Robots Approved For Cardiac Surgery 197
An anonymous reader writes "CNN has an article up on
a new robotic heart-surgery system. By making 4 relatively small incisions into the
patients chest the da Vinci
Surgical System, guided by real surgeons, uses its pencil sized "tools" to conduct
several different heart procedures including closed-chest coronary bypass surgery. By
operating on a patient with their chest closed, patient recovery times have reduced
from weeks to just days. Despite the robotic surgery taking longer than traditional
operations, this reduced recovery times makes the robotic surgery cost less
overall than traditional open heart surgery. Fortunately, if anything goes
wrong with the robot, the human surgeons can jump right in and pick up where the robot
has stopped. Already the robot (in place in over 130 hospitals world wide) has been
FDA approved
for Mitral Valve repair surgery. More insightful info on the da Vinci System here."
It's not the first such system, either.
That is awesome (Score:1, Funny)
Re:That is awesome (Score:2)
---
I've always wondered why Palestine/Iraq/Afghanistan doesn't simply train armies of script kiddies. They could cause as much mayhem as any suicide bomber in a Starbucks. Obviously I don't condone that kind of shit, but you have to wonder how far away we are from that reality. These suicide bombers aren't taking out tactical leaders, they're trying to incite fear and publicity.
Imagine an army of 1000 Iraqie script kiddies backed by 10 smart Iraqies who know how to audit C code and use disassemblers. I'm sorry to say that we'd be fucked.
---
How much coverage did the DoS'ing of eBay, Yahoo, Etc Co. get? WAY more than the bombing of some ship in Yemen.
All I can think of in these situations is a bug that a guy I know found in BIND. 90% of the root DNS servers in the world were vulnerable to it, just as they are to the recent ISS one. If someone in Afghanistan had found that instead of us, what would they do with it? They'd Hacked By Chinese every one of them. Imagine the implications of all the root NS's being hacked. Imagine the productivity loss in just a few hours. This is what we're up against. I'm afraid.
Re:That is awesome (Score:2)
It's funny as a heart attack.
Drum roll, please!
(Actually, it's quite a bit funnier: I chuckled at the joke a lot more than I chuckled when I had my heart attack.)
Is this a robot? (Score:5, Insightful)
Re:Is this a robot? (Score:2)
Re:Is this a robot? (Score:3, Insightful)
Is this a robot? Or is this a human surgeon performing surgery with a very sophisticated set of tools?
From the topic description: From the CNN article:These imply the human surgeons can just sit and watch while the robot goes about its work, but Da Vinci's web site says otherwise. I don't think there's any artificial intelligence involved, but I see where the confusion lies.
Scary... (Score:5, Funny)
Windows (Score:2, Insightful)
I'd prefer... (Score:5, Insightful)
When it comes to something that needs to be that robust, I want a control system consisting of highly reliable real-time (not pseudo-realtime like embedded distros) microcontrollers.
I want parts designed to last 20 years, not something that could fail in one due to a motherboard failure, or at any time due to a hard drive failure. Software just doesn't cut it here.
Reliable software possible (Score:2)
Think about the computer systems that control fly-by-wire planes in flight, the space shuttles, or nuclear weapon control systems.
"Possible" (Score:2)
In THIS application, the course control is handled by a human rather than a software AI. So no software is needed.
robots vrs doctors (Score:4, Insightful)
Re:robots vrs doctors (Score:3, Interesting)
I would argue that a robot capable of performing heart surgery is slightly more complicated than a TI83. Let's all remember that the number of errors in a system typically goes up with the complexity.
Re:robots vrs doctors (Score:2, Insightful)
First off, I don't have a TI-83. Real men have TI-92+s. Or a slide rule. Which I also have.
Secondly, what if the robot was running off, say, one of those famously screwy Pentium 90's or 100's with the floating point bug?
Third, what if it runs on Windows 95?
That being said, I'd still rather have the robot than some med school flunky that got his or her degree from some small Caribbean country.
