Robotic surgery turns surgical trainees into spectators
spectrum.ieee.org
Robotic surgery turns surgical trainees into spectators
1–10 of 90 posts
Re: Robotic surgery turns surgical trainees into spectators
#2I’m a bit shocked that simulators aren’t made readily accessible to surgeons. I thought that would be the biggest advantage of robotic surgery - a surgeon could prep with a few practice surgeries on the sim, while being taken through a few “sometimes this is what goes wrong, here is how you recognize/recover”-scenarios.
Re: Robotic surgery turns surgical trainees into spectators
#3I'm a programmer and my wife is a robotic surgeon who did many, many operations with these da Vinci machines (and also trained with them in residency). Her focus is on what's known as "MIGS", described here: https://en.wikipedia.org/wiki/Robot-assisted_surgery#Gynecol...
Glad to ask her any engineering- or programmer-minded questions that HN folks might have about what robotic surgery is like. (I'll collect any that are posted here, turn a list of them into a batch for her, and transcribe her answers.)
One thing that I notice that the author of this article leaves out is that though trainees are often "watching" a surgery rather than controlling it via the second console, this is a much better form of "watching" than most surgical trainees are typically accustomed. This is because both consoles attached to the robot get the immersive PoV of the primary surgeon. This should be compared to the alternatives, "'straight-stick' laparoscopy" and "open surgery", wherein the view of the surgery for trainees is usually quite limited.
FWIW, my wife trained "both ways" (robotic and 'straight-stick') and believes there are trade-offs -- it depends on the patient condition and what one is trying to accomplish.
Re: Robotic surgery turns surgical trainees into spectators
#4I’m a bit shocked that simulators aren’t made readily accessible to surgeons. I thought that would be the biggest advantage of robotic surgery - a surgeon could prep with a few practice surgeries on the sim, while being taken through a few “sometimes this is what goes wrong, here is how you recognize/recover”-scenarios.
I don't know for sure, but I suspect cadavers are cheap enough and much "higher fidelity" than any sim could ever be.
Re: Robotic surgery turns surgical trainees into spectators
#5I’m a bit shocked that simulators aren’t made readily accessible to surgeons. I thought that would be the biggest advantage of robotic surgery - a surgeon could prep with a few practice surgeries on the sim, while being taken through a few “sometimes this is what goes wrong, here is how you recognize/recover”-scenarios.
It's easy to simulate the robotic manipulators - the dynamics are well known and they are rigid objects.
On the other hand, simulating say skin/muscle/blood or anything that closely resembles human body is near impossible. Without that, a simulator is pretty much useless and it'll probably easier to train the surgeons on real robot + some animal like pig
Re: Robotic surgery turns surgical trainees into spectators
#6I’m a bit shocked that simulators aren’t made readily accessible to surgeons. I thought that would be the biggest advantage of robotic surgery - a surgeon could prep with a few practice surgeries on the sim, while being taken through a few “sometimes this is what goes wrong, here is how you recognize/recover”-scenarios.
It's easy to simulate the robotic manipulators - the dynamics are well known and they are rigid objects. On the other hand, simulating say skin/muscle/blood or anything that closely resembles human body is near impossible. Without that, a simulator is pretty much useless and it'll probably easier to train the surgeons on real robot + some animal like pig
But don't we now have thousands of hours of real-use? Surely in the age of Dall-e, a system to use that as input to ape if not fully simulate the surgical environment is within reach.
Re: Robotic surgery turns surgical trainees into spectators
#7> Many people assume that patient outcomes must be better with robotic surgery. It’s not obvious that’s true. In fact, a recent survey of 50 randomized control trials that compared robotic surgery to conventional and laparoscopic surgeries found that outcomes were comparable, and robotic surgeries were actually a bit slower.
Fascinating. I definitely assumed that the robotic surgeries had better outcomes.
I wonder how much of this kind of thing is contributing to higher costs in US healthcare.
Re: Robotic surgery turns surgical trainees into spectators
#8Question: is surgery hard?
I’m aware you need to be steady. I’m aware it can take a great deal of time and focus and endurance. But how hard is it to figure out a surgery, and execute it?
Re: Robotic surgery turns surgical trainees into spectators
#9> Many people assume that patient outcomes must be better with robotic surgery. It’s not obvious that’s true. In fact, a recent survey of 50 randomized control trials that compared robotic surgery to conventional and laparoscopic surgeries found that outcomes were comparable, and robotic surgeries were actually a bit slower. Fascinating. I definitely assumed that the robotic surgeries had better outcomes. I wonder ho…
I wonder if they’re more expensive though?
Re: Robotic surgery turns surgical trainees into spectators
#10> Many people assume that patient outcomes must be better with robotic surgery. It’s not obvious that’s true. In fact, a recent survey of 50 randomized control trials that compared robotic surgery to conventional and laparoscopic surgeries found that outcomes were comparable, and robotic surgeries were actually a bit slower. Fascinating. I definitely assumed that the robotic surgeries had better outcomes. I wonder ho…
I wonder if they’re more expensive though?
> The cost of the da Vinci robot was obtained from Intuitive Surgical. This analysis utilized the $1.5 million da Vinci-S robot. The cost of the robot was amortized over 5 years; thus, the robot costs $300,000 per year and the service contract is $112,000 per year.
So it adds the cost of one extra surgeon, for the same outcomes, but slower?
Here's a list of advantages. [1]