering nobody knows who has or has not received training.

Additionally, there is the concern relating to the dependence of the surgeon on the presence of the robots. With the use of robots, some particular skills of a surgeon might disappear; thus, any urgent situation could not be solved. It can be claimed that surgeon training is maintained; however, with the long-term usage of robots, such skills can disappear due to the lack of practice.

With not only technical problems but also economical and profession ethics problems, why are surgical robots still being used?

24: 
Nguyen Minh
Tri Abu Assi Abdulla
Lim Jun Rong
Nicholas Lu Zhihao

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14 thoughts on “Are robots the future of the healthcare sector?

  1. I have read through the article and found it portentous. However, I would like a further elaboration on the duration required to break even on the set-up cost of surgical robots at minimium rate of 520 surgeries performed each year as mentioned in the statements against the use of surgical robots. Also, examples only shown that robotic surgeons failed to perform prostate-illness-related operations, if possible, can you please provide alternative examples? Besides fully-autonomous robotic surgeons, would you agree that semi-autonomous robotic surgeons can be an option for healthcare in the future?

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  2. I have read through the article and found it portentous. However, I would like a further elaboration on the duration required to break even on the set-up cost of surgical robots at minimium rate of performing 520 surgeries each year as mentioned in the statements against the use of surgical robots. Also, examples only shown that robotic surgeons failed to perform prostate-illness-related operations, if possible, can you please provide alternative examples? Besides fully-autonomous robotic surgeons, would you agree that semi-autonomous robotic surgeons can be an option for healthcare in the future?

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  3. I think you just have to look at the arguments against in conjunction with the statistics for, These poorly trained surgeons next to the case study showing a 99.95% success rate.

    Again while not exactly linked but following the case study statistics of 50 deaths in 100,000 surgeries.

    Next to 75 deaths that’s still over a 100,000 successful surgeries. But given the lack of statistics for normal human performed surgeries I’ll assume it’s a much better statistic for the use of robotics.

    Again taking the argument against suggesting there is no evidence that robotic surgery has any better outcome yet the argument for shows less blood loss, less shorter recovery, smaller risk of infection.

    If a hospital does not have the numbers to make the amount of surgeries then it would need to be economically feasible then they continue as is.

    The arguments against come across exactly that, weak arguments vs case studies and statistics.

    Robotics are more than the future, they are here and now.

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  4. I am standing on the side of against the system.

    Firstly, if the robot is controlled by human, there must be systematic delay between actual movement by the doctor and robot arm response , so actually the operation will not get faster and may cause inconvenience to surgeon. Too much information influx on screen and unfamiliar inspection view will even negatively affect surgeons’ performance.Surgeons will also need to trained on handling machine failures during surgery ( you cannot stop the surgery and say, hey i need to pause now and ask the electricians to come in, fix the machine / system and get back to surgery right….) Also if the diseases are required to perform surgery at micron scale, these diseases are probably lethal or widely spread within body, chemotherapy or medicines may work better or any methods won’t work.

    Secondly, if the robot is controlled by programs, it is not cost effective. The cost of training doctors is much less than developing the entire system. Regardless of more complex surgery, getting a system to perform simple surgery requires a stable system, frequent software and system renewal, repair and maintenance and most importantly , maintaining the stability of such a huge machine and operation system. Gigantic financial investment will be required to perform simple surgeries thus impractical. Surgeries will become a game of luxury.

    On the contrary, human surgeons are able to handle urgent conditions, also human surgeons are less likely to have “system failure” during surgery as they will automatically ask for sick leave in advance if they are incapable to perform surgery. Repairing a faulty robot costs more than treating a sicked doctor. Also ” system renewal” will be automatically performed as new generations of doctors will get into the profession with latest knowledge and techniques.

    I’m not trying to saying advancement of medical technology is unnecessary, however I think instead of developing a medical system to replace surgeons, developing surgical tools and instruments which can simplify surgery preparation, improve hygiene of operating room and provide convenience to surgeons during surgery will be a more practical direction.

    (BTW you can check out the movie Prometheus, surgery performed by a robot is real creepy and you can feel how risky it is. I cannot imagine what a simple failure of PID controller can do on an anesthetized patient.)

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  5. This is a very interesting article.

    Personally, I believe that we should definitely take advantage of robot’s high successful rate when conducting different surgeries. However, due to the high cost of a standard da Vinci, it is unrealistic to use a high volume of robots for every hospital.

    One disadvantage of implementing robot system is its low flexibility. The system is only able to carry out the task by following the coding written in the system, which is less likely to create a more efficient solution in the future.

    On the other hand, human beings are known to be creative, It is believed surgeons will more likely to innovate something new and better after experiencing a different kind of problems.

    Maybe we could potentially separate surgeries into two categories: one is in need of high accuracy and the other is in need of experiences of dealing complicated surgery processes.

    It would be great If we can find a balance point to split tasks to Surgeon and Robot.

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  6. Although autonomous robotics has been surging into most industries, I believe that fully-autonomous robotic surgeons may need a few more years until implementation. No matter how developed current robotics may be, they remain incapable of improvisation. This is a crucial factor during times of emergency and unexpected happenings.

    Autonomous robots may have the upper hand in attributes such as hygiene, blood-loss and post-surgery scarring, but the money spent on the robots and their maintenance could be used for further training of the surgeons to improve these areas without the implementation of autonomous design.

