Da Vinci Surgery
Surgery has existed since the 1800s, but only within the past seventeen years have surgeons enlisted the help of robots. The DaVinci is a robotic technology allowing doctors to control movements from a console and make smaller, less invasive cuts on the body. The machine was invented in 2000, and as of now, it has performed on 3 million patients. Currently, around 64 countries use the robot for surgeries, and the technology isn’t cheap; the DaVinci costs about $2 million for one robot, and surgeries that use the robot cost around $3,000-6,000. Despite the high price tag, is robotic surgery our future?
The robot comes with futuristic controls, four robotic arms, and a 3D screen. To better understand how it works, it’s best to break the technology down into two components, the robot itself and the console. The robot, which operates on the patient, has three small robotic arms that attach to surgical tools, such as scissors or a scalpel. Each instrument or tool can be swapped out for other instruments. The fourth arm holds a camera that gives the surgeon a 3D view of the patient from the console. The console is where the surgeon operates. The doctor looks through the machine’s eye holes to see the 3D magnified image of the procedure while controlling the robot’s arms through hand controllers and foot pedals. Patients who need Cardiac (heart), Colorectal, Gynecologic (health care for women), or head & neck surgery could benefit from the technology, but it’s not for everyone. Those needing simpler surgeries such as hysterectomies, can undergo a much less invasive surgery at a fraction of the cost and with minimal incisions (cuts).
The DaVinci is more precise than a person’s hand and makes fewer mistakes than a surgeon thanks to the machine’s steady touch. The system provides tremor filtering and motion scaling – the conversion of the surgeon’s large hand movements into smaller movements of the surgical instrument. Unlike a human hand, the machine can rotate 540 degrees, a feat that isn’t possible for human hands. The technology leaves smaller scars on the patient, results in less blood loss, and has a faster recovery time than most normal surgeries. To show the DaVinci’s capabilities and just how precise the device is, Edward Hospital, located in the United States, performed surgery on a grape, slowly peeling back its thin layers and stitching them back on. It seems like there are no downsides to DaVinci, but there are many issues the technology still hasn’t resolved.
The technology’s high cost is already dividing doctors who have been able to master the new technology and those who haven’t, and it has caused many doctors to lose their practice. Post med school students are not performing as many open heart surgeries because many procedures are now done robotically. Technology is incredible, but surgeons still need to perform open heart surgeries, and because of the DaVinci, less doctors are being trained for open procedures.
Paul Levy, the Chief Executive of Beth Israel Deaconess Medical Center in Boston told the Wall Street Journal that although the technology is becoming more and more popular, it may not be in the public’s best interests. “There’s a medical arms race,” he said. “Technologies are being adopted and becoming widespread based on the marketing skills of equipment makers and suppliers, not necessarily on the public good,” Levy told the WSJ. Each robot can cost between $1 million and $2.25 million dollars depending on the model and any repairs, which would cost around $1,500. Then, there’s the cost for maintaining each machine, an additional $140,000 hospitals must pay to keep them up and running. All these factors add up to a lot of money, which is why many doctors and hospitals do not approve of investing in robotic surgery.
Despite the divided opinions, the future of robotics in surgeries is bright. Soon surgeons could use tele-medicine and perform long distance operations where doctors operate on a patient in another city or continent. In fact, the first design concept of a surgical robot system was aimed to provide surgical care for astronauts with remote controlled robots. The U.S. Army has long been interested in robotic surgery for the battlefield. But the technology could also be used to deliver health services to people who live in remote areas or developing countries.
Medical professionals already know tele-medicine has potential. The first long distance surgery was performed between New York and Strasbourg, France in 2001. The surgery was successful, but a delay between the surgeon’s commands from the console to the robot’s movements signaled that there was still work to be done. That was sixteen years ago. Now, many more tele-surgeries will occur as the Internet is both stronger and faster. Tele-medicine will increase competition between doctors, but it will also push them to be the best in their field. Dr. Michael Palese a urological surgeon and Director of Minimally Invasive Urology at Mount Sinai Hospital in New York City, specializes in robotic surgery and performs over 800 surgeries a year. He uses the robot for many of them. “In the future there will be tele-medicine, where you can operate on someone somewhere else in the world,” Palese said. “I don’t think that’s far-fetched science fiction anymore. I think that I’ll see that in my lifetime.”
The da Vinci Surgical System is used to stitch a grape back together. The same technology that can be used to stitch a tiny grape is designed to help perform delicate, minimally invasive surgery.