Your article gives the impression that the robots are doing the surgery, what I have read indicates that the "robots are simply movement de-enhancers and eye enhancers. In other words they allow the surgeon to make finer movements by reducing the amount of each movement from the controls, ultimately allowing for finer/ more precise cutting. This is combined with magnifying cameras which allow the surgeon to see in finer detail. These are less robot surgeons than computerized remote control scalpels. Yes?

So really contrary to your statement the surgeon does see the surgical site although there is less looking on the way in, as the path is smaller.

As to the study you mentioned; you yourself pointed out one problem with the data, there was no differentiation between standard laparoscopic and robo-assisted laparoscopic procedures. In addition, although you didn’t mention it, I’d be willing to bet that there was no tracking of any difference in the severity of the condition across the surgical choices. It would IMO make sense that the more difficult/higher risk the patient are the more likely to 'go robotic'. This could certainly bias the report.

Now my assumption about the report is no more or less valid than anybody else’s but it is a good reason to take said report with a huge grain of salt. Hopefully the next study will capture these variables and actually be of use in discussing the benefits of 'robotic surgical enhancement'.

I had the same issue with the article. A remote device is not a robot. With a remote controlled device like the one in the picture, all the decisions are still made by a human.

Plus, much of the stuff mentioned as an advantage of humans is the same for both robot surgery and human surgery. Even if a machine is used for the procedure, the machine isn't going to be talking to the patient before and after the surgery. That's going to be done by a live doctor who is nodding, holding hands, knowing the kids' names, and doing everything else that would be done without a robo-doc.

the article seems to draw wide sweeping conclusions about a technology which is still pretty new.did the study in question include bad outcomes due to "complications" which are typically higher with open surgery vs laparoscopic?

also what about other operations such as hip replacements.i read several years ago how these have been greatly improved by the use of computer controlled routers to machine the pockets in the bones where the replacements attach.previous methods involved hand tools including chisels and hammers, resulting in sloppy fits and long recovery times.

everyone knows that the longer you stay in hospital the higher your chance of getting some infection, so reduced hospital stays are desireable.

another potential future use of this technology is remote surgery,whereby a patient would be operated on by an expert who otherwise would not be available, such as on a battlefield.the military is looking at this very seriously.

morganb:

Your article gives the impression that the robots are doing the surgery, what I have read indicates that the "robots are simply movement de-enhancers and eye enhancers... These are less robot surgeons than computerized remote control scalpels.

Indeed this article is very confused and misleading on this point. And Sepkowitz is not simply misusing the term "robot," either. Consider these sentences:

"We don't yet let robots wash the car or mow the lawn, but dissect out a cancerous prostate? Sure, go ahead."

This clearly implies that the sort of autonomous device that might mow your lawn (and which already vacuums people's houses) is doing surgery. Sepkowitz really does appear to have no idea what he is talking about.

I just remembered, there is a robot for mowing lawns. It looks like a roomba with big wheels on the sides and it works similarly. Plus, drive-through automatic car washes have been around for decades.

So we do let robots wash our cars and mow our lawns.

Axon:

"We don't yet let robots wash the car or mow the lawn, but dissect out a cancerous prostate? Sure, go ahead."

This clearly implies that the sort of autonomous device that might mow your lawn (and which already vacuums people's houses) is doing surgery. Sepkowitz really does appear to have no idea what he is talking about.

for another thing, there are robot lawnmowers now, kind of roomba-ish, and if those drivethrough automatic carwashes aren't robots, then who is stuck inside them doing the washing?

morganb:

Your article gives the impression that the robots are doing the surgery, what I have read indicates that the "robots are simply movement de-enhancers and eye enhancers. In other words they allow the surgeon to make finer movements by reducing the amount of each movement from the controls, ultimately allowing for finer/ more precise cutting. This is combined with magnifying cameras which allow the surgeon to see in finer detail. These are less robot surgeons than computerized remote control scalpels. Yes?

So really contrary to your statement the surgeon does see the surgical site although there is less looking on the way in, as the path is smaller.

As to the study you mentioned; you yourself pointed out one problem with the data, there was no differentiation between standard laparoscopic and robo-assisted laparoscopic procedures. In addition, although you didn’t mention it, I’d be willing to bet that there was no tracking of any difference in the severity of the condition across the surgical choices. It would IMO make sense that the more difficult/higher risk the patient are the more likely to 'go robotic'. This could certainly bias the report.

Now my assumption about the report is no more or less valid than anybody else’s but it is a good reason to take said report with a huge grain of salt. Hopefully the next study will capture these variables and actually be of use in discussing the benefits of 'robotic surgical enhancement'.

yeah, this is what the nerds call "waldos" (extra nerd trivia points: originally coined by Robert Heinlein in a science fiction novel, named after the character who invented them) and are just remote handling things, suitable for playing with plutonium samples or doing microsurgery. in fact, pantographic mechanisms that reduce gross human motions into tiny microscopic motions have been around for probably centuries, letting people carve the bible into the head of a pin or whatever; this is just the digital version, with all the typical digital improvements and vulnerabilities compared to the mechanical system.

and if they worry you, consider that airliners now and even some cars are turning to "fly by wire" where there is no direct mechanical connection between the controls and what they control, and it's all done through computerized inputs and outputs.

Fly by wire would only scare me if the operating system is Windows. Hate to be at 30k feet in the air and have the pilot have to reboot the system.