Robot carries out first autonomous soft tissue surgery-intestinal anastomosis

[Brahnold Bloodaxe]

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http://www.wired.co.uk/news/archive/2016-05/05/autonomous-robot-surgeon

A robot has for the first time carried out fully autonomous surgery on a live subject: an intestinal anastomosis on a pig, during which two loops of intestine were stitched together. Four surgeries were carried out and all the subjects survived without complications.

.......

When compared to the intestinal anastomosis procedures carried out both manually by experienced surgeons and with existing robot-assisted surgical techniques using the daVinci Surgical System, STAR was found to outperform both in terms of surgical quality. The results of the procedures were assessed on factors such as "consistent suture spacing, which helps to promote healing, and in withstanding higher leak pressures, as leakage can be a significant complication from anastomosis surgery".

However, STAR currently takes longer than a surgeon working manually: 35 minutes, to a human's eight minutes. Its time is comparable to the time it takes humans to carry out laparoscopic intestinal anastomosis – keyhole surgery that relies on tiny cameras to track progress and haptic feedback instruments to do the suturing.

Dr Peter C. Kim said that "the intent of this demonstration is not to replace surgeons, but to expand human capacity and capability through enhanced vision, dexterity and complementary machine intelligence for improved surgical outcomes." STAR is designed to improve the accuracy of always-challenging soft tissue surgery, allowing a human surgeon to invest their expertise by supervising the procedure and interrupting if necessary, while the robot plans and performs the soft tissue sutures.

Technical lead Axel Krieger says that "by using novel tissue tracking and applied force measurement, coupled with suture automation software, our robotic system can detect arbitrary tissue motions in real time and automatically adjust." Until STAR's development, says Krieger, "autonomous robot surgery has been limited to applications with rigid anatomy, such as bone cutting, because they are more predictable."

STAR tracks the position of flexible soft tissues using near infrared florescent (NIRF) markers applied to the areas it needs to suture, monitored by a camera system that's able to see in three dimensions. An intelligent algorithm guides the robot's surgical plan and allows it to autonomously adjust and react in real time as tissue moves. It also has finely calibrated force sensors and actuators and an articulated laparoscopic suturing tool with eight degrees of movement – one more than the human arm, according to Science, which also provides video footage of the robot performing surgery on inanimate tissue.

Dr Kim says that the next step in STAR's development will be to create improved sensors and further miniaturise the tools used by the robot. He says that, if the team can find a suitable partner to develop the technology, we could be seeing it in clinical use in as little as two years.

 

[Brahnold Bloodaxe]

This obviously isn't a replacement for a surgeon since it's more like a glorified "suture gun" but the fact they're able to get a robot to manipulate soft tissue well enough to perform a perfect anastomosis is worrying. I did not realize the technology is so far along. Certainly nothing for current attendings to worry about, but if you're an M1 or just entering medical school, the fact this is possible in the year 2016 doesn't bode well for your job security in the year 2027 and beyond when you will finally finish training and start trying to make a living. Let alone mid career in 2040+.

Thoughts?

 

[addy]

This obviously isn't a replacement for a surgeon since it's more like a glorified "suture gun" but the fact they're able to get a robot to manipulate soft tissue well enough to perform a perfect anastomosis is worrying. I did not realize the technology is so far along. Certainly nothing for current attendings to worry about, but if you're an M1 or just entering medical school, the fact this is possible in the year 2016 doesn't bode well for your job security in the year 2027 and beyond when you will finally finish training and start trying to make a living. Let alone mid career in 2040+.

Thoughts?

Do you think people reconsidered their career choices when they saw a staple gun making gastrectomies 10x easier? Doubt it.

 

[Brahnold Bloodaxe]

Certainly not. The point here is not the STAR robot in 2016 and its limited application. It's the fact that broadly speaking, technology exists in 2016 that is able to autonomously create a better seal than experienced surgeons and what this implies for 2030+. I've had no exposure to surgery, but I imagine that creating really good soft tissue connections is something that surgeons consider part of their value added. I think I've seen it mentioned in some thread or other that general surgeons should leave bladder repairs to urologists because the latter can stitch em up with fewer leaks, so suturing doesn't seem to be a trivial aspect of a surgeon's skillset.

