Opinion | Surgical robotics is here to stay. But when things go wrong, who’s to blame?
- Darren Mann says as the use of automation and AI in surgery becomes more daring and more ubiquitous, safeguards must keep pace with the speed of new discoveries, and responsibilities for safety must be fairly shared between doctor and engineer
Time was when the requisite qualities for a surgeon were distinctly biological – “eye of a hawk, heart of a lion and hands of a lady”. But in modern-day hospitals, machines are quietly supplanting handicraft in the operating theatre.
These “master-slave” type of devices use tele-manipulation of articulating arms operated by a surgeon sitting at a console with video monitor and joystick/pedal controls. Worldwide, the commercial space is monopolised by the first FDA-approved system – aptly named after the original Renaissance man, da Vinci. The technique is essentially that of minimal-access (‘laparoscopic’) surgery, and robotic-assisted surgical devices have been applied across specialities.
Six thousand surgical robots globally performed a million operations last year. The market was worth US$6 billion. A basic system costs US$2 million.
Robotic surgeries are 6-28 per cent more expensive than the laparoscopic equivalent (averaging US$2,200 more), but proof of advantage over standard surgical techniques has been elusive: complication and success rates are comparable.
Surgical robotics is poised to go “generic” as original patents expire and new developers and applications enter the field. Next-generation devices will feature enhanced voice control, “fly-by-wire” algorithms to counter perceived faulty operator intent and eventually AI-driven autonomy and self-learning. “Medusa” snake-head flexible endoscopic systems promise scarless surgery through natural orifices. Star Trek’s Dr “Bones” McCoy’s refrain “I’m a doctor, Jim, not an engineer” never rang truer.
With sufficient data speeds, operating consoles can be far removed from the mechanical system. The first telepresence surgery “Operation Lindbergh” was performed in 2001 – a transatlantic procedure by surgeons in New York on a patient in France; and 5G remote surgery was tested on an animal in China just this year.
