Robotics and Surgery

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KobeshouldbeaMD

KobeshouldbeaMD

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Sorry if this sounds like a naive or silly question to ask, but how do you guys feel about the idea that one day a machine will able to do surgery/procedures unsupervised on human patients?

Do you guys think this will ever be possible? If yes, how soon?

Just an idea, let me know what you guys think.


Rutgers New Jersey Medical School class of 2019!
 
southernIM said:
For the like fifth time this month
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285/290/AOA/Gold humanism/head fry cook - do I even have a shot at surgery residency?

Do you know Smith/Jones/Khan/Patel/Anderson/White/Black/Weinstein/Goldstein/Bernstein? Is he really that great of a surgeon?

Should I apply to Duke/Northwestern/Penn/Michigan/NYU?

And, drum roll please...the single best tyro post...

bump
 
Hahahah you guys are too funny. Sorry, I probably should've surveyed the threads before starting a new one.

Thanks for pointing me in the right direction though.


Rutgers New Jersey Medical School class of 2019!
 
I don't think robots will replace surgeons, but I DO think surgeons could become robots. I plan to have both legs and my left forearm replaced entirely by cybernetics. Maybe a laser eye, too. When I become 51% robot, I will have replaced myself.
 
HighPriest said:
I don't think robots will replace surgeons, but I DO think surgeons could become robots. I plan to have both legs and my left forearm replaced entirely by cybernetics. Maybe a laser eye, too. When I become 51% robot, I will have replaced myself.
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"We can rebuild him."

You need an engine block with a handle on it for you to conveniently lift it, to show off your "bionic-itude".

(Of course, that denies the logic of the rest of your axial and appendicular skeleton that is NOT reinforced, which will crumble like a piece of bread when subjected to such loading forces.)
 
Apollyon said:
"We can rebuild him."

You need an engine block with a handle on it for you to conveniently lift it, to show off your "bionic-itude".

(Of course, that denies the logic of the rest of your axial and appendicular skeleton that is NOT reinforced, which will crumble like a piece of bread when subjected to such loading forces.)
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I don't need to be the terminator, but some sort of sinus-exterminating machine.
 
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I was always more worried about the Japanese buying up our medical jobs. Anyone actually old enough to remember the movie "Gun Ho"? What if the same thing happens with medicine?
 
to be honest i think engineers could make a robot do a cholecistectomy right now unsupervised with just 20% mortality rate. Just couple a davinci robot to an image reconnaissance processor and algorithm script.
 
Kahreek said:
to be honest i think engineers could make a robot do a cholecistectomy right now unsupervised with just 20% mortality rate. Just couple a davinci robot to an image reconnaissance processor and algorithm script.
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ONLY a 20% mortality rate???

And no. I don't think it's possible. Go to the VA for a week and watch all the lap choles that have absolutely no tissue planes where you can't define the anatomy at all and then tell me a robot could do it.

Tired of non-surgeons talking about robots. Listen, the robot is a tool and definitely has it's utility in pelvic surgery and thoracic surgery (due to the articulation and small spaces you can get into), but someone still needs to drive the damn thing. It's not like you plug the thing in and it just goes to work. People don't get this part. You still need a surgeon who understands the anatomy and has the technical skill to perform the procedure. And to take over when sh** hits the fan (like when a branch of the pulmonary artery gets torn or when you get into the iliac vessels).

Plus the robot can't present at M&M.
 
i was being sarcastic.
but dont underestimate technology, multiple MRI/ct before surgery, plus 3d reconstruction, the robot would have a very good grasp of anatomy on his "ram", make it run a failsafe programing script of the procedure, and i tell you we would have a mortality rate as low as 20% with only bilions worth of investment, but it would be possible.

Surgical expertise would still be needed, but in-printed in computer language before the procedure, if you will
 
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when robots replace the surgeon, we might as well replace 99% of the jobs with robots, though. And stop breeding and let our robot masters overrule us.
 
to be honest, some groups are just begging to be asked stupid questions like these, when i see most robotic surgeries cant think of anything but gimmick. Advertising material rather than technical advancement.
 
Kahreek said:
to be honest, some groups are just begging to be asked stupid questions like these, when i see most robotic surgeries cant think of anything but gimmick. Advertising material rather than technical advancement.
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It's a total gimmick in my opinion. Hospitals use "robotic surgery" to con the public into thinking they're getting something new and cutting edge.

Robotic chole's are a huge waste of time,, and they make the operation much more dangerous.
 
I think the first step is making a robot that car fix a car all by itself... can't even do that. Robots doing surgery? Seriously? People have lost all sense. Not in my great great great great grandkids lifetime will this happen.
 
BmWQCStCIAAc5FG.jpg:large

I use the robot for everything, even office-based procedures.