I hate to be the guy who points this out, but (Score:5, Informative)
I mention it because I caught the news about a robot being involved in a surgery accident on the newswire a couple days ago, and then yesterday I caught a puff piece on the DaVinci system on the TV news (ABC, I think?) - no mention of that recent fatality.
No mention of the fatality in the CNN article, either. And for that matter, no mention of it here. I find this very strange. Slashdot editors missing it, I can understand. But wouldn't even the most brain-dead journalist make this connection? Let alone the big-leaguers?
Re:I hate to be the guy who points this out, but (Score:2)
Using this technology in surgeries, etc. is great, but could this be a case where humans blindly put their trust in the machine? Until this technology is perfected and absolutely error-free/failsafe/100% accurate, I'll opt for the human to do the surgery.
Risk factors (Score:2)
Re:I hate to be the guy who points this out, but (Score:4, Insightful)
Yes, because human surgeons are perfect!
That's why malpractice insurance is so damn cheap.
Re:I hate to be the guy who points this out, but (Score:2)
These 'scalpel' things are too dangerous. Until the technology is perfect and nobody dies from them (because we know the doctor never makes a mistake), I'll stick to my leeches.
Somedays I wonder how these attitudes survive evolution...
Re:I hate to be the guy who points this out, but (Score:5, Interesting)
Complications include things like having your chest split open again a few hours later. Yes, it happens. I've had to pick up 12 units of blood for a patient that had this happen (and at one of the best cardiac hospitals in the US too, not some random place). Those 12 units lasted long enough to get him from ICU to surgery. No idea if he survived or not - I was just a gopher.
Will the robot be flawless? Seriously doubt it. But you don't reject a new tool just because it has flaws -- as long as it has fewer flaws (or, hell, even more predictable flaws) than the tool or method that preceded it.
I'm very sorry for the person that died, as well as their families, and I hope that whatever situation caused that will be analyzed and fixed so that it doesn't occur again.
Hey, hold on (Score:3, Insightful)
Re:Hey, hold on (Score:2, Informative)
It's not the journalist's job to decide what was the fault of the machine and what wasn't. I basically trust the surgeons to do the right thing; it's the journalists I'd keep my eye on.
As I've said elsewhere, it's unclear how the accident happened, obviously, but with something like this I consider both the underlying technique as well as the user interface potential risk factors. Of course, it could just have been human error, but that's the whole point of risk factor analysis; the line between "human error" and a false expectation or a design problem does not actually exist.
unit? (Score:2)
I should know this kind of thing already, given the exposure I've had to the medical field, but how much blood is in a "unit"? Saying "12 units" doesn't communicate anything to a non-medical guy like me.
Actually, on further thought, it communicates a very wrong thing to me -- I'm a Type I diabetic, and to me "one unit" [of insulin] is 0.01 cc, or 0.01 ml. So "12 units of blood" sounds like something I would lose out of, say, a scraped knee. :-)
Re:unit? (Score:3, Informative)
Looking at Google:
unit (of blood)
a unit of volume for human blood and various blood components or products. A unit of whole blood is 450 milliliters, which is about 0.9510 U.S. pint. For components of blood, one unit is the amount of that substance that would normally be found in one unit of whole blood. The adult human body contains roughly 12 units of whole blood.
Re:unit? (Score:2)
Blood that you get from blood banks is not the same as what comes out of your arm though -- donated blood is processed into three different parts - red blood cells, platelets, and plasma. White blood cells (leukocytes) are usually removed because they're often not well tolerated by the recipient.
Red blood cells are generally referred to as a "unit". It's fairly easy to type-match since there's only 8 different base types (A, B, AB, O, and +/- RH of each; RH factors can now be removed so it's no longer a big factor - I'm O+ but the red cross stalks me down every 56 days because I'm as good as an O- for being a universal donor).
Platelets are needed for coagulation - when you get a cut platelets gather at the area and cause the blood to thicken and form a scab.