I've said it before but I'll emphasize it again: I'm not suggesting autonomous robotic surgery becoming mainstream is close to the horizon. At the same time, the outrageous length of medical training in general and surgical training in particular means getting that first job and paying off debt isn't exactly close to the horizon for today's med students, either. So it's sobering to realize that robotically performing one of the most manually challenging aspects of surgery is already kind of being perfected in 2016.

 

[LucidSplash]

Still not worried. Would also argue "better" is only in limited context of their study which appears to be 1)At least 40% requiring adjustments from the team (non automated), 2) on harvested pig intestine not in a live model, 3) in non-inflamed tissue, 4) in only one portion of an operation. Show me a robot that can do an 8-hour lysis of adhesions in a hostile abdomen without any enterotomies (no I mean really that would be welcomed by most surgeons) and then we'll talk.

I doubt anyone is worried about robots taking our jobs.

Certainly not. The point here is not the STAR robot in 2016 and its limited application. It's the fact that broadly speaking, technology exists in 2016 that is able to autonomously create a better seal than experienced surgeons and what this implies for 2030+. I've had no exposure to surgery, but I imagine that creating really good soft tissue connections is something that surgeons consider part of their value added. I think I've seen it mentioned in some thread or other that general surgeons should leave bladder repairs to urologists because the latter can stitch em up with fewer leaks, so suturing doesn't seem to be a trivial aspect of a surgeon's skillset.

I've said it before but I'll emphasize it again: I'm not suggesting autonomous robotic surgery becoming mainstream is close to the horizon. At the same time, the outrageous length of medical training in general and surgical training in particular means getting that first job and paying off debt isn't exactly close to the horizon for today's med students, either. So it's sobering to realize that robotically performing one of the most manually challenging aspects of surgery is already kind of being perfected in 2016.

 

[Brahnold Bloodaxe]

Still not worried. Would also argue "better" is only in limited context of their study which appears to be 1)At least 40% requiring adjustments from the team (non automated), 2) on harvested pig intestine not in a live model, 3) in non-inflamed tissue, 4) in only one portion of an operation. Show me a robot that can do an 8-hour lysis of adhesions in a hostile abdomen without any enterotomies (no I mean really that would be welcomed by most surgeons) and then we'll talk.

The operation was carried out on live pigs, the youtube video is footage from a demonstration on inanimate tissue. According to the principal investigator the manual adjustments were done in large part to ensure an optimal outcome since it was the first time and it was done on a live animal and they wanted to be rather safe than sorry. I want to emphasize the "first time" bit: it's only gonna get better from there. As far as your other points, I completely agree. Which is why I've already mentioned that it's not 2016 I'm worrying about but 2026. And anyway, even it this kind of technology never evolves past routine bread and butter operations, such operations are, well, bread and butter.

You imagine wrong.

We utilize and incorporate new technology readily into procedures all the time. Many are already performing anastomoses using automated stapling devices for exactly the reason that the provide a more even seal/connection than what we accomplish by hand.

There are coupling devices already in use in vascular/micro surgery that have the potential to replace hand-sewn micro anastomoses entirely someday. That's not "sobering" - it's exciting.

Well that's the dichotomy though, isn't it? On the one hand, everyone likes shiny new toys that help them perform their job better. On the other hand, at what point do you start worrying that the toys are getting so good that they're eventually gonna put you out of a job? As a current resident, you're (rightly) not as worried about future developments because you can already kind of see your practice landscape by this point in your training. For a fresh med student interested in surgery though, that first attending paycheck is at least 11-12 years away and while advancements in robotics aren't necessarily harbingers of certain doom and gloom, they're not exactly reassuring, either.

