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James Nichols

Professor Winter

Technology and the Future

February 19, 2017

The Future of Robots in Surgery

Advancements in robot technology has increased the amount of robots and wirelessly

controlled devices used in different work environments around the world. As these robots

continue to advance and become more useful in more fields we will see more and more become

normal machines that we use to assist us in our everyday jobs. A large proponent of robots in the

workplace would be in hospitals, and more specifically, in surgeries performed by medical

professionals. Robots would allow for advancements in medical surgeries due to their efficiency,

their stability, and the ability to be operated remotely are all major

advantages in this industry. This essay will discuss a brief history on

the robots used in surgery, the different ways robotic technology can be

implemented into surgeries and the different risks and rewards

associated with having this new technology implemented in the

medical industry . We will discuss what kind of surgeries these robots

would be able to perform in as well as the advantages that may come

from having these kinds of machines in the medical system. 1

The first major robot that was used to perform a surgery was called the PUMA 560 which was

made in 1985, this robot's purpose was to perform neurosurgical biopsies with a much greater

precision than before(A Brief History of Surgical Robots).The PUMA 560 was revolutionary but

1 Image 1A-Picture of the PUMA 560 which was used to perform neurological bases
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the technology still had a long ways to go. After the PUMA 560 there came many more robots

designed to assist with surgeries. In 1994 there came the development of the Orthopilot, the

Orthopilot was used to assist surgeons by holding the patient steady and help get the proper

alignment when aligning joints. The main applications of the Orthopilot were total knee and hip

replacement, cartilage defect management, and high tibial osteotomy(A Brief History of Surgical

Robots). This device allowed for much more precision when performing these types of

procedures. Although these robots were very useful while performing specific procedures, there

needed to be more versatility with the types of procedures these robots can do. Due to the lack or

versatility of these early robots there became a need to develop better robots that could perform

with more accuracy and versatility than the early types. Then in 2000 the Da 2Vinci Surgical

System was patented and approved by the FDA. The Da Vinci System allows for a much greater

range of motion and application. It had the ability to create real time 3D visuals allowing for the

doctor to see inside the incision with much greater accuracy and reliability. The Da Vinci had 3

interchangeable arms which the surgeon could control

at a control panel not farm from the patient. These

robots that are used in surgeries continue to develop

and become more versatile. Their arms become

interchangeable with more procedures and their limbs

gain more mobility allowing for more movement and

accuracy and an overall less invasive surgery for the

patient. These technologies will continue to develop

2 Image 1B- The newest model of the Da Vinci Surgical Robot

and will be used in many different ways to assist many different people in ways that we never

before thought were possible.

There are multiple ways that these robots can be of use to surgeons and patients alike. For the

professionals performing the operations there are many advantages to having a robot assist you.

With designs like the Da Vinci surgeons are able to get a live feed from the robot as it uses its

arms to perform an operation on a patient. This means that the surgeon has a much greater field

of vision in much greater detail. They also get added stability due to the robot limbs being held in

place. This makes the margin of error for a surgeon much lower than without the robot. It also

helps prevent mistakes due to fatigue, even the best surgeon can make mistakes if he is working

for 8-12 hours straight, by having robots assist with the procedure it eliminates many mistakes

that could have happened due to exhaustion. Not only is this a benefit for the surgeon but it also

a great benefit to the patient who now doesn't have to worry about human error as much during

their surgery which could be potentially life threatening. According to a study on the results of

the 3past 14 years of FDA data on procedures taken place using robots it was found that although

robotic surgeries have been implemented at large throughout the U.S, the average mortality rate

of people who pass away by procedures done by robots or done by humans have stayed relatively

the same (Adverse Events in Robotic Surgery: A Retrospective Study of 14 Years of FDA Data).

