Robots in Surgery

Robots give surgeons a helping hand | Financial Times

Rogers sees it differently, though. He compares the trend towards robotic surgery to the use of painting robots in the car industry, with which his hometown is synonymous. “I’m from Detroit where they use robots to paint cars: if you need to get to a hard to reach area, you don’t do it with a person, a robot does it,” he explains. He likens conventional keyhole surgery to “building a ship in a bottle with chopsticks”.

These kind of comparisons are perfunctory. Statistics never reveal the true picture. You can coax and strangle any results from the data, provided you get “creative” with it. I am sure there are enough cost-benefit studies done to milk the insurance and “social-sector” to show that robots are providing “superior” outcomes. The same argument could be made for laparoscopic surgeries.

The real reason is to develop realistic scenarios around 5G automation and “autonomous surgeries” and at distance, all in the name of “cost-cutting”. The robots can collect data and provide “feedback mechanisms”; they will slowly imbibe it with the AI characteristics. What if these robots compare it with the “idealised scenarios”? It will open up a different can of worms.

What is the way out? Should the robotic surgeries be banned? No. Use them as adjunct tools and make the software underpinning it as “open-source”. Even if you don’t understand the bits and pieces of the software, making the software open-source will force the company to be transparent about what it’s pushing in the back-end, including any data collection practices. It will be resisted.

The rest of the write up compares the European and American practices (and different healthcare systems).

There’s no benefit in the systematic review.

The Evidence Behind Robot-Assisted Abdominopelvic Surgery: A Systematic Review: Annals of Internal Medicine: Vol 174, No 8

A total of 50 studies with 4898 patients were included. Of the 39 studies that reported incidence of Clavien–Dindo complications, 4 (10%) showed fewer complications with robot-assisted surgery. The majority of studies showed no difference in intraoperative complications, conversion rates, and long-term outcomes. Overall, robot-assisted surgery had longer operative duration than laparoscopy, but no obvious difference was seen versus open surgery.

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