    All in all I believe that the most efficient strategy would be to invest that money in semi-autonomous robots that can aid traditional surgeons during practice.

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  7. In my opinion, the advantages of the discussed system overcome its disadvantages. Below are a number of comments that seem to support this opinion.

    First, the advantage in precision that the robotic system provides makes the use of the system a need, rather than a preference. That is because that kind of precision, which enable robots to perform advanced surgeries, cannot be achieved by a normal surgeon.

    Second, its true that robotic systems fail sometimes, which is an expected thing. What matters when considering the usage of a system is the difference that it makes. In other words, to see if the da Vinci system is successful, its failure rate needs to be compared to the failure rate of normal operations.

    Third, the failures of the robotic system that are mentioned in the beginning of the second section of this article may have been caused by poor-training. So that has to be considered when studying the robustness of the robotic system. In addition to that, high expenses is not a valid reason for ignoring training, especially in such field.

    Fourth, the high costs can be reduced by only using the system in big hospitals, where the number of surgeries is expected to exceed 520 per year. Furthermore, if the robotic system is a necessity for some operations and is expected to give better surgical results, then paying for it slightly more than the cost of traditional surgery should not be an issue.

    Finally, this article has mainly considered the da Vinci robotic system. Newer and more advanced systems should be expected to have more advantages and better success rates. This means that supporting the current generation of robotic systems, can encourage even better performing systems in the future.

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  8. Simply how logically the creatures replace the creator of any thing, guys in my opinion that’s comparison is a field of ridicule because simply reboot is a some kind of advance in the science in a specific time and it could be skipped by another kind advance , and all of that are made and will be made by Human !!
    So how could, you compare a specific work in specific time with the worker himself !!!

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  9. It is quite an interesting topic to discuss whether putting the robots into healthcare jobs is “moral” or not. On the one hand, robots may have higher skills (sometimes) than human beings on medical operations that need preciseness. If the robots doctor plans really works, no wonder how it will influence the changes in medical world.

    However, on the other hand, we also need to consider any ethical challenge that this change may bring. For instance, many patients might not be happy to have robots as their healthcare experts in real life.

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  10. I believe that the robots are very expensive and lack specialization. The specialization is needed to adapt to changes in the field of medicine. It is very Important to note that method of surgery is dynamic. New methods come out everyday and I don’t really think that robots can adapt to such changes. Therefore I support humans handling surgery.

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  11. Very interesting article.bhowever, my personal opinion on this matter is more of a compromise between two extremes. This is because frankly speaking I would be terrified just at the thought of a robot operating in me despite its incredible accuracy but due to the possibility that something may go wrong with the surgery that the robot is not accustomed to or not “programmed” to deal with. Thus I personally feel safer with the idea of having an experienced surgeon operate on me despite not being fully accurate due to the nature of human error which is eliminated by the use of a robot. Therefore I believe that the use of both, whether robot operating in presence of an experienced surgeon or surgeon controlling a robot to perform the operation would be the best compromise in my opinion, which I believe can be specifically handy when it comes to cases such as transplant operations which can take up to 10 hours as humans normally can’t function properly for that long, the use of such robot would be beneficial in this case as well as many others rather than just in its own.

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  12. It is very enchanting to know that our aspirarions of robitising everything has extended to the most critical operations! This is brave.

    However from a simplistic moral point of view i deplore using preprogrammed machines to cut & paste through human organs ! They lack human insight & adaptibility to emerging situations; they lack the doctor’s knowledge that might click at any second of unusuality throughout the surgery. Minute differences between the program expextations & the situation prospect volatility can be fatal !

    The responce to the argument that the surgeon may be exhausted is very simple: Train more surgeons & decreas the rate of surgeries per surgeon.

    Technology is ingenious; but nothing can immmitate the complexity of human intellegence!! We are unable to fully unclock the human mind.It is a mysteriously convoluted algorithim.So why are supposing that a mere program with limited complexity can replace it in a death/life call ??!

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  13. The most important thing for me here is that this piece of writing does not provide me with all the facts I need to come up with a conclusive point of view on this subject. With such limited information how can anyone be expected to form a justifiable view?

    The ‘robots’ cause X number of deaths, how many deaths to surgeons cause? and these deaths are they only in the field of prostate cancer or all over (do they include orthoptics? etc.).

    The humans are a dynamic creation, constantly changing with times as new discoveries are made. A decision can only be made on this topic after more research and conclusive evidence is found, either for or against.

    Peace muggles.

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  14. While there is no doubt many benefits to the advent of robotic technology in modern medicine we can never underestimate the power of the human touch. (Are we deviating from Hippocratic oath?)
    More recently we saw the power of robotics in medicine during the outbreak of the Ebola Virus with the use of the “disinfection robot”.
    Certainly robots play a critical and ever growing role in medicine today as mentioned in the above article.
    The Da Vinci system can allow for complex procedures like open heart surgery-this is a mind boggling marriage of medicine and technology. It begs the question however of how comfortable one would feel if s/he were being operated on by a robot? This raises ethical concerns, not to mention legal concerns as well as potential security risks.
    Very interesting article. I feel the key finding mentioned lies in the fact that “there is no strong scientific evidence or any analysis to prove that the use of surgical robots provides better outcomes than traditional treatments”.

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