I also install robotic colons that are more efficient and reliable than native colons. Keep your eyes out for my 5-year data.
 
Kahreek said:
i was being sarcastic.
but dont underestimate technology, multiple MRI/ct before surgery, plus 3d reconstruction, the robot would have a very good grasp of anatomy on his "ram", make it run a failsafe programing script of the procedure, and i tell you we would have a mortality rate as low as 20% with only bilions worth of investment, but it would be possible.

Surgical expertise would still be needed, but in-printed in computer language before the procedure, if you will
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Not likely with today's Von Neumann type machines but use D-Wave's adiabatic computer to train an array of IBM's new Synapse chips and you might see some interesting things happen. If I had a couple of million to spare I'd tinker with it.
 
balaguru said:
Not likely with today's Von Neumann type machines but use D-Wave's adiabatic computer to train an array of IBM's new Synapse chips and you might see some interesting things happen. If I had a couple of million to spare I'd tinker with it.
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exactly what i meant, give them IBM synapse chips.
Or better we could breed surgeons in artificial wombs, register them as machines in the hospital facilites. And still have all the advantages of biologic computers.
I am just saying **** 🙂
 
DarknightX said:
ONLY a 20% mortality rate???

And no. I don't think it's possible. Go to the VA for a week and watch all the lap choles that have absolutely no tissue planes where you can't define the anatomy at all and then tell me a robot could do it.

Tired of non-surgeons talking about robots. Listen, the robot is a tool and definitely has it's utility in pelvic surgery and thoracic surgery (due to the articulation and small spaces you can get into), but someone still needs to drive the damn thing. It's not like you plug the thing in and it just goes to work. People don't get this part. You still need a surgeon who understands the anatomy and has the technical skill to perform the procedure. And to take over when sh** hits the fan (like when a branch of the pulmonary artery gets torn or when you get into the iliac vessels).

Plus the robot can't present at M&M.
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I'm not so sure the robot has all that much utility in thoracic surgery. You have some guys like Cerfolio that love the robot and swear by it. I'm not sure that it really adds much over VATS techniques.
 
ThoracicGuy said:
I'm not so sure the robot has all that much utility in thoracic surgery. You have some guys like Cerfolio that love the robot and swear by it. I'm not sure that it really adds much over VATS techniques.
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I used to think that until I worked with an attending who used it for every thoracic case. The visualization is really excellent and the articulation makes it really easy to get around vessels and do a good lymph node dissection.

I don't care for the robot in general, but I think it has it's utility in thoracic and pelvic cases
 
docoffice77 said:
I think the first step is making a robot that car fix a car all by itself... can't even do that. Robots doing surgery? Seriously? People have lost all sense. Not in my great great great great grandkids lifetime will this happen.
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Well this is just an insane thing to say. Think back to what the world was like when your great great great great grandfather was alive. Practically our whole lives would be witchcraft to him. Then consider that we've advanced more technologically in the last 10 years than the previous 100.
 
"Then consider that we've advanced more technologically in the last 10 years than the previous 100."

Simply not true. World is technologically almost the same than in 10 years ago in 2004. Now compare that to period between 1904-2004 and you realise how insane your statement is.
 
Dock1234 said:
"Then consider that we've advanced more technologically in the last 10 years than the previous 100."

Simply not true. World is technologically almost the same than in 10 years ago in 2004. Now compare that to period between 1904-2004 and you realise how insane your statement is.
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Especially in Surgery. Besides the robot, not much has changed since 2004 until now.

You could argue that laparoscopy was the last big thing in surgery, and that was in place over 20 years ago.
 
Actually even the robotic surgery hasn't really changed in last 10 years. Da Vinci was approved by FDA in 2000, almost 15 years ago. And that Da Vinci robot seems to be almost only game in town when it comes to robotic surgery. It's actually surprising that they have almost monopoly for some reason

And sure they have new da Vinci models but are they really that different from the original? It seems to me that they have made very little progress in last 10 years, apart from selling lots of those robots.
 
Dock1234 said:
And sure they have new da Vinci models but are they really that different from the original? It seems to me that they have made very little progress in last 10 years, apart from selling lots of those robots.
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The Da Vinci robots have improved dramatically since the first and second generations...lower profile instruments, more toys, single incision platform, suction/energy/stapler, better responsiveness, better cameras, etc. We have an old robot in our MIS lab where you have to screw the arms on, etc....and one of the arms is broken.

I was told that the Si would be the last robot we'd ever have to purchase since it could be upgraded......then the Xi came out....and now I've been told that seriously, this time, it's the LAST robot we'll ever have to purchase.....hmmm....

Soon enough, there will be a pretty bad@$$ single-site platform...can't remember the code name, but I've seen several videos....that has six degrees of freedom, etc.

