Should we trust robotic surgery? — Hopes&Fears — flow “Science”


But that’s not the end. Rather than fading to black, the video ends on a lengthy disclosure statement listing potential “complications.” “[U]p to and including death,” it says. This week, that warning rang particularly true: on Monday, MIT released a study linking surgical robotic machine failures to 144 deaths in the US since 2000, finding drastically higher risks for certain types of surgery and far too little study of robots’ mechanical reliability.


It’s left plenty of people in the press and medical community asking, just because robots can perform on the delicate skin of a grape, should they go to work on the complex web of human fascia?


THE IMPETUS FOR THE DEVELOPMENT OF SUCH A TOOL WAS FAIRLY STRAIGHTFORWARD: surgeons wanted to be able to perform surgeries with as few incisions as possible so patients would recover more quickly and cost hospitals less money. During the 1980s, healthcare in the United States gradually became more centralized — and privatized. Doctors were being paid based on what they billed for with few questions asked. By the end of the decade, it had started to become apparent that this was a system rife with exploitation, and combined with the overall effect of inflation, healthcare was quickly becoming the most massive expenditure of the United States GDP. In 1984, engineers released The Arthrobot: a cross between Siri and a claw machine, piloted by a handful of biomedical engineers at the University of British Columbia, Vancouver. It was even programmed to say, “You are doing a great job.”


Robotic surgery has also been extremely desirable in the military and space travel. In the early ‘90s, after the first successful robot-assisted surgery was performed (a gallbladder removal, or cholecystectomy), NASA began investigating how robotic-assisted surgery could be beneficial in developing what they termed medical “telepresence.” The idea being that, whether a person was in space, a soldier in far-flung corners of a war-torn country, a scientist in the most remote of arctic locales, or even a civilian trapped by a natural disaster, if robots could be deployed and a surgeon could operate the machine remotely, it would likely change the way we practice medicine forever. It would also, perhaps, make humans braver: imagine what expeditions could be pursued if remote health care was accessible. Another popular anecdote is that of a physician behind enemy lines operating remotely on wounded soldiers still on the battlefield using not just robots, but real time, high speed data transmission, which would provide the kind of visuals that are the crux of this technology.


A pair of robotic clamps approaches a tiny, glistening orb and proceeds to lay an almond-shaped flap of celluloid-thin skin over exposed flesh. The Da Vinci robot (or, robotic arms remote controlled by a surgeon looking through a high def camera) proceeds to mend a wet grape, the test subject chosen to demonstrate the robot’s superhuman suturing ability with perilous, but measured, precision. After a miraculous finale– the execution of a perfect knot– the camera zooms out to underscore the enormity of scale, the fragility of the task, immediately projecting leaps of the imagination to tumors, cysts, and miniscule tissues.



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