What effect will robotics have on medicine

Great Debates
1

With all the health care debates going on, what is everyone’s predictions for what will happen in medicine in the next 20+ years due to robotics?

Right now the Da Vinci robotic system can reduce complications and speed recovery, but it costs more than surgery w/o the robotic system.

http://www.baptisthealth.net/EN/FACILITIES/SOUTH-MIAMI-HOSPITAL/Pages/Robotic-Surgery-Enables-Quicker-Recovery.aspx

In 2006 a robotic heart surgeon, which learned how to perform surgeries due to observing 10,000 of them, was able to independently perform a heart surgery w/o human intervention.

According to people like Kurzweil, information technologies like robotics undergo an exponential growth in capability as well as rapid depreciation in performance capacity per dollar spent (sometimes 50% a year).

So even though now a robot heart surgeon could cost millions, perhaps by the 2020s having a robot that has the software which gives it the equivalent of 100,000 heart (or bone, or pancreatic, or knee) surgeries may only cost a few thousand or tens of thousands of dollars. I have heard more than one futurist compare the world’s state of robotics to the world’s position with computers in the 1980s, meaning we are on the brink of a revolution in price and performance that places them in almost all of the devices we use daily. A laptop today has thousands of times more processing and storage ability than a computer that took up a room a few decades ago. The Playstation 3 can perform as many calculations per second as the worlds fastest supercomputers did in the early 90s (roughly 100 Gflops).

So does anyone think that within 20-30 years much of (at least much more of) medicine will be done by autonomous robots, or do you think that either the technology will not be advanced enough by then, safe enough by then or the public won’t feel comfortable with it?

What effect will it have on medicine if in 2030 a robot that costs $15,000 is able to perform autonomous and world class surgeries on multiple different bodily systems (nervous, skeletal, cardiovascular, etc), or if a robot that only cost $5,000 could perform some of the activity that a nurse and CNA now does?

2

Some areas of medicine are already completely robotic. Like the transition in corrective eye surgery from RK to Lasik. The latter is done entirely robotically after peeling back the outer layer of the eye, the actual lens is reshaped by computer controlled laser. The patient is awake and the eye is not immobilized, and the computer system tracks the position of the eye 4000 times a second. The doctor obviously makes the decisions of how the eye will be re-shaped, but the actual shaping is accomplished with an accuracy and speed beyond any human hand.

Some areas of medicine are essentially performed by robotics right now…you just don’t think of them as such. For instance, if you’re in an intensive care ward, all your vital signs are monitored by automated processes - heart rate, blood pressure, respiration, etc. 50 years ago, that required doctors and nurses to manually perform each check. Now, a small number of nurses can constantly monitor a whole ward full of seriously ill people. My Mom was in intensive care at St Lukes, and overnight there were three nurses to monitor 20 critically ill people.

Robotic surgery is being used today for prostate, gynecologic, urologic and cardiothoracic procedures.

An area that I think will grow is expert systems for diagnosis. We’ll see it in reading x-rays, with systems flagging items for the doctor to examine more closely. As soon as that proves to reduce both misses and false positives, one radiologist will be doing the work of a dozen. The basic idea is to collect the knowledge of the best people in the field, filtering out their prejudices, ultimately producing better results than any human can - like a Doctor House without the asshole behavior.

3

I had a DaVinci hysterectomy a month ago. My pain level post op never got above a 2 [twice, once immediately post op, due to being shifted from op table to gurney and gurney to bed, and once the next day as a result of a 75 mile drive home over some fairly bumpy roads. I took all of a percocet and a vicodin for pain management]

The op site scabs have already dried up and fallen off, and I have been released by the doc to resume life as normal [with the exception of no more errant girly bits tormenting me unless medicated into oblivion, and I will never again have a cyst on an ovary explode, and the mystery lump was a combined dermoid and lipoma. I also have a healthy appendix and my intestinal track is scoped out and clear of any polyps so I dont need a colonoscopy for another 5 years] All I have are 5 tiny little scars.

Put me down as a firm believer in robotic procedures!

4

My niece just has a cyst removed from her ovary, but with traditional surgery. She’s been suffering some complications and considerable pain. I wish she had been offered robotic surgery.

5

Your medical insurance claim can now be denied at the speed of light.

6

My father had a DaVinci prostatectomy about a half year ago, with similar results. The recovery was much faster and more complete than it would have been with conventional surgery.

7

Ouchies, give her my sympathy …

There is a board called hystersisters that has all sorts of advice that would actually also apply for any abdominal procedure …

A stomach pillow - hold it against the stomach to support it if you have to cough or sneeze. Chill pad to cool the stomach helps with incision pain though I had issues with the itchies from the ultrasound goop more than pain. Elastic ace bandage type bands to support the abdomen to reduce pain. Gasx and stool softeners to reduce the gas and reduce the straining to poo.

[granted, I didnt use any of them, I was ready =) ]

8

Really, it is a boon as the costs for the insurance company are reduced - instead of out of work for 6-8 weeks, I could have gone back at 3 weeks [if I had a job] less hospital stay [traditional hysterectomy can be up to 4 days] and fewer pain meds. Not sure about the infection rate, I had no issues at all personally. I was unfoleyed about 6 hours post op, and able to get myself to the bathroom. I was farting and eating half an hour after I got back to the room.

Actually, the only slightly negative thing that happened was the massage booties they had on my lower legs to prevent clot issues felt great, however they caused a bout of restless leg syndrome [my PCP and I decided that the nerves had gotten overstimulated] but 2 weeks of gabapentin stopped it before it got made permanent. Well, I also have hot flashes, and we opted to not do HRT, I will just tough it out as I would have to eventually anyway. And they are not hot flashes, it is my inner child playing with matches :smiley:

9

I really like this TED talk about “Surgery’s past, present and robotic future”. After talking about the history of surgery, laparoscopy, and the Da Vinci robot, there is some really cool stuff about possible near-future inventions. Like a robot similar to Da Vinci except you only need one incision instead of multiple incisions, which is easier to quickly reposition to different areas of the body (Da Vinci takes a long time to set up).

10

Thanks for sharing that clip. They call it a “robot”, but the di Vinci system is actually a very sophisticated “waldo” in that it’s just an extension of the surgeon’s hands. It will be interesting as this technology evolves to actually do the surgery under the guidance of the surgeon, making incisions far more precise than any human could manage, saving more healthy tissue.

11

My guess is that remote treatment will become more and more available.

Dr Reconstruct-pro has office hours on Mondays, Wednesdays and Fridays. On Tuesdays and Thursdays she oversees a network of robots at clinics around the world. No more need to fly patients from other parts of the world, into the Mayo Clinic. Just schedule an appointment and head to one of the conveniently located local clinics.