Hopefully soon it will turn the surgeons into spectators as well.
Robotic surgery turns surgical trainees into spectators
71–80 of 90 posts
Re: Robotic surgery turns surgical trainees into spectators
#72Earlier quoted context omitted.
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
It's a solved problem https://www.intuitive.com/en-us/products-and-services/da-vin...
Do you believe the marketing of this company?
In my experience in a related field, simulators are about 2% as useful as advertised. The cousin thread explains how difficult building a flesh simulator is, so I wouldn't expect surgical experience on a simulator to be very useful.
Re: Robotic surgery turns surgical trainees into spectators
#73Surgeon here who does the majority of my “major case” work robotically. Author of this article has a coastal-centric point of view. My residency was apprenticeship model and I graduated very confident in my capabilities to perform robotic surgery “skin-to-skin”. The phenomenon he references about trainees no longer being able to start a surgery without the “attending” surgeon present is not related to robotics. It is…
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Re: Robotic surgery turns surgical trainees into spectators
#74Earlier quoted context omitted.
Yes and no, for example, they have no blood circulation anymore, thus one of the potentially fatal risks of any surgery - bleeding - can't be "trained" there.
It can, they can plumb things up with pumps to simulate whatever. This same limitation applies to simulators though, so this application isn't an answer to the parent comments question.
I would think pumping blood through a cadaver is a quick way to get a visit from a handful of agencies.
Re: Robotic surgery turns surgical trainees into spectators
#75Earlier quoted context omitted.
It'll be interesting to see the growth of simulation in other fields similar to that used in radiation oncology [0]. The trick about human bodies is that they aren't all the same and they don't say the same. Once the robot can perform sufficiently similarly in simulation as in real life, then a high risk and cost intervention like surgery will be simulated before performance. An additional aspect of simulation is cal…
The thing about simulation in radiation oncology is its more focused on simulation of the physics of the beam delivery, and not so much on simulation of the tissue or human body portion of the equation. This is more the latter.
When I saw the keywords in these posts it reminded me of a job I interviewed for. This was in 1991 and the state of the art was to plot iso-dose contours on top of X-ray images, presumably using facts about the beam and the tissues at hand. The plan was to evolve from there to 3D images, possibly rendering these planing data in arbitrary orientations in real time. The link provided above discusses tattooing the patient for future reference and other things, using a machine that was 'similar' to the beam machine but without the beam itself. So it is good to see that planning has moved on in 30 years.
Re: Robotic surgery turns surgical trainees into spectators
#76Earlier quoted context omitted.
Guns were pretty much immediately better. They were easy to use, cheap to reload, and you could shoot through armor.
I'm not sure this is true. Reloading muskets took a long time, no? You had to fumble with pouring the powder, tamping it, putting in the round, possibly also a sabot. "Reloading" a bow takes a second.
Bows could shoot faster and further but you would tire out. You also had to be a trained archer vs a random nobody with a gun. Becoming an archer was hard, and arrows were a lot more expensive.
1k longbowmen beat 1k musket bros, but that’s not the comparison that really mattered.
Re: Robotic surgery turns surgical trainees into spectators
#77Earlier quoted context omitted.
It can, they can plumb things up with pumps to simulate whatever. This same limitation applies to simulators though, so this application isn't an answer to the parent comments question.
I would think pumping blood through a cadaver is a quick way to get a visit from a handful of agencies.
There are lots of hoops to jump through to get to use cadavers for one's work, but the act of pumping blood itself isn't particularly of concern to any agencies.
Here is one example paper: https://pubmed.ncbi.nlm.nih.gov/29023350/
Re: Robotic surgery turns surgical trainees into spectators
#78Earlier quoted context omitted.
It's a solved problem https://www.intuitive.com/en-us/products-and-services/da-vin...
Do you believe the marketing of this company? In my experience in a related field, simulators are about 2% as useful as advertised. The cousin thread explains how difficult building a flesh simulator is, so I wouldn't expect surgical experience on a simulator to be very useful.
I've used it, it's pretty good.
Re: Robotic surgery turns surgical trainees into spectators
#79Earlier quoted context omitted.
> To learn from an alternative perspective, what might be an example of a patient condition or objective where robotic surgery may have a meaningful advantage over conventional surgery? Stereotactic surgery in Neurosurgery.
Aren't these non-intrusive and done using gamma knives? I read somewhere that computer+radiologist perform the planning of beams and the gamma knive does all the work
Radiation oncologist*, this is far outside my (radiologist) scope!
Re: Robotic surgery turns surgical trainees into spectators
#80Surgeon here who does the majority of my “major case” work robotically. Author of this article has a coastal-centric point of view. My residency was apprenticeship model and I graduated very confident in my capabilities to perform robotic surgery “skin-to-skin”. The phenomenon he references about trainees no longer being able to start a surgery without the “attending” surgeon present is not related to robotics. It is…
I don’t think it’s so much “coastal” as “big-name (and big) programs”. Wife is an attending at a one-a-year program here in the northeast, and the residents definitely get _way_ more operating experience then they do at, say, Michigan. The skills issue you identify with some big-name programs is a real thing for sure, though.
How long were her shifts as a resident? I remember reading an article about laws seeking to limit resident hours about a decade ago but I'm not of the opinion that anything regarding hours has really changed since the days of William Halsted.