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1 SidewaysQuark  Thu, Dec 19, 2013 9:22:33am

Given the progressive nature of robotic technology, I suspect this will change in the (not-so-distant) future, but that the expertise of the surgeons will likely ALWAYS be needed. (They just might change in role from “surgeon doing the cutting” to “surgical director”.)

2 kirkspencer  Thu, Dec 19, 2013 9:29:40am

Might want to chase through to the actual JAMA article.

Three methods of colectomy were studied: Open (traditional normal), Lathroscopic, and Robot assisted (not instead of).

Compared to Open, the robot was better in every measure except total hospital cost, where it was slightly higher (14,847 vs 13,666).

Lathroscopic costs less than either (11,996). At P>0.5, the differences other than cost weren’t significant. However the actual numbers are indicative:
In-hospital mortality - RC 0.0%, LC 0.7%
Complication rates - RC 14.7%, LC 18.5%
Ostomy rates - RC 3.0%, LC 5.1%
Conversions to open procedure - RC 5.7%, LC 9.9%
Routine discharge rates - RC 88.7%, LC 88.5%

If these indications continue then as the number of RC procedures increase they will become significant. And as the article you noted said, the costs will likely decrease as well.

3 CriticalDragon1177  Thu, Dec 19, 2013 9:52:40am

re: #2 kirkspencer

Thanks for pointing that out. Good point. Although if robotic technology becomes advanced enough, it could eventually replace the surgeon altogether. However, that may not happen any time soon.

4 Romantic Heretic  Thu, Dec 19, 2013 10:41:01am

I doubt robots will ever replace humans at anything other than the most simple and repetitive of tasks.

Anything more requires judgement and artistry, neither of which can be quantified. If something can’t be quantified a computer cannot deal with it.

5 KingKenrod  Thu, Dec 19, 2013 11:28:26am

I thought the main benefit of robot surgery is much shorter recovery times, right? Because work can be done through much less invasive means.

6 nines09  Thu, Dec 19, 2013 12:36:18pm

Human surgeon=Thinks. Computerized Robotics=Does not.

7 kirkspencer  Thu, Dec 19, 2013 12:38:06pm

re: #4 Romantic Heretic

I doubt robots will ever replace humans at anything other than the most simple and repetitive of tasks.

Anything more requires judgement and artistry, neither of which can be quantified. If something can’t be quantified a computer cannot deal with it.

Another rant I keep tapping. They’re not going to replace wholesale. They’re going to replace by making a few as effective and efficient as several. hence ‘robot assisted’ processes.

The key thing for the robot is repetitive. So long as the tasks are repetitive or predictable (and so programmable) the computer is quite capable of doing the job well. In fact repetitive highly complex jobs are actually more likely to be done better by the machine than by the human.

I think you’d be surprised at how many jobs we think of as requiring judgment and artistry don’t - or have a lot of repetitive non-judmental tasks associated with it. Take as an example “closing” after an open surgery. Checking that objects (clamps, sponges, etc) aren’t left in the cavity, then pulling and stitching it closed. It’s often left for assistants (interns, surgical nurses) to do so the surgeon can get to the next task that requires his expertise.

Which takes me back to my key point. With an anesthesia robot and a robot providing tools and a robot for the closing (all machines presently under testing) you’re pulling at least three and up to six people out of the operating room.

8 rosiee  Thu, Dec 19, 2013 12:56:10pm

re: #4 Romantic Heretic

It won’t be long till there are robot artists and robot actors.

9 Romantic Heretic  Thu, Dec 19, 2013 1:01:21pm

re: #8 rosiee

How can you fake something when you don’t know what it is?

10 kirkspencer  Thu, Dec 19, 2013 1:20:22pm

re: #9 Romantic Heretic

How can you fake something when you don’t know what it is?

That’s why they call it acting. //

11 Renaissance_Man  Thu, Dec 19, 2013 2:36:49pm

Robotic surgery isn’t understood too well by the general public. The robot doesn’t actually do anything on its own. The robot is a remote system that the surgeon controls with his fingers that emulates his movements in a precise and controlled fashion, allowing him to essentially operate with his hands yet without the large open incision, thus avoiding the loss of control and potential awkwardness of laparoscopic surgery. It thus keeps the benefits of minimally invasive surgery, which are well established, and expands minimally invasive options to surgeries that might otherwise have been too difficult to do with standard laparoscopic equipment.

That doesn’t make it ‘better’, per se - it just shortens hospital stays and decreases recovery time. The real argument is whether or not it reduces overall costs, by shortening hospital stays even though the procedure costs more. The answer to that is that for some surgeries it does, while others it doesn’t.


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