This is due to the lack in sound technology used in the construction of these robots. There are

still many failures associated with robots that stem from problems like failed parts, or

malfunctioning equipment. Although, as our technology advances and becomes more secure it is

likely that in the future the death toll the amounts from robotic assisted surgeries could become

3 Image 1C- Graph depicting the mortality rate of procedures performed with robotic assistance and
without robotic assistance
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less than human performed surgeries in which case many of the current surgeons would have to

adapt in order to use this new technology.

A major benefit of robot assisted surgery from the patient's point of view is that the surgeries

involving robots are much less invasive than a normal surgery and tend to have an increased

recovery time(http://www.mountcarmelhealth.com/robotic-surgery-321). Due to the fine joints

and precision on the robot the surgeon is able to make much smaller cuts while still having full

visibility of the area due to the camera on the end of the robot conveying a live feed of the area

to the surgeon. This allows for a faster healing time (Barbash 5-6) because of the smaller incision

as well as less pain and discomfort for the patient.

As our technology advances and we gain new advanced in telecommunications we will

have a whole

new way of

performing

surgeries.

Currently if a

patient needs

to see a doctor

they need to

get themselves

to that doctor

whether he/she be close or far. In some cases patients may have to fly across the country to

receive adequate care. As we grow more advanced it soon may be possible for surgeons to use

robots to perform surgeries from across the country remotely. If there were to be a facility in
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which a robot had the capabilities to perform your procedure but no surgeon to perform it you

could have a qualified surgeon from across the country perform the procedure using the robot as

an extension of himself to treat the patient. Not only does this allow a doctor to perform a

procedure on anyone throughout the country that is close to a robot without them being there in

person, it also saves on travel costs for the patient making proper health care more widely

available for our citizens. A main flaw with this type of procedure would be that surgeons are

unable to get an accurate feeling on the area they are operation on due to the lack of sense of

touch possessed by the robot. If a doctor cannot feel with his hands what he is doing than he can

without realizing it damage a part of the area he is working on by accident(Adverse Events in

Robotic Surgery: A Retrospective Study of 14 Years of FDA Data). To overcome this problem

there would need to be a way to relay a whole variation of information to the doctor like where

all of his robotic limbs are in relation to each other and maybe even adding in a sensation of

touch that is transmitted through the robot to the surgeon. These could maybe be a few ways to

overcome the lack of sensation while operating with a robot assistant.

As technology continues to advance and we continue to move forward and make progress

in robot technology, the prospect of having more robot assisted surgeries will continue to grow.

Robot assisted surgery provides many advantages to traditional surgery. These advantages

include, decreased pain for the patient, faster healing time, less invasive procedure, and fewer

complications. Although there are still just as many risks associated with robotic surgery as there

are normal surgeries, as we advance our technology and make these robots more versatile and

durable we will see an increase in the success and overall usage of robotic surgeries. In

conclusion robotic assisted surgeries should be seen as something that could potentially

drastically change the lives of the American people and people throughout the world by
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providing by providing better access with better success ratings and cheaper overall costs.

Robotic assisted procedures will continue to advance and one day they may even become a more

efficient alternative to traditional procedures.

Sources:

Barbash, Gabriel I., MD, and Sherry A. Glied, Ph.D. "New Technology and Health Care Costs -

The Case of Robot-Assisted Surgery NEJM." New England Journal of Medicine. N.p., 19

Aug. 2010. Web. 20 Feb. 2017.

Alemzadeh, Homa, Jaishankar Raman, Nancy Leveson, Zbigniew Kalbarczyk, and Ravishankar

K. Iyer. "Adverse Events in Robotic Surgery: A Retrospective Study of 14 Years of FDA Data."

PLoS ONE. Public Library of Science, 20 Apr. 2016. Web. 20 Feb. 2017.

"All About Robotic Surgery." Surgical Robots, Robotic Surgery, Robotic Systems. N.p., n.d. Web.

20 Feb. 2017.

http://www.mountcarmelhealth.com/robotic-surgery-321

http://www.davincisurgery.com/
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