 

[LucidSplash]

Well, since it's going to take me years as an attending to break even on my investment if you consider time and funds put in as well as opportunity cost, even the 10-year jump I have on you isn't enough for me to be out of the woods if the doomsday scenario you are worried about were to come about. We'd be in the same boat. Even if I were planning on operating on intestines beyond my chief year (which I'm not) my response remains the same: not worried. To be clear, you shouldn't be either.

Also I have operated on live pigs and while this is the best model there is (IMHO) for human tissue, it's still not remotely the same.

Also I am not sure why you keep asking if we are worried and then arguing against our replies. This isn't something to worry about. You seem to think you're poking holes in the logic behind our positive outlook for the field but from my perspective you're just repeating the same concerns to the same response. You're overthinking this. We all want more than 10-year careers and there isn't any reason for us, and thus not you, to worry.

The operation was carried out on live pigs, the youtube video is footage from a demonstration on inanimate tissue. According to the principal investigator the manual adjustments were done in large part to ensure an optimal outcome since it was the first time and it was done on a live animal and they wanted to be rather safe than sorry. I want to emphasize the "first time" bit: it's only gonna get better from there. As far as your other points, I completely agree. Which is why I've already mentioned that it's not 2016 I'm worrying about but 2026. And anyway, even it this kind of technology never evolves past routine bread and butter operations, such operations are, well, bread and butter.



Well that's the dichotomy though, isn't it? On the one hand, everyone likes shiny new toys that help them perform their job better. On the other hand, at what point do you start worrying that the toys are getting so good that they're eventually gonna put you out of a job? As a current resident, you're (rightly) not as worried about future developments because you can already kind of see your practice landscape by this point in your training. For a fresh med student interested in surgery though, that first attending paycheck is at least 11-12 years away and while advancements in robotics aren't necessarily harbingers of certain doom and gloom, they're not exactly reassuring, either.

 

[vhawk]

It isnt something to worry about its something to be excited about. It opens some doors and potentially makes some things more doable that currently arent. I'm envisioning a pancreaticojejunostomy anastamosis that is technically perfect every time and maybe decreases leak rates such that we expand indication for Whipples since we wont have a huge leak morbidity to worry about.

 

[Brahnold Bloodaxe]

Well, since it's going to take me years as an attending to break even on my investment if you consider time and funds put in as well as opportunity cost, even the 10-year jump I have on you isn't enough for me to be out of the woods if the doomsday scenario you are worried about were to come about. We'd be in the same boat. Even if I were planning on operating on intestines beyond my chief year (which I'm not) my response remains the same: not worried. To be clear, you shouldn't be either.

Also I have operated on live pigs and while this is the best model there is (IMHO) for human tissue, it's still not remotely the same.

Also I am not sure why you keep asking if we are worried and then arguing against our replies. This isn't something to worry about. You seem to think you're poking holes in the logic behind our positive outlook for the field but from my perspective you're just repeating the same concerns to the same response. You're overthinking this. We all want more than 10-year careers and there isn't any reason for us, and thus not you, to worry.

Well look, I'm glad you're optimistic. I certainly didn't start this thread for the sake of being argumentative and antagonizing people. I read the responses, and when I think I see a hole in a response I raise it up and address it, hoping to have a conversation and test whether my concerns have validity or not. Certainly, disagreement often generates ill will, but at the same time a conversation is pointless if the parties agree on everything for the sake of agreeing.

The way I see it, most of you guys commenting on this thread have expressed a generalized lack of concern over these developments, which I find reassuring. At the same time, I would find it even more reassuring if concrete reasons could be given as to why a lack of concern over rapid progress of autonomous robotic surgery is justified from the point of view of surgeon self-interest. Surgeons are relatively highly paid compared to other "workers" who mostly engage in high volume repetitive tasks, which makes them the perfect target for automation from a purely financial perspective. The motivation to replace you guys is there, but not yet the technology. Yet we are seeing progress in the technology, which I would assume would be worrying unless one has very specific reasons why it shouldn't be....

