Risking Lives in the Hands of a Robot - Essay Example

Risking lives in the hands of a robot? Executive Summary The ancient times witnessed a special bond between a patient and a healer. The direct path of communication and physical examination often resulted in such accurate diagnoses that the recovery time would be decreased to a significant degree. Intervention of technology in the lives of the humans has been more extensive in the current times than ever before. This development has leaped medical sciences to such a level that humans are even ready to risk their lives in the hands of a programmed machine, commonly known as a surgical robot. In a robotic surgery, the surgeon sits at a remote location from the actual venue of the operating room on a platform that resembles a game console, controlling the robotic arms that operate on the patient. Thus, the direct contact with the patient is served by a surgical robot, commercially known as Da Vinci surgical robot. Alongside the benefits of robotic surgeries, the immature nature and experience of the medical attendants in this new technological development has proven to raise some concerns for its practicality and reliability. This paper shall address some of those common concerns, as well as the benefits that are being retrieved from the adoption of this technology. 1. Introduction It would not be wrong to count the field of robotics amongst the most progressive ones. These machines have evolved from the status of only performing interesting stunts, like differentiating between colors or imitating human walk, to being programmed to acquire important roles in the society. Such important roles may range from being care takers for elderly people as well as being the hands of a surgeon. Intuitive Surgical Inc. is the first company that has been approved by Food and Drug Administration (FDA) to sell their surgical robots in the market (Leddy, Lendvay and Satava, 100). Leonardo Da Vinci, being a great anatomist and inventor of his times and even later generations, had great interest in automation. Intuitive Surgical Inc. gave the information that Da Vinci bears the honor of designing the first robot in 1450s (Intuitive Surgical). This design was discovered in recent history in 1950s that inspired the modern field of robotic technology to an extensive degree. It is due to such contribution from the great legend that the innovative surgical robot has been named Da Vinci Surgical Robots. A typical robotic surgery includes a robot (coupled with robotic arms, visual scanning devices etc.) operating on a patient while being controlled by a surgeon sitting at a distant location. The location may be a few blocks or few thousand miles away. The connection between the robot and the surgeon is maintained with the aid of internet. A research paper pointed out that the concept of such a remotely controlled surgery emerged from the incapability of providing soldiers timely treatment and surgical procedures for their injuries (Leddy, Lendvay and Satava, 99). Robotic surgical equipment were placed on the top of the vehicles in the warzone and connected with the surgeon whenever required for surgical procedures for the injured military officers. With the passage of time, the innovative nature of the technology made its way into the commercial world and now, being accepted as one of the best alternates in medical sciences. 2. Viability and Risks of Robotic Surgeries After crossing the investigational stages, robotic surgeries are being performed on a commercial scale. Hospitals are adopting them as a competitive edge over others in the market due to the degree of smaller incisions and thus lesser recovery time for patients. Few more benefits that have been witnessed in robotic surgeries during the short span of its emergence include reduction of tremor from the surgeon’s hands, smoother movement of the apparatus and surgical tools, better visualization and minimal invasiveness than conventional modes of surgeries (Advincula, 7). Robotic surgeries are being adopted for diverse types of surgeries, namely urological and gynecological procedures. Usually, surgeons tend to stand during their surgeries to have a better view of the patient. However, in robotic surgeries, the surgeons can comfortably sit on the workstation from where they control the movement of the robotic arms and components. These platforms are designed according to the required ergonomics and prove to be helpful in conducting surgeries for longer durations as compared to open and laparoscopic ones. Lesser degree of fatigue for the operator can facilitate effective decision making (Advincula, 8). Movement of robotic arms is different than humans since they tend to bend at greater angles. Human arms possess only 5 degrees of freedom to mark the incisions and other surgical functions while the surgical robots have as high as 7 degrees of freedom, thereby facilitating greater accuracy and smaller incisions (Leddy, Lendvay and Satava, 100). Alongside these benefits of robotic surgeries, few complications and risks are also included in the research findings. A common concern that comes to mind upon reading about such an innovative step in medical sciences is related to the quality of internet connection maintained during the operation. Blackouts and termination of internet connections are not unusual instances even after extensive improvement in the field of networking. In the occurrence of a blackout or closure of internet connection during an open or laparoscopic surgery, hospitals make use of their back up power but internet services are usually bought from third party service providers that cannot be relied upon for such crucial procedures. Figure 1: The first section of the above picture shows console from where the surgical robot is controlled. The second section