Is the use of robots in surgery the next advancement, or an overpriced marketing tactic?
Robot surgeons aren't the futuristic creations you see in sci-fi movies. They've been in action on Earth since 1985 and have partnered with human doctors for over three decades. The first documented robotic surgery dates back to 1985, when the PUMA 560 robotic surgical arm assisted in a neurosurgical biopsy.
In the ensuing years, this robotic arm and its successors made history. The first laparoscopic procedure – a cholecystectomy – was executed using a robotic system in 1987, and in 1988, PUMA lent a hand for a transurethral resection. The potential for precision in minimally invasive surgeries skyrocketed with the introduction of the robot's steady, mechanical hand.
By 1990, the Food and Drug Administration green-lighted the first robot approved for endoscopic surgery – the AESOP system from Computer Motion. However, it wasn't until 2000, with the FDA's blessing of the da Vinci Surgery System, that robot-assisted surgery stepped into the spotlight. This robust system quickly dominated the field, offering a sleeker, ergonomic design that was a world away from the bulky, 1980s-era PUMA.
The miniaturized surgical instruments of the da Vinci system were hailed as a breakthrough in minimally invasive surgery, as they eliminated the need for external leverage and reduced contact between instrument and interior tissue, minimizing the risk of infection. A clever feature called "Endo-wrist" was designed to mimic the delicate movements of skilled human surgeons, who could now control the machine via a series of controls.
Since its FDA approval in 2000, Intuitive Surgical – the manufacturer of the da Vinci – has updated the system 10 times. By 2013, robots were used in 422,000 surgeries across the US – a 15% increase from the previous year.
However, the benefits of robot-assisted surgery have been questioned by some medical experts. A high-profile study led by surgical oncologists at Memorial Sloan-Kettering Cancer Center found no difference in the rates of complications or length of hospital stay between traditional open surgery and robotic surgery for bladder cancer. The results were so clear that they ended the trial early.
While Intuitive Surgical objected to the conclusions drawn by the Sloan-Kettering study, some recent research indicates that the advantages of the robotic system are minimal. These findings contribute to a growing sense of dissatisfaction with robotic surgery, perhaps best exemplified in an opinion piece by Dr. Robert Pearl, CEO of The Permanente Medical Group, who claimed that robot-assisted surgery lacks sufficient supporting evidence and introduces unjustified costs to hospitals.
Despite the mixed reviews, researchers, surgeons, and developers remain undeterred. Intriguing innovations are on the horizon, with exciting developments in the realm of microsurgery, surgery outside the abdomen, and natural orifice surgery. The future of robot-assisted surgery is brimming with possibilities that promise to revolutionize the medical world.
- Although robot surgeons have been in action since 1985, collaborating with human doctors for over three decades, their benefits have been questioned by some medical experts.
- The first documented robotic surgery was done in 1985, using a PUMA 560 robotic surgical arm for a neurosurgical biopsy.
- The precision in minimally invasive surgeries significantly increased with the introduction of robots, starting from the first laparoscopic procedure in 1987.
- The introduction of the da Vinci Surgery System in 2000 revolutionized the field of robot-assisted surgery, with its sleeker, ergonomic design compared to the bulky PUMA of the 1980s.
- Despite the controversy surrounding the cost-effectiveness of robot-assisted surgery, developers and researchers continue to innovate, with exciting developments in microsurgery, surgery outside the abdomen, and natural orifice surgery on the horizon.