 

[goldenroc]

As a fellow medical student, can I ask if you have ever scrubbed into a surgery? The kind of stuff this robot is doing is just manual labor, you can train a monkey (in this case, program a robot) to do it, and do it perfect every time. It's like saying since computers can do calculations much more accurate than humans, we don't need accountants for taxes and audits anymore. Accountants still exist because the rules of taxes and auditing has to be applied to different situations and that is a mental task the robot is not designed to do. Also, from this video, I don't see how this technology could be incorporated yet in terms of reducing cost and OR time. Even if they perfect that, it would just be a tool like a stapler, how would it ever replace a surgeon's decision making? Show me a robot that can manage patients pre to post op, and I will drop out of medical school altogether and join the utopian society of endless sex, booze, and entertainment for everyone.

 

[LucidSplash]

See the responses above. Rotate on surgery as an MS3 and then come back and tell us what you think based on your own experience, since we have already given you the benefit of ours though apparently in an insufficient way. I think in your case this is one of those things you will have to experience on your own to understand. Luckily as you need to rotate on all major specialties during your MS3, not being sure about our opinions on this subject doesn't preclude you from considering surgery as a career. But I don't think anyone here can assuage your worry because you don't understand the role of a surgeon. You'd need a viable AI, like Star Trek Data level AI, to do a surgeons job. We are way more than 10 years away from that. Light Years away - pun intended. (I crack myself up).

Also, the OR time and anesthesia typically cost more (to the patient/insurance) than the surgeons fee so those are probably better targets for cost reduction. As a rule, surgeons make money for hospitals, they don't cost them money. A lot of small hospitals would not stay afloat without the income generated by the operating rooms and thus the surgeons. What you are calling rapid advancement of automated surgery is not autonomous and not a threat, it is a tool only. Once you actually spend some time rotating with us, you will be better able to understand the perspective. For now, focus on studying and knocking Step 1 out of the park. Worry only distracts you and lessens the chance you'll have the opportunity to be considered to join us in our awesome, non threatened, field.

Well look, I'm glad you're optimistic. I certainly didn't start this thread for the sake of being argumentative and antagonizing people. I read the responses, and when I think I see a hole in a response I raise it up and address it, hoping to have a conversation and test whether my concerns have validity or not. Certainly, disagreement often generates ill will, but at the same time a conversation is pointless if the parties agree on everything for the sake of agreeing.

The way I see it, most of you guys commenting on this thread have expressed a generalized lack of concern over these developments, which I find reassuring. At the same time, I would find it even more reassuring if concrete reasons could be given as to why a lack of concern over rapid progress of autonomous robotic surgery is justified from the point of view of surgeon self-interest. Surgeons are relatively highly paid compared to other "workers" who mostly engage in high volume repetitive tasks, which makes them the perfect target for automation from a purely financial perspective. The motivation to replace you guys is there, but not yet the technology. Yet we are seeing progress in the technology, which I would assume would be worrying unless one has very specific reasons why it shouldn't be....

 

[vhawk]

I don't think I would describe surgery as a high volume repetitive task, maybe that's where we are miscommunicating. It's more like bespoke tailoring

 

[dpmd]

Certainly not. The point here is not the STAR robot in 2016 and its limited application. It's the fact that broadly speaking, technology exists in 2016 that is able to autonomously create a better seal than experienced surgeons and what this implies for 2030+. I've had no exposure to surgery, but I imagine that creating really good soft tissue connections is something that surgeons consider part of their value added. I think I've seen it mentioned in some thread or other that general surgeons should leave bladder repairs to urologists because the latter can stitch em up with fewer leaks, so suturing doesn't seem to be a trivial aspect of a surgeon's skillset.

I've said it before but I'll emphasize it again: I'm not suggesting autonomous robotic surgery becoming mainstream is close to the horizon. At the same time, the outrageous length of medical training in general and surgical training in particular means getting that first job and paying off debt isn't exactly close to the horizon for today's med students, either. So it's sobering to realize that robotically performing one of the most manually challenging aspects of surgery is already kind of being perfected in 2016.