shows the actual contact of the metallic robotic arms with the patient. (Intuitive Surgical Inc., 2013) It can be seen in Figure 1 that the surgeon is controlling the robot from a setup that resembles a game console and has a visual display of how his movements are translating through the robot onto the patient. A comparative analysis was conducted between conventional modes of surgeries and robotic surgeries. One aspect that points out a significant obstacle in the adoption of robotic surgeries is the cost involved in the adoption of this new technology. The initial setup required to make an operating room equipped for robotic surgeries amounts to millions of dollars. The components and tools fixed in the machine also require extensive maintenance since they need to be changed after every 10 uses. An alarmingly high incremental cost of $3,860 per patient was stated for a robotic surgery as compared to an open surgery while $4,625 incremental costs for every patient for laparoscopic surgeries. These figures can amount to cause a significant bent in the overall expenses of the hospital and prove to be a major obstacle in its widespread acceptance (Ho, v). It would not be wrong to state that the technology of robotic surgeries is still in its initiation phase and facing many inhibitions like the emergence of any new concept. The recent lawsuits against the manufacturers, Intuitive Surgical Inc. are also increasing concerns about the viability and level of dependability on it. Bernstein Liebhard LLP, a law firm in New York, conducted a research and stated that the increasing number of concerns being reported to Food and Drug Authority (FDA) are far lower than the actual concerns that are heard through direct communication with the patients (Stern). Few figures were also quoted and published in Journal of Healthcare Quality of 71 fatal cases out of 245 robotic surgeries since the year 2000. According to this report, Inutitive Surgical Inc. is currently facing 33 lawsuits in different states and cities of USA for a diverse range of reasons, namely fatal infections, bleeding to death, injury in tissues etc. Figure 2: Positioning Da Vinci Surgical robot over the patient before the initiation of the procedure. (Naish, 2013 October 21) Figure 2 shows how a medical attendant positions the robot so that the surgeon can be given the go-ahead sign to start the operation. Medical assistants are always present in the operating room when a robotic surgery takes places but they do not have any decision making authority. Few real life cases have been reported to be unsuccessful due to the inclusion of Da Vinci Surgical robots (Quality and Patient Safety Division: Commonwealth of Massachusetts Board of Registration in Medicine). One of the cases that has been included in the report involved a proctosigmoidectomy for a certain part of the body. The surgery was considered a success and the patient was sent in the recovery room. The next day, it was discovered that there was unwanted tissue still left in the patient’s body that could transform into a complication later. Upon this discovery, he was sent back for another surgery to correct the problem. Later, the matter was investigated and it was found out that the visual scanning from the robotic device could not detect the presence of the resected tissue and thus the surgeon also could not perceive its presence from an indirect view. 3. Conclusion The advancement in the field of technology has leaped mankind to such a stage where one needs to choose their life savior from an experienced surgeon to a robot being remotely controlled. Surgeons are often seen to physically touch the organs in the patient’s body to predict the condition and thus, make appropriate decision about the later course of the surgery. In a remotely controlled surgery, this physical examination is impossible and the surgeon has to rely on the visual display being provided by the robotic device. It is a very common statement from doctors and surgeons that almost every patient or medical condition is different from the others; this denotes that atypical scenarios should always be expected to take place during the treatment of a patient. One of the major concerns against robotic surgeries is related to the capability of the machines and thus the surgeon to effectively handle atypical scenarios from a remote location. In the light of the research findings, it is recommended for surgeons and medical attendants to gain effective training in the application of this innovative leap in medical sciences and avoid its implementation for complex and longer surgeries. FDA had given its approval to Da Vinci robots only for soft tissue surgeries to analyze the implications and results. Therefore, careful investigation and possible repercussions should be evaluated before opting for a Da Vinci Surgery for any patient as it is not free from risks. Works Cited Advincula, Arnold. et al. “A Consensus Document on Robotic Surgery”, SAGES – Society of American Gastrointestinal and Endoscopic Surgeons”, (2007). Ho, Chuong. et al., “Robot-Assisted Surgery Compared with Open Surgery and Laparoscopic Surgery: Clinical Effectiveness and Economic Analyses”, Canadian Agency for Drugs and Technologies in Health, Issue 137, (2011). Intuitive Surgical Inc., Web. 2013, Leddy, Laura. Lendvay, Thomas. Satava, Richard., “Robotic surgery: applications and cost effectiveness”, Dove Press Journal: Open Access Surgery, (2010). Naish, John. “Would YOU put your life in the hands of a robot surgeon?”, DailyMail UK, 21 October 2013. Stern, Felecia. “Da Vinci Surgery Lawsuit News”, PR Web, 4 September 2013, Web. 10 November 2013. Quality and Patient Safety Division: Commonwealth of Massachusetts Board of Registration in Medicine. Advisory on Robot-Assisted Surgery. Massachussets, (2013). Read More