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.
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.
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. 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.
- 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?
Tri Abu Assi Abdulla
Lim Jun Rong
Nicholas Lu Zhihao