You are misremembering the bolded. The point made was that despite the fact that there is no reason to believe the urologist would have any fewer leaks, if a complication occurred it might be better from a malpractice standpoint to have called a urologist to do the repair.

Also, I don't think I would consider an intestinal anastomosis as a particularly manually challenging aspect of surgery (particularly if we are talking about using staplers which I use exclusively unless there is a reason I can't or shouldn't use the stapler)

 

[Mad Jack]

Certainly not. The point here is not the STAR robot in 2016 and its limited application. It's the fact that broadly speaking, technology exists in 2016 that is able to autonomously create a better seal than experienced surgeons and what this implies for 2030+. I've had no exposure to surgery, but I imagine that creating really good soft tissue connections is something that surgeons consider part of their value added. I think I've seen it mentioned in some thread or other that general surgeons should leave bladder repairs to urologists because the latter can stitch em up with fewer leaks, so suturing doesn't seem to be a trivial aspect of a surgeon's skillset.

I've said it before but I'll emphasize it again: I'm not suggesting autonomous robotic surgery becoming mainstream is close to the horizon. At the same time, the outrageous length of medical training in general and surgical training in particular means getting that first job and paying off debt isn't exactly close to the horizon for today's med students, either. So it's sobering to realize that robotically performing one of the most manually challenging aspects of surgery is already kind of being perfected in 2016.

Suturing is like 5% of what a surgeon does. You're confusing a glorified tool with a surgeon replacement, it's completely ridiculous.

 

[doc05]

a 35 minute small-bowel anastomosis? that's about 33 minutes of wasted OR time. how is this ever going to catch on?

 

[vhawk]

How long did your first one take you?

 

[dpmd]

How long did your first one take you?

My first was stapled and took a few minutes. Maybe 10 max

 

[vhawk]

My first was stapled and took a few minutes. Maybe 10 max

How about your first handsewn? We dont know how long it takes the robot to fire a stapler.

 

[supremetaco]

Why aren't residents the same as attendings? They can both suture and staple. Take that difference, magnify it by a couple hundred times and you have the difference between the machine and the attending.

As a crude example, anyone can fire a gun. The difference between you and the sniper is when and where you shoot it. How's the machine gonna know which tissues to sew together or what procedure to perform, and what if the patient has abnormal landmarks or a genetic deformity? If anything, it'll just make the surgeon's life easier, speed up procedure times (increase RVUs), and decrease waiting lists. Can't tell if this is just a troll post or not.

 

[dpmd]

How about your first handsewn? We dont know how long it takes the robot to fire a stapler.

I think I was a chief before I did my first handsewn so it definitely wasn't as long as some people's first time.

 

[vhawk]

I think I was a chief before I did my first handsewn so it definitely wasn't as long as some people's first time.

I just wanna see this thing do a PJ

 

[dpmd]

😱

They really liked staplers where i trained i guess. But we had an issue with a colorectal anastomosis where coming from below with an eea wasn't going to work. Coming from above probably would have but the tissue was iffy with a size mismatch and we had a length issue so revision wouldn't have been possible if there was an issue so i got to learn how that day (but had done vascular anastomoses before so that helped plus it wasn't the first time i had ever sewn on bowel before).

 

[vhawk]

I probably did 3 or 4 as a junior resident simply because I told my attending I hadnt done one and they werent in a hurry. Obviously its something you need to be able to do in a pinch but you learn the basic skills so even if you've never done one you should still probably be fine I guess.

 

[dilated]

There are exciting things going on in robotics and surgery but this sure isn't one of them. Getting a robot to place sutures when you've ALREADY TAGGED THE LUMENS FOR IT is not particularly ground breaking, especially when it can't even do it itself half the time. Just goes to show that what the media hypes up is usually not really the leading edge of any scientific field -- there are way more exciting things out there (ex: the Berkeley deep learning robot that learns how to pick things up from scratch). Great marketing effort though.