Plasma is the majority of the blood - it's essentially a suspension which everything else is in. It's also how the body gets rid of wastes and transports stuff around (including red blood cells, horomones, etc).
Re:I hate to be the guy who points this out, but (Score:2)
In reading the article, it would seem that the culpable party was the surgeon, not the machine. To trumpet the fact that the Da Vinci robot was involved in the operation would be a disservice to science and medicine--this was human error, not equipment malfunction.
It would be wrong to spotlight the tool in this case, just as it would be wrong to spotlight the surgeon had Da Vinci malfunctioned.
I was waiting for someone to make this mistake (Score:2)
Really? Point out where the article draws that conclusion.
As I just said elsewhere, it's unclear how the accident happened, obviously, but with something like this I consider both the underlying technique as well as the user interface potential risk factors. Of course, it could just have been human error, but that's the whole point of risk factor analysis; the line between "human error" and a false expectation or a design problem does not actually exist.
Re:I was waiting for someone to make this mistake (Score:5, Interesting)
Well, to quote the article,
The hospital and Intuitive Surgical Inc., which manufactures the da Vinci Surgical Systems robot, evaluated the machine and found no mechanical problems. [Hospital president Isaac] Mallah said the robot did not cause the problem. It does not act without prompting and is always controlled by a trained surgeon.
There really isn't room for ambiguity in that statement; the hospital president says flat out that the robot was not the cause of the problem.
As I just said elsewhere, it's unclear how the accident happened, obviously, but with something like this I consider both the underlying technique as well as the user interface potential risk factors. Of course, it could just have been human error, but that's the whole point of risk factor analysis; the line between "human error" and a false expectation or a design problem does not actually exist.
Yes, it is unclear how this happened, but I stand by my statement that the machine should not receive undue media attention at this time, especially in light of the fact that 1) the investigation is young, ongoing, and under the auspices of regulatory agencies; and 2) the machine was found to have no mechanical problems.
A media scare could easily set this medical development back several years. Doing so prematurely on and little evidence would be a terrible disservice to those who could benefit from this type of surgery.
Re:I was waiting for someone to make this mistake (Score:5, Informative)
I'm not even sure how you can believe your own words. By your "no room for ambiguity" standards, this should be an article titled "surgeon error results in patient death." It should say not "something went terribly wrong," but "the surgeon made a terrible mistake."
Fortunately, you immediately contradict yourself by admitting that it is unclear what caused the problem - the correct conclusion to draw from the article. Perhaps, if you were considering surgery with this tool, you would suddenly take a much keener interest in these fine points. By the way, taking into account the nature of the injuries, do you think this would have happened without the robot?
Your reasons for silence by journalists are particularly specious. Finding "no mechanical problems" should not be confused with "finding no problems" - again, two entirely different things. Even as a layman, I would not assume the problem was mechanical. Nor would I assume that any part of the machine "acted without prompting." Neither are very reassuring assertions. Rather, considering the circumstances (aorta cut going unnoticed for 90 minutes), one expects an interface problem, or a problem with the underlying technique. Remember, you're working in unconventional ways in tight spaces. The purpose of these trials is to evaluate the risks. Cases like this can expose important ones.
Perhaps if people left choices about medical treatments to their doctors, and there were no regular ads for drugs, medical facilities, and services targeted directly at consumers, you could make the argument that the mainstream press could be forgiven the omission. Unfortunately, this is not the case.
What do you consider "undue media attention?" Should fatalities be kept secret? Or just "not reported" in most venues? Would you like to discuss the difference? And remember, we're not talking about a quick spot; this is during extensive coverage of the device and the technique... not even then?
But where you've made the largest leap of all is the false dilemma between silence and "a media scare [that] could easily set this medical development back several years." I'm frankly shocked; proper handling, full disclosure, and maximum awareness of cases like this push medical development forward, not backwards. The only thing they might set backwards are the bottom line of the company selling the drug/device/procedure. The incentive on the part of that company to minimize such evidence, to "make the product appear to be perfect" is very powerful, often with hundreds of millions and even billions at stake...
