Sushruta has been dubbed as the father of surgery for writing one of the most detailed and ancient account of surgical processes. The sushruta samhita, works as a guideline for ayurvedic medicine worldwide and is still considered in high regard. However, today we have a medical robot performing the most complex of operations on a daily basis. I could only imagine surgery saying, “Father would have definitely been intrigued.”
Introducing the metal assistant
Involving machines in an operation raises the question of trust and reliability on the machine. However humans have been clever, they started with hands, moved to metal tools, then sterilised those tools. Now we are planning on controlling tools via a machine to add further precision. A medical robot allows for smaller incisions, better control of the instruments with a significant low risk of complication. Ideally it should be a welcome change. However, there’s a reason I said ideally.
Risks involved with medical robot
We all remember the iconic scene from star wars, where robots work on an injured Anakin Skywalker, and restore him to the infamous darth vader suit. However, a question that the clip raised was, why did none of those robots anaesthetise Anakin? This humanitarian touch missing from the robots makes a big difference. Human intervention could have made it an entirely different scenario.
An estimated 6 lakh procedures were performed using a medical robot in 2015. Popularly known as Da Vinci Surgical system, it is growing at an estimated rate of about 10% each year. The indian market is not far behind. The trend is expected to catch up with about 100 hospitals across 25 cities adopting medical robots by 2020.
It’s internationally disastrous
According to online available stats, as of 2014, the robots had killed 144 patients, hurt 1,391 and malfunctioned 8,061 times in the US alone. A study by the British Journal of Surgery, concluded Human Development Index (HDI) was a major factor in the mortality rate for surgeries. “Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors.”
Additionally, a worrying matter is of collection of data in low-HDI countries. Surgical death rates are routinely collected in high income countries, such as the United Kingdom and United States, but there is little to no surveillance in as many as 70% of low and middle income countries.
Increased price point
The cost associated with robotic surgeries is another issue to be considered. A robot assisted surgery costs about $3,000 to $6,000 more than traditional laparoscopic surgery. Da Vinci surgeries additionally took longer time to perform and added an average of $2,000 to the said procedure. After all, it did take about 2 million to get one.
It’s not all bad
Risks involved with a medical robot will always be there but so will be the ones with humans performing surgeries. The involvement of robots has been advantageous in some ways as well. Chris Nebel, DO, FACS, member of Owensboro Health, specialising in general surgery, explained in the Owensboro Messenger-Inquirer, “The principle behind minimally invasive surgery is simple: Cut less, heal more.”