DaVinci: Regardless of its drawbacks, robotic-assisted surgical procedure is on the rise | Science & Tech

Robotic-assisted surgical methods have been launched to Spanish hospitals in 2005. Since then, they’ve been used to function on greater than 65,000 individuals. This determine doesn’t embody trauma operations (knee, hip and backbone), that are more and more carried out by way of robot-assisted surgical procedure.

The most effective-known and most widely-installed system – and till just lately, the one one which existed – is the Da Vinci medical robotic, developed by the American firm Intuitive Surgical. Nonetheless, in 2022, the Barcelona Puigvert Basis started to function with HUGO.

“In the mean time, HUGO solely has certification for urology,” says Dr. Salvador Morales-Conde, president of the Spanish Affiliation of Surgeons, “however the firm that markets [the system] is pending approval for common surgical procedure.”

These methods don’t function straight: they’re instruments utilized by human surgeons. The medical robots supply a really subtle scalpel {that a} surgeon doesn’t want to carry in his or her arms – it incorporates a digital camera, tweezers, a needle and different devices required in a surgical intervention.

When you’ve been working for 4, 5 hours in the identical place, with stiff shoulders… there comes a second when you possibly can’t take it anymore and will even have small hand tremors

Dr Belén Cuesta, Rey Juan Carlos Hospital in Madrid

“Previously, we operated with open surgical procedure,” explains Dr. Ana Belén Cuesta, a gynecological surgeon on the Rey Juan Carlos Hospital in Madrid, who has been working with the help of a robotic for 5 years. “Which means we needed to open the stomach cavity. Then, we began utilizing laparoscopy to make the surgical procedure much less invasive. When the robotic got here up, I had a number of doubts, as a result of I didn’t see any benefits to it. However since I’ve been working with it, I’ve found that it does make up for the shortcomings of laparoscopy.”

Laparoscopy is a kind of surgical process that enables entry to the within of the stomach and pelvis with out having to make massive incisions within the pores and skin. Tubes containing surgical devices and cameras are subsequently inserted. Laparoscopy is also referred to as minimally-invasive surgical procedure – scars are a lot smaller, postoperative ache is diminished and restoration is quicker.

Robotic surgical methods handle to do the identical factor, however the distinction is that surgeons don’t have to carry and transfer the tubes themselves – they will function the gadget from a console.

“With the robotic,” continues Dr. Belén Cuesta, “we see the inside of the stomach cavity in 3D, whereas laparoscopy solely permits two-dimensional imaginative and prescient. That is necessary, as a result of we will recognize the constructions of the organs significantly better. As well as, laparoscopy makes use of inflexible devices – it’s as if we’ve got to function with a wrist that has no mobility. The robotic’s devices, alternatively, can transfer in all instructions. Due to this, we will entry smaller, difficult-to-access areas.”

“The operations we do are normally lengthy, particularly oncological ones. And in a laparoscopy, when you’ve been working for 4 or 5 hours in the identical place, with stiff shoulders… there comes a second when you possibly can’t take it anymore and you might even have small tremors in your arms. The robotic prevents this by stabilizing the devices.”

There are apparent benefits to robot-assisted surgical procedure. However not all the things is idyllic. For starters, there’s a excessive price ticket. A Da Vinci robotic prices between €1.5 million and €2.5 million. Along with that, a hospital should pay a minimal of €140,000 per yr for upkeep.

The defenders of this expertise typically argue that, regardless of the excessive buy and upkeep costs, robot-assisted surgical procedure has benefits, corresponding to shorter period of operations or shorter restoration time for sufferers. However printed analysis doesn’t verify these info. In June 2021, the Annals of Inner Drugs printed analysis on 50 research taking a look at almost 5,000 robotic surgical procedure sufferers. The authors concluded that there isn’t a distinction between robotic-assisted surgical procedure and laparoscopy within the chance of issues, even in the long run. In addition they level out that, for instance, in gynecological surgical procedure, robotic operations elevated their period by 13% in comparison with laparoscopic ones. Moreover, a research by researchers from the College of California at San Diego, printed in March 2022, stories that after 10 years of utilizing a robotic as a surgical assistant of their hospital, sufferers operated on stay hospitalized for longer than those that obtained laparoscopy.

Technical failures may also not be ignored, as a result of, in spite of everything, machines are fallible. One other research printed in 2016 analyzed the technical issues present in robot-assisted surgical procedures after 14 years of use: within the instances analyzed, they discovered that 10.4% of the surgical procedures needed to be interrupted attributable to some kind of technical failure that concerned restarting the system, the robotic needing to be reprogrammed, or persevering with with the surgical procedure by typical means.

Nonetheless, in response to Dr. Julio Mayol, president of the Spanish Society for Surgical Analysis, “Robots may help us scale back the variability of apply and enhance the security of surgical procedure. It’s true that their worth is excessive, however that’s going to alter. When Da Vinci’s patents finish, there’s going to be extra competitors.”

Dr. Mayol acknowledges that the present scenario is just not ultimate: “It’s debatable how [these machines] are getting used. We should always set up a bunch of sufferers with comparable traits to permit us to know how this expertise could be carried out in the very best means. For that, we would want to work as a community.”

The 65,000 operations carried out in Spain with robots over the previous 17 years represents a small share of the three.6 million operations finished throughout that point. However the drop within the worth of robots and the arrival of recent fashions from different firms will make their implementation leap within the coming years.