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The Cost of Robotic Surgery

The Cost of Robotic Surgery

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Published by: julia_lange on Sep 15, 2009
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11/05/2012

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Robotic Surgery 1
Running head: THE COST OF ROBOTIC SURGERY
The Cost of Robotic Surgery: Mechanizing HealingJulia LangeUniversity of California Santa Barbara
 
Robotic Surgery 2AbstractIn the field of robotic minimally invasive surgery, it is apparent that advances in technology haveconferred increased precision during—and the decreased risk of complications after—a widerange of surgical procedures. Furthermore, patients who are operated on by robots controlled bysurgeons enjoy shorter recovery times and fewer visible post-operative scars than those subject totraditional open-surgical procedures. Contemporary robotic hardware serves as a platform withmany affordances to further develop autonomous software for minimally-invasive surgicaltechniques. The evolution of surgery has engaged human hands as primary tools equipped withsecondary trinkets to cut, sew, and maneuver within and around patient organs. Delicate control,a fine-tuned dexterity of hand, and refined expertise have been essential in defining standard procedure for surgeons. A traditional surgeon must feel resistance under the scalpel and gauge if more or less force is necessary to exert. It is the surgeon's hand that has ultimately provided theimpetus to guide the knife in surgery and the surgeon's muscle has been the engine of repair andhealing for centuries. With advances in robotic technology in the operating room, though, thesurgeon's hand is no longer the driving force behind the scalpel. Soon, the surgeon's mind willnot even be the director of where the robot makes the incision. Research in robotic surgeryacknowledges the challenges of integrating new technology in surgical wards, but does not focusenough on the repercussions that the advance in technology will have on the role of the surgeonin the operating room and in society. More fundamentally, as technology advances and slowlydisplaces the human surgeon from his or her traditional role, the deep-seated ideals of the ancient pact between patient and surgeon are compromised. What it means to wield a scalpel—cutting toheal, slashing to repair, hacking to mend, and extirpating to cure—changes entirely when thehuman component is removed from above the operating table. In my research, I argue that therobotic lack of intuition, empathy, basic human emotion, and responsibility as surgical tools isharmful to surgery’s practice, its history, and fundamental goals. Surgery plays a central role inmedicine, and its history has shaped it into the current practice surgery has become. With everyadvancement, there has remained a human wielding the rock, bone, or metallic instrument. Theancient art of surgery has always emphasized the humanness of the surgeon. Advances intechnology, especially those that threaten the very practitioners, undermine the original sentimentof the ancient practice of surgery and compromise the role of the surgeon (Priestley, 1957).Recognizing the technology-driven ideological shift in the operating room is significant due tothe social implications for surgeons as well as all other medical professionals and patients. The philosophy that has existed for thousands of years, since man began healing his fellow human, isat stake. When further advances universalize artificially-intelligent autonomous robot surgeons,human surgeons will become obsolete, the patient-doctor relationship will vastly change, and thedefinition of surgery will be altered forever.
 
Robotic Surgery 3An Introduction to Robotic SurgeryTwenty-five years ago, if a patient were dispatched to the operating room with twisting pain due to an acute pancreatitis, a surgeon would swiftly make a nearly foot-long incision in her abdomen to investigate the cause and excise diseased tissue. She would be at risk for complications during surgery and recovery. Extensive post-operative bleeding and pain wouldhave her taking painkillers, and she would potentially incur adverse side effects or develop adependence on them. Her 12-inch laceration would require nursing and extensive soft tissueinflicted during surgery would keep her in the recovery ward for over one week (Park, 2006).Today, this radical invasiveness and prolonged recovery time is almost unheard of in suchsurgical procedures.Robotic technology has enabled surgeons to perform once-disfiguring procedures withfew complications, faster recovery time, and only minute scars. Arising from ideologies of thelaparoscopic movement toward minimally invasive surgical technique, robotic technology hasquickly evolved in the last two decades. Two popular robotic surgical systems are in widespreaduse across the United States, the da Vinci Surgical System and the Zeus Robotic SurgicalSystem. Though costly—both in the vicinity of US $1.5 million (Guidarelli, 2006)--almost 1000systems are in use in United States hospitals (IntuitiveSurgical.com). The FDA-approvedoperation list for these machines is constantly expanding, and more types of robot-assistedsurgeries are being performed every year.During earliest-developed robotic surgery, robots controlled by surgeons make centimeter incisions as ports for the insertion of miniature CT and MRI scanners, clamps, needles, andknives. Surgeons can perform many different procedures with robotic systems, including

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