There are competing robotic platforms being developed, but it's a very expensive game to play, and sometimes Intuitive just buys out the company before they can do anything big.
 
there is not enough money in the world to insure a self operating surgery robot.
 
I think the hype cycle and technology adaptation curve in medicine is about 10x longer than in other industries... Right now I'd wager that the DaVinci is in the "Trough of Disillusionment" phase, but it's probably only going to get better.

technology-adoption.png
 
Has anyone else ever wondered what robotic surgery will do to all these medical dramas like Greys Anatomy? I mean it's harder to create any drama when people just sit on their consoles 😀
 
ram006 said:
Today, one of our automatic carts bumped me so I kicked it. I hope I didn't start the robot revolution.
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Every time I see one of these stupid threads about being replaced by robots I think about how we can't even program a stinking food deliver cart that won't get in everyone's way or bump people. But sure, having a robot do a whipple is totally in the cards.
 
Here's the thing: if you can get a robot to do surgery unattended, then you can get a robot to see clinic unattended. Punch in your symptoms and the robot will scan you and identify abnormalities. Since 90% of my consults from primary care carry no physical exam whatsoever, it's basically the same thing. It'll be like redbox, but for sore throats.
 
Winged Scapula said:
Go on...I'm listening.
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I'm sure the robot will be fantastic at dealing with breast patients (who won't be at all creeped out by being groped by a robot!). 😉

Then again, it's probably no less creepy than a robot doing a DRE for a hemorrhoid consult or something. Could probably even have an anoscope attachment...
 
Smurfette said:
I'm sure the robot will be fantastic at dealing with breast patients (who won't be at all creeped out by being groped by a robot!). 😉

At least the robot won't give off a rapey vibe. I've known some staff docs who experienced some secondary gain from these exams. (DREs too, I would imagine).
Click to expand...
 
Dock1234 said:
Has anyone else ever wondered what robotic surgery will do to all these medical dramas like Greys Anatomy? I mean it's harder to create any drama when people just sit on their consoles 😀
Click to expand...

Will they have the robot present at M&M?

I can just picture it:

Robot Computer Voice: "F*** you moderator, robots do not make mistakes!"
 
Dock1234 said:
"Then consider that we've advanced more technologically in the last 10 years than the previous 100."

Simply not true. World is technologically almost the same than in 10 years ago in 2004. Now compare that to period between 1904-2004 and you realise how insane your statement is.
Click to expand...

Laughable. Expectations have simply raised faster than technological advancement. You just arent stunned and floored by anything any more. "World is technologically almost the same as in 2004" is one of the most misguided statements I think I've ever read.
 
DarknightX said:
Especially in Surgery. Besides the robot, not much has changed since 2004 until now.

You could argue that laparoscopy was the last big thing in surgery, and that was in place over 20 years ago.
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When you say "especially in surgery" you mean "uniquely in surgery." You guys understand we have viable driverless cars right?

There is an old saw about the history of the development of AI, essentially saying that the history of AI is just the history of destroying expectations of AI. At first, a computer would be considered "artificial intelligence" if it could solve complex math problems. Then that was achieved, and "of course a computer can do math, thats what computers do." Then it was considered AI if it could win a game of chess, an extremely intricate complex game requiring abstract thinking. Then that was solved, and now its "sure, of course computers can do chess, they are so good and computations." Then the goalpost shifted to things like language and being able to navigate real-world tasks like driving in a dynamic environment. I certainly wont claim that either of those things are mastered by computers (nor by humans) but the current state of technology would be considered absolute witchcraft even 20-30 years ago.
 
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Dock1234 said:
Actually even the robotic surgery hasn't really changed in last 10 years. Da Vinci was approved by FDA in 2000, almost 15 years ago. And that Da Vinci robot seems to be almost only game in town when it comes to robotic surgery. It's actually surprising that they have almost monopoly for some reason

And sure they have new da Vinci models but are they really that different from the original? It seems to me that they have made very little progress in last 10 years, apart from selling lots of those robots.
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Uh thats because they do have a monopoly. There are at least two other companies that have fully functional platforms that are just waiting for certain patents to expire before they go on the market, in the next couple of years. This will likely change the game dramatically.

But I wasnt intending to shill for robotic surgery (though I am more optimistic than most on that subject).
 
vhawk said:
When you say "especially in surgery" you mean "uniquely in surgery." You guys understand we have viable driverless cars right?