 

[badasshairday]

This obviously isn't a replacement for a surgeon since it's more like a glorified "suture gun" but the fact they're able to get a robot to manipulate soft tissue well enough to perform a perfect anastomosis is worrying. I did not realize the technology is so far along. Certainly nothing for current attendings to worry about, but if you're an M1 or just entering medical school, the fact this is possible in the year 2016 doesn't bode well for your job security in the year 2027 and beyond when you will finally finish training and start trying to make a living. Let alone mid career in 2040+.

Thoughts?

Thoughts?

Yeah. LOL.

 

[doc05]

This obviously isn't a replacement for a surgeon since it's more like a glorified "suture gun" but the fact they're able to get a robot to manipulate soft tissue well enough to perform a perfect anastomosis is worrying. I did not realize the technology is so far along. Certainly nothing for current attendings to worry about, but if you're an M1 or just entering medical school, the fact this is possible in the year 2016 doesn't bode well for your job security in the year 2027 and beyond when you will finally finish training and start trying to make a living. Let alone mid career in 2040+.

Thoughts?

Thoughts?

There's nothing difficult about anastomosing two pieces of bowel. When this thing can sew to an irradiated rectum, or a calcified tibial, then I might be impressed.

 

[vhawk]

Thoughts?

There's nothing difficult about anastomosing two pieces of bowel. When this thing can sew to an irradiated rectum, or a calcified tibial, then I might be impressed.

There is nothing difficult about driving a car. And yet the fact that we are on the cusp on driverless cars is one of the most significant technological advancements in human history. So it sort of seems like you should make a different point.

 

[Matthew9Thirtyfive]

There is nothing difficult about driving a car. And yet the fact that we are on the cusp on driverless cars is one of the most significant technological advancements in human history. So it sort of seems like you should make a different point.

Not the same. The car example would be more akin to programming a robot to do any case start to finish while being able to detect issues and overcome them. That's why the automated cars are so exciting and the ones that can only parallel park are just neat. Huge difference.

 

[vhawk]

Not the same. The car example would be more akin to programming a robot to do any case start to finish while being able to detect issues and overcome them. That's why the automated cars are so exciting and the ones that can only parallel park are just neat. Huge difference.

Why isn't it similar? You dismissed the accomplishment because "anyone can do it". Why can't I say "your whole operation robot is more akin to a car that can decide where it wants to go plan out the route get there and make sure it takes a photo at the world's largest ball of twine on the way?"

Also just a huge lol at the idea that cars that can self park are "just neat." This is the ultimate curse of AI. Things are considered absolutely impossible to be done by AI right up until the moment they are accomplished and then instantly it's "yawn neat I guess anything can do that that doesn't count as AI".

 

[Vandalia]

Remember, surgeons used to be barbers. Or barbers used to be surgeons. However, you want to phrase it.

(with a bit of hyperbole)

I submit that you could take a line cook from an upper level restaurant and in under a month you could teach her just about every manual skill a surgeon needs to do. The physical part is the easiest part of a physicians job. What makes a physician, what makes a surgeon, is not in the hands, it is in the brain. Almost anyone can quickly learn to make an incision, or tie a suture, or in this case an anastomosis. Being a surgeon is knowing when, why, where and how to do it. That takes years, if not decades to master.

I recently finished a book by a neurosurgeon with Parkinson's disease. He is still able to earn a living despite the fact that he basically cannot use his hands. The skill is in the brains, not the hands. And that is still something that robotics/computers are horrible at.

 

[Matthew9Thirtyfive]

Why isn't it similar? You dismissed the accomplishment because "anyone can do it". Why can't I say "your whole operation robot is more akin to a car that can decide where it wants to go plan out the route get there and make sure it takes a photo at the world's largest ball of twine on the way?"

Because it's not. Robots that can do rote tasks when prompted and set up in the proper way have been around for a while, relatively speaking. You don't see the similarities between a car that can parallel park when given the right conditions and a robot that can perform a different rote task when given the right conditions? And you're telling me that you don't see the difference between performing a rote task that you can train almost anyone to do and complex perioperative management? Or between parking a car and navigating streets with real, unpredictable drivers and pedestrians, not to mention traffic control devices?

