Could healthcare robotics lead to surgery without surgeons?

Robot assisted surgery

In this article we discuss robot assisted surgery. Many industries are waking up to the benefits of utilising robots in their processes. From warehouse packing to manufacturing, specialised robots are continually being developed that are more efficient and effective than their human counterparts. The healthcare sector is no exception.

Emerging robotics technology for surgical use

Currently, robotic surgery would be better described as robot assisted surgery. Although robotic systems are used during the surgery, they are controlled by a surgeon.

robot assisted surgery systems such as da Vinci Surgery allow surgeons to operate instruments during minimally invasive surgery that are inserted into the patient through a series of small incisions. This can lead to faster recovery times for patients as the incisions are smaller and it gives the surgeon greater dexterity and manoeuvrability than by using their own hands to complete the surgery.

In robot assisted surgery, a robot can move and operate with perfect precision and create small motions that would be impossible for a human hand to make. A robot doesn’t experience tremors (e.g. an unexpected finger twitch) or suffer fatigue. It will function in exactly the same way at the end of the operation as it did at the beginning – can the same be said of the surgeon, especially during operations that span multiple hours?

The future of robot assisted surgery

In 2015, tech-giants Google announced that they were partnering with healthcare heavyweight Johnson & Johnson to develop healthcare robots with artificial intelligence (AI). They plan to use advanced imaging techniques, sensors and augmented reality in order to create more complex systems for robot assisted surgery.

The main purpose of the robots would be to increase the surgeon’s abilities and offer them greater control and insight rather than to replace the surgeon. Robot assisted surgery is about augmentation and assistive technology rather than handing over the wheel to a robot.

Nevertheless, is it such a jump to assume that, if AI-driven robots become mainstream in surgery, the next technological advancement would be to reduce the human element – or even remove it entirely?

If AI was developed to the point where robots were placed in full control of operations without any interference or control by surgeons, it would cease to be robot assisted surgery and would raise many important questions and dilemmas:

• Would the role of surgeons and clinical staff be obsolete?
• How would it affect procedure planning and diagnoses? Would highly-skilled, specialist doctors still be required for that or could robots learn how to diagnose a patient and automatically know the best way to treat them?
• Would operations be cheaper (due to reduced wages) or more expensive (to cover to the cost of the machines and surgeons to supervise)?
• What would people’s perspectives be? Would they trust a robot to operate on them, even if it was proven to be a safer option with a higher rate of success?
• What would happen if something unexpected happened during surgery? Would the robot be able to adapt to solve the problem, or would their pre-programmed knowledge fail to address the issue and potentially cause long-term damage or even death to the patient?
• Would robots be capable of learning and gaining experience with each operation that they complete? After all, surgeons thrive on the experience and natural human impulses – they are there to help others and preserve life. Would a machine ever be able to embrace and react to the desire to save a life?
• Could robots ever perform high-risk procedures that don’t follow the norm? If they operate based on programmed logic and the logic is telling them that the surgery has a very low chance of success, would their AI systems perhaps decide not to complete it?

Public perceptions and ethics

As robot assisted surgery becomes more widespread, issues surrounding public perception and trust need to be addressed. The thought of having mechanical equipment inserted into you during surgery can be terrifying.

An important part of a surgeon’s training is their ability to calm a nervous patient both before and during surgery – particularly when it is performed under local anaesthetic so the patient is awake and aware of their surroundings.

A comforting word can go a long way to soothing a patient; would a robot ever be able to have that effect?

The medical profession has an ethical duty to inform their patients of both the potential benefits and risks of choosing robot assisted surgery over traditional surgery.

Patient reassurance and trust are perhaps areas that may get missed out of these discussions. A patient may not realise until it’s too late just how much they need to see a calming smile, be told that everything is going to be ok and that the surgery is progressing smoothly.

At the moment, in robot assisted surgery surgeons remain in control of the robotics at all times. But what would happen if there was an equipment malfunction or the system went offline?

Safety and liability rules will surely need to be developed as surgical technology develops, particularly if AI is introduced in this field.

Asking the public to put their complete faith in a robot at such a critical moment – when it really is life or death – will take years of persuasion.

Perhaps as long as it takes to develop the systems in the first place.

If you were given the choice of having a self-thinking robot operate on you, rather than a surgeon, would you agree?

Who would you trust more – the surgeon, with their years of training and experience, or the robot with its enhanced precision and control?

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