There is an old saw about the history of the development of AI, essentially saying that the history of AI is just the history of destroying expectations of AI. At first, a computer would be considered "artificial intelligence" if it could solve complex math problems. Then that was achieved, and "of course a computer can do math, thats what computers do." Then it was considered AI if it could win a game of chess, an extremely intricate complex game requiring abstract thinking. Then that was solved, and now its "sure, of course computers can do chess, they are so good and computations." Then the goalpost shifted to things like language and being able to navigate real-world tasks like driving in a dynamic environment. I certainly wont claim that either of those things are mastered by computers (nor by humans) but the current state of technology would be considered absolute witchcraft even 20-30 years ago.
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Then why does Siri still suck and why am I stuck driving in traffic?
 
vhawk said:
There is an old saw about the history of the development of AI, essentially saying that the history of AI is just the history of destroying expectations of AI.
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Not necessarily. One could argue the "ultimate goal" for AI development is to create a system that functions like the human mind. And that's been around for at least 70 years, when Turing described what would become the Turing test.

And that's ultimately what prevents a computer/robot from being a surgeon. While I can program something to run through a complex algorithm that might address 95% of all surgical situations, the question is what happens when it runs into a situation it doesn't understand/isn't programmed for. The human mind is capable of synthesizing past experiences that may be similar into a new solution. At this point, that's beyond the capability of any AI.
 
FaytlND said:
Not necessarily. One could argue the "ultimate goal" for AI development is to create a system that functions like the human mind. And that's been around for at least 70 years, when Turing described what would become the Turing test.

And that's ultimately what prevents a computer/robot from being a surgeon. While I can program something to run through a complex algorithm that might address 95% of all surgical situations, the question is what happens when it runs into a situation it doesn't understand/isn't programmed for. The human mind is capable of synthesizing past experiences that may be similar into a new solution. At this point, that's beyond the capability of any AI.
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It's been claimed that a machine passed the Turing test this year.

http://www.washingtonpost.com/news/...ust-passed-the-turing-test-in-landmark-trial/

Few if any surgeons can address 100% of all surgical situations even for a single procedure like the lap chole.

The more I think about it the more I feel that it wouldn't that difficult to program a robot with today's technology to perform a surgical procedure and ask for help when uncertainty climbs above a certain threshold. I doubt it would be economically viable; however, the same techniques could be implemented to provide aides to the surgeon to make him/her more efficient in the OR.
 
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balaguru said:
It's been claimed that a machine passed the Turing test this year.

http://www.washingtonpost.com/news/...ust-passed-the-turing-test-in-landmark-trial/

Few if any surgeons can address 100% of all surgical situations even for a single procedure like the lap chole.

The more I think about it the more I feel that it wouldn't that difficult to program a robot with today's technology to perform a surgical procedure and ask for help when uncertainty climbs above a certain threshold. I doubt it would be economically viable; however, the same techniques could be implemented to provide aides to the surgeon to make him/her more efficient in the OR.
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I had seen that. I's a weird, wild world we're living in. You know, cats and dogs, living together...mass hysteria.

But I agree on the robot being a "surgeon aid". Even something as passive as tremor dampening makes things significantly easier. Now if you could add something like the ability to provide an appropriate dissection plane on the HUD based on prior imaging, that would be a pretty big deal.
 
I want to see the robot do that gene therapy which will grow the new organs in the petri dish and then do an IR-guided OrganImplant (TM). Then the surgeons will be *really* obsolete.
 
FaytlND said:
I had seen that. I's a weird, wild world we're living in. You know, cats and dogs, living together...mass hysteria.

But I agree on the robot being a "surgeon aid". Even something as passive as tremor dampening makes things significantly easier. Now if you could add something like the ability to provide an appropriate dissection plane on the HUD based on prior imaging, that would be a pretty big deal.
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One way to approach that would be to map the surface topology of the surgical field. You already have 3D visualization so this shouldn't be too hard. This technology already exists for 3D printers. On the topology place equally distant points. Attach each point to its neighbors. For each point define m for mass. For each link define k for the spring constant and c for the damping coefficient. Place force measuring devices on the instruments. As the surgeon manipulates tissues use linear regression or monte carlo methods to estimate m, k and c. Define planes as abrupt changes in these values for neighboring regions. Display the planes on the monitor in such a way that their color intesity reflects their statistical certainty. Finally, send all royalties to my paypal account.
 
balaguru said:
Not likely with today's Von Neumann type machines but use D-Wave's adiabatic computer to train an array of IBM's new Synapse chips and you might see some interesting things happen. If I had a couple of million to spare I'd tinker with it.
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IMO that sort of technology is decades away at least...Adiabatic computing is different than the "normal" quantum computing paradigm and a couple of prominent computational complexity theorists don't event think that D waves entanglement is happening at the global level. Besides, the hard part isn't in building the device per se, but in formulating a problem in terms of the architecture. I have no doubt it'll happen but there's no way anyone will formulate the solution to a surgical problem in terms of a complex Hamiltonian anytime soon.
 
If you can get a robot to write notes and see patients... You'd have the approval of many people
 
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