That's just being obtuse.

Also just a huge lol at the idea that cars that can self park are "just neat." This is the ultimate curse of AI. Things are considered absolutely impossible to be done by AI right up until the moment they are accomplished and then instantly it's "yawn neat I guess anything can do that that doesn't count as AI".

I guess hyperbole is lost on you. Also, the concept of graded emotion. If I waste "amazing" on parallel parking, I won't have anywhere to go when cars are fully automated. To make it clear, I have a definite appreciation for CS, AI included.

 

[ProfMD]

I, for one, have little concern about robots taking over my job. So far, we have a robot that performed a single straightforward procedure under ideal conditions. What about more complex tasks under less than ideal conditions?

As others alluded to, a big part of being a surgeon is decision making. Deciding who to operate on, what procedure to do, planning the operation, adjusting those plans on the fly as necessary, doing to postop care, etc. Seems a while before any robot can do this.

There is an old saying (can't remember who said it and I have to paraphrase):
As a surgeon, you spend the first couple of years learning how to operate, the next couple of years learning when to operate, and the rest of your career learning when not to operate.

 

[vhawk]

Because it's not. Robots that can do rote tasks when prompted and set up in the proper way have been around for a while, relatively speaking. You don't see the similarities between a car that can parallel park when given the right conditions and a robot that can perform a different rote task when given the right conditions? And you're telling me that you don't see the difference between performing a rote task that you can train almost anyone to do and complex perioperative management? Or between parking a car and navigating streets with real, unpredictable drivers and pedestrians, not to mention traffic control devices?

That's just being obtuse.



I guess hyperbole is lost on you. Also, the concept of graded emotion. If I waste "amazing" on parallel parking, I won't have anywhere to go when cars are fully automated. To make it clear, I have a definite appreciation for CS, AI included.

Everything is a "rote task" once a robot or an AI or a machine can do it. This isnt me being obtuse, its you shifting the goalposts.

Dont worry, when the AutoSurgeryBot9000 is doing whipples, you will be yawning at that too. And you will call it "graded emotion." I doubt you'll ever "waste" amazing.

 

[vhawk]

I, for one, have little concern about robots taking over my job. So far, we have a robot that performed a single straightforward procedure under ideal conditions. What about more complex tasks under less than ideal conditions?

Well....that would come after the easier parts...

As others alluded to, a big part of being a surgeon is decision making. Deciding who to operate on, what procedure to do, planning the operation, adjusting those plans on the fly as necessary, doing to postop care, etc. Seems a while before any robot can do this.

Really? It seems to me that could be the easier part, honestly. There are plenty of aspects of decision-making that humans are terrible at, due to being subject to inherent cognitive biases. In any event I wouldn't be so confident that you can't be outthought by a computer.

There is an old saying (can't remember who said it and I have to paraphrase):
As a surgeon, you spend the first couple of years learning how to operate, the next couple of years learning when to operate, and the rest of your career learning when not to operate.

Well **** then the robots have been crushing us all along!

 

[Matthew9Thirtyfive]

Everything is a "rote task" once a robot or an AI or a machine can do it. This isnt me being obtuse, its you shifting the goalposts.

Sorry, I'm not going to waste more time trying to explain it to you.

Dont worry, when the AutoSurgeryBot9000 is doing whipples, you will be yawning at that too. And you will call it "graded emotion." I doubt you'll ever "waste" amazing.

I didn't yawn at anything, but nice try.

 

[Apollyon]

We are way more than 10 years away from that. Light Years away - pun intended. (I crack myself up).

I'm just a dumb ER doc, so I am missing the pun. Is it that a light year is a measure of distance?

I, for one, have little concern about robots taking over my job.

I, for one, welcome our new computer overlords!

 

[balaguru]

As someone with a CS degree who had a decent career as a programmer, I'll throw my $0.02 in. I think it's safe to say I will never let a computer drive my car or operate for me for one simple reason: most software is written iteratively and in a distributed fashion with varying levels of quality. Formal methods (https://en.wikipedia.org/wiki/Formal_methods) are rarely used. It's just too expensive and slow. If you want a very real example of how things can go wrong ask Toyota about the software they wrote to simply operate a throttle valve. On review by technical experts, their code was described as "spaghetti code". Ironically, Toyota is considered a leader in the quality business with the development of their initiative Total Quality Management.

With that said, I think their is a lot of potential in developing surgery aids with robots like Da Vinci's. This would work much like driver aids in Formula 1.

 

[dafuturesurgeon]

As a student interested in the surgical field, im weary of this.

We go into the surgical field to take medicine into our own hands literally.. Surgery is a physical tangible speciality.

Why would we want to give that up to some automated machines and 0's and 1's?

Aren't you afraid if this become more prevalent, surgeons and future surgeons (as myself) will essentially go extinct?

Your thoughts?

 

[PathoTurnUp1865]

You are so paranoid it's astounding! If you are so scared of the future go find a different field! Jesus man

 

[dafuturesurgeon]

Patho chill dude. Im not going to another field. I just read the article and i just had a question. Paranoia? i think not. Case closed

 

[ProfMD]

As a student interested in the surgical field, im weary of this.

We go into the surgical field to take medicine into our own hands literally.. Surgery is a physical tangible speciality.

Why would we want to give that up to some automated machines and 0's and 1's?

Aren't you afraid if this become more prevalent, surgeons and future surgeons (as myself) will essentially go extinct?

Your thoughts?

Not at all concerned.

 

[PathoTurnUp1865]

You are so paranoid it's astounding! If you are so scared of the future go find a different field! Jesus man

I'm talking about op

 

[vhawk]

As a student interested in the surgical field, im weary of this.

We go into the surgical field to take medicine into our own hands literally.. Surgery is a physical tangible speciality.

Why would we want to give that up to some automated machines and 0's and 1's?

Aren't you afraid if this become more prevalent, surgeons and future surgeons (as myself) will essentially go extinct?

Your thoughts?

No I don't think revolutionizing the field and opening up unthinkable new avenues of surgical management of disease is likely to make surgeons extinct.

Eventually maybe but like I said the day that surgeons go extinct will be the greatest day in the history of mankind because of how amazing life will be from all the OTHER advances that are much more likely to have already occurred. Unemployment will already be at a glorious 100% by that time.

 

[joker2400]

As a student interested in the surgical field, im weary of this.

We go into the surgical field to take medicine into our own hands literally.. Surgery is a physical tangible speciality.

Why would we want to give that up to some automated machines and 0's and 1's?

Aren't you afraid if this become more prevalent, surgeons and future surgeons (as myself) will essentially go extinct?

Your thoughts?

I am also weary of this conversation about robots replacing surgeons.

 

[Brahnold Bloodaxe]

As someone with a CS degree who had a decent career as a programmer, I'll throw my $0.02 in. I think it's safe to say I will never let a computer drive my car or operate for me for one simple reason: most software is written iteratively and in a distributed fashion with varying levels of quality. Formal methods (https://en.wikipedia.org/wiki/Formal_methods) are rarely used. It's just too expensive and slow. If you want a very real example of how things can go wrong ask Toyota about the software they wrote to simply operate a throttle valve. On review by technical experts, their code was described as "spaghetti code". Ironically, Toyota is considered a leader in the quality business with the development of their initiative Total Quality Management.

With that said, I think their is a lot of potential in developing surgery aids with robots like Da Vinci's. This would work much like driver aids in Formula 1.

This is a fair point. Any software capable of directing truly autonomous surgery would have to be massively sophisticated, and thus complicated. Developing and maintaining the code base to ensure it's never going to do such basic no-no's as nicking an artery or slicing a nerve would be a nightmare.