I'm surprised to find myself getting this basic, but the foundation of both capitalism and democracy is one of full disclosure, where voters and buyers are trusted to make their own decisions given all the facts. It does not admit "fear of scaring people off" as a reason not to discuss fatalities resulting from a new product or service.
Re:I was waiting for someone to make this mistake (Score:2)
But, the investigation is currently underway. While a number of people associated with the situation have stated that the robot wasn't at fault, we'll just have to wait and see what the result is. So, what should be done in the meantime?
If you report that somebody died under the robot without knowing the full facts and filling our your article with speculation, you're just going to scare people. Now, perhaps the robot needs to go back for redesign, but if the investigation shows up an issues, it'll probably get its FDA approval removed (don't forget, it is approved for use by the people empowered to keep your surgeon from using something dangerous on you) -- and then you can report to your heart's content and scare people rightly... although it'll be moot since it'll have its approval revoked anyway.
But what if it wasn't the robot's fault, and you just created a scare? People who would have been operated on by the robot now refuse, end up elect for something that's actually more dangerous and you get more people dying due to complications.
So why don't we all just sit and wait for the results to come out before making judgements?
Re:I was waiting for someone to make this mistake (Score:2)
Re:I was waiting for someone to make this mistake (Score:2)
Remember saccharine?
It was found that, in near-fatal quantities over an extended period of time, saccharine could cause cancer in lab rats.
The media picked up the results of the study, read "saccharine causes cancer!", and the rest is history. For years, saccharine was considered a horrible, dangerous substance by many people, despite repeated responses from scientific authorities to the contrary. Why? They'd seen it on the news! They'd read it in the paper! Saccharine causes cancer!
Was it responsible, ethical, or right of the media to so thoroughly slander the safety of saccharine? Is this how the media is meant to keep the public informed?
I'm surprised to find myself getting this basic, but the foundation of both capitalism and democracy is one of full disclosure, where voters and buyers are trusted to make their own decisions given all the facts. It does not admit "fear of scaring people off" as a reason not to discuss fatalities resulting from a new product or service.
And I'm saying, again, that the fact that the Da Vinci machine was used in this operation has been disclosed, that an investigation by regulatory agencies is underway, and that media speculation on this matter would be premature and irresponsible at this point.
The media is not a panacea for society's ills, no more than the government or industry. I continue to believe that the media is acting in a careful, responsible fashion.
You repeatedly attack me for advocating silence; I do not advocate silence. I advocate discretion. I advocate responsibility. I have full faith in the media's ability to root out foul play and bring it to light--journalists live for such a major break, and there are undoubtedly several digging into the matter. I also know fully well that an unscrupulous or agenda-driven journalist could do immense harm to the progress of this surgical device by playing off people's fears of robots and machines performing heart surgery.
Full disclosure is but part of the foundation of both capitalism and democracy. Trust, diligent review, and due process are all essential bricks in that same foundation.
Why is it that you do not clamor for the details of the surgeon's history? Why do you not ask about whether or not he's been under undue stress, or if he has a history of errors in other surgical procedures--after all, it is a hospital official who claims that the surgeon is experienced and highly skilled, and don't hospital officials have a vested interest in protecting their own? I mean, this guy is still practicing at that very hospital! Why have you chosen to target an entirely surgeon-guided tool instead of the surgeon himself?
Re:I was waiting for someone to make this mistake (Score:2)
I am deeply disillusioned with the media industry, though in this case, I am not even making an allegation of corruption. Foremost, they have an inherent problem with their dependency on advertising and sponsorship, often by the very companies they are reporting on. Like Aurther Andersen doing "consulting" for Enron while "auditing" their finances. Then there's the inexplicable consolidation, which leaves ownership of huge swaths of the media in a single pair of hands. You are naive to assume the media is doing the right thing in a particular instance. But I digress.
You say "I do not advocate silence. I advocate discretion." We have a very specific context, in which I don't think you even have that hair to split. I understand your point, and your anecdote about saccharine is instructive, but your false dilemma remains. There is a long distance between the "discretion" of glossing over recent fatalities during in-depth coverage of a device or technique, and doing "immense harm to...progress." A terribly long distance.
I am not advocating irresponsible or "unscrupulous" journalism; however, I worry that with your emphasis on "discretion," you are. I think it obvious that journalists doing in-depth coverage of DaVinci could report on the fatality, and even quote experts involved in the investigation, without arousing panic that would set back science.
Frankly, both "discretion" and "openness" have been tried over the years in various media cultures. As it turns out, a policy of "discretion" is unambiguously dangerous (did you ever spend any time in the Soviet Union?) and a policy of "openness," for all its "perils" is unquestionably safer, not to mention its respect for the dignity of the audience.
Let an unscrupulous journalist fear-monger about robots surgeons. I will line up with you to condemn it. This doesn't even touch my point.
Also, I wanted to ask; do you think I am correct in my understanding that massive-dose experiments are conducted in order to discover through "saturation conditions" what potential cumulative effects and other risk factors might be; thus increasing the case for further (including long-term) study? Or will you imply that massive-dose experiments are simply animal torture which serves no scientific purpose? To put it in perspective, I don't avoid eating saccharine, but I think you're equally out of bounds implying, as you perhaps have in both cases we've discussed so far, that there is no risk that these new developments won't pan out in the end, and no gain in media coverage of any problems.
Re:I was waiting for someone to make this mistake (Score:2)
Re:I hate to be the guy who points this out, but (Score:2, Insightful)
IANAMD, however I am certain it is not the first time that a new surgical technique designed to be less risky for the patient was actually more risky because of the novelty it presented the surgeons performing it. There's no way to leapfrog the novelty of the technique, but in the long run, for the general public, it will be less risky because it is less intrusive.
Re:I hate to be the guy who points this out, but (Score:2)
Re:I hate to be the guy who points this out, but (Score:2, Interesting)
Re:I hate to be the guy who points this out, but (Score:5, Insightful)
I, for one, would much prefer to be operated on using this new system--the electronics damp out tremors, and I don't have to worry about a surgeon sneezing and lacerating my intestine. The trauma of major incisions is eliminated, saving me from weeks of hospital food, pain meds, and severe scarring.
Surgeons will take time to become accustomed to this new system. Without a gaping incision, it is harder to see what's going on. There are new failure modes possible. A nick in the aorta is immediately obvious in conventional surgery, not so much so under these conditions. There may also be a 'novelty' penalty. This is a new technique, so there aren't really any experts in the field who have performed thousands of procedures with these devices. There is a learning curve.
Nevertheless, medical decisions are usually made on the basis of a risk calculation. If there are fewer overall complications and deaths, then I'll accept 10 robot-related deaths per year in exchange for the prevention of 100 lethal post-op infections due to poor wound healing.
I've made this point elsewhere (Score:2)
1) No mechanical fault != no fault. I'm amazed I have to point out this distinction so often.
2) "There are new failure modes possible." Exactly. See? I think you already understand.
3) "I'll accept 10 robot-related deaths per year in exchange for the prevention of 100 lethal post-op infections due to poor wound healing." You just made those numbers up. Wouldn't it be nice if that were true? That's what the trial is meant to establish.
4) I have no criticism for the robot or its designers. Any judgement (positive or negative) would be premature. My point is about the news media, which has sloppily or mysteriously (probably the former) failed to mention some relevant facts when reporting in-depth about the device - like a very recent fatality under provocative circumstances.
Do you think surgeons perfoming that kind of operation (removing a cancerous kidney) routinely sever the aorta and then fail to notice for 90 minutes? This sort of info is just the sort of thing that rounds off a well-written story on a new technique.
Re:I've made this point elsewhere (Score:2)
Re:I hate to be the guy who points this out, but (Score:2)
The CNN article was talking of the use of this robotic technique in cardiac surgery.
The patient death concerned the use of the same equipment, but in renal surgery. This is a very different situation-- the surgical approach is entirely different-- the whole operating room is set up differently. Very different techniques are in use. The profiles of risk factors are extremely different both in the OR and postop.
This is analogous to developing a trans-Sahara four wheel drive vehicle and all the procedures for its safe use, and then trying to adapt it to arctic conditions. Yeah, snow drifts and sand dunes have a lot in common. With some modifications to the procedures, the vehicle might well be as safe on the snow as on the sand. But the fact of an accident in a Montana blizzard of itself means nothing with regards to the vehicle's safe performance in the Sahara.
In my opinion the news has acted responsibly in not tying the fatal renal operation into a report on a new and extensively developed set of cardiac procedures. There is as yet no reasonable basis for making that connection, and there might never be.
Re:I hate to be the guy who points this out, but (Score:2)
Re:I hate to be the guy who points this out, but (Score:3, Informative)
Re:I hate to be the guy who points this out, but (Score:2)
The aorta runs from its arch over the heart to where it bifurcates in the pelvic bowl into the left and right femoral arteries. The kidneys sit very close to the aorta, and another huge vessel, the inferior vena cava. The kidneys connect between these two.
During renal surgery, the patient is positioned on his side and the table is bent upward to stretch the area between the base of the rib cage and the crest of the pelvis. One of the implications of this is that bleeding from a nicked vessel could easily go undetected with the blood pooling at the bottom of the abdominal cavity. This would be consistent with the ninety minute delay before the patient developed signs of trouble. If he had not been recovering from anesthesia, he may well have reported a lot of pain and shown signs of an "impending doom" anxiety that would have tipped off the nursing staff to a problem. But during those ninety minutes he would have been returning to consciousness.
I am very puzzled by one aspect of this case. It seems from the reports that excision of the kidney was intended from the start. That would require the kind of long incision whose avoidance is one of the chief reasons for using the robot. Also the renal procedure is an abdominal one, not a thoracic one, and the risks that the robot was designed to minimize are much less severe in the abdominal cavity. So I'm puzzled about what the perceived benefits for using the robot in this area were supposed to have been.
Re:I hate to be the guy who points this out, but (Score:5, Interesting)
it depends largely on where the aorta is cut. If you're talking about the major section of the aorta, near the aortic and mitric valves, then yes - the internal bleeding would be catastrophic, and the patient would die in a matter of minutes.
it sounds like this article is describing a cut in the aorta farther away from the heart than you're thinking. that would cause significantly less bleeding, and since imaging of such a location would be a secondary consideration, a complication in that area could go unnoticed for some time.
at any rate, a surgical system like the da Vinci could one day save many, many lives. I've got Marfan's Syndrome, and suffer from leaky aortic and mitric valves, as well as an aorta within 5mm of dissection. Closed-chest robotic surgery of this kind, which causes almost no damage to the heart and its effected connective tissues, would almost eliminate the need for me to undergo open-heart surgery one day.
Systems like this should be adopted cautiously, but i think that their introduction would lead to a dramatic drop in complications post-op, which is one of the the leading causes of death among open-heart surgery patients. Even those that survive the surgery are often left with drastically diminished cardiovascular capacity, due to the degree of trauma inflicted on the heart during the surgery. This was my father's case - he underwent open heart surgery twice to replace his aorta. The repeated surgery left his heart on a hair's trigger - the result of complications non-invasive surgery could have prevented.
pardon the soapbox, but this is a fairly close-hitting topic for me.
-WarbleVX
don't trust it... (Score:2)
unless it has stopped after impaling itself thru your heart i guess..
I don't mind having a surgeon drive, but totally automated makes me a bit nervous.
Re:don't trust it... (Score:5, Informative)
Quick! (Score:1)
Bot: *pause* I'm sorry. I can't do that.
Technology... oy.
Who to Sue? (Score:3, Interesting)
Doc
Re:Who to Sue? (Score:5, Informative)
- the surgeons involved
- the hospital
- the manufacturer of the device
- possibly the other staff depending no the nature of the, uh, "problem"
Once in court, the insurance companies for these individuals will duke it out and the "blame" for the "accident" will be divvied out between all the members. So the docters will be held x%, hospital y%, manufacturer z% where x+y+z==100.
This is standard lawsuit fare, no different really. It's all in the percentages and who pays what amount. In the end it's always trivial to find all parties involved at least partially responsible.
Re:Who to Sue? (Score:2, Interesting)
No, he is not there, but he is not at the controls. Who was at fault for the Valdez oil spill? r>The captain was in charge and he was bui (boating under the influence). He did not actually throw the oil overboard himself but when he steered the boat into the reef, he caused the oil to spill.
The scientists will be at the helm of the robots so if anything goes wrong, they will have to take the rap and they will have to defend themselves in court when someone sues for malpractice.
Re:Who to Sue? (Score:2)
I think this is an extremely mission critical tool and the engineers should take the rap if it blue-screens. I mean what happens if a patient dies because a scalpel breaks in half and it turns out the scalpel company was cutting corners that month? is that the doctor's fault?
But if the guy gets sewed up with the robot still inside, thats another story..
Cardiac Surgery (Score:4, Insightful)
Re:Cardiac Surgery (Score:2)
Re:Cardiac Surgery (Score:2)
Other problems? (Score:5, Insightful)
Re:Other problems? (Score:2)
other defects or abnormalities with the heart and surrounding vessels.
Funny, my auto mechanic always seems to find a bunch of latent problems with several unrelated parts of my engine whenever I go in for a simple oil change...
Re:Other problems? (Score:2)
Realistically, the number of problems found incidentally in surgery is dwarfed by the number of problems that cutting open someone's chest, sawing their sternum in half, jacking open their ribcage and then stapling the whole thing back together again.
It's like saying that it's better to reboot a healthy system when the webserver crashes because you might fix other problems that you haven't noticed yet -- Windows logic.
incisions? (Score:5, Funny)
...
Fortunately, if anything goes wrong with the robot, the human surgeons can jump right in
I think they're going to need bigger incisions...
manufacturer's url (Score:4, Informative)
scary but probably good (Score:4, Insightful)
I however, would not like to be one of the beta testers for this thing!
I hope the control computer is not networked (Score:3, Insightful)
Re:I hope the control computer is not networked (Score:2)
That said, if you really wanted to assassinate someone in a hospital, there are quite a few ways to do so that are already accessible to the determined murderer. Slip into the recovery room and inject a shot of potassium chloride into one of the victim's IV bags. Very effective. Or just use a pillow, if you have some privacy.
If you want them to die in surgery, tamper with the equipment that monitors vital signs. Continuously read out healthy blood pressure and pulse. Bonus points if you can deliver a small electric current across the EKG leads. Mess with the anaesthetic gas mix. Quite a few people die under general anaesthetic even when things go right.
Frankly, if you're going under the knife and you're going to be unconscious, then you're pretty vulnerable. Be glad that your surgeons are using tools to minimize the trauma to you. If you really fear assassination, then lock yourself in the basement with a bottle of Scotch, and wait for your inflamed appendix to kill you itself.
Re:I hope the control computer is not networked (Score:2)
I do not fear assassination - I just wanted to raise discussion hoping someone would have more details on HOW it is secured - they obviously must have thought about it and there might be something to learn. If the control console has any interface it is likely that tbere exists something that you can plug into it. And there probably is some interface for doing maintenance tasks. There's bunch of off-the-shelf gadgets which allow you (simulate running) about anything over anything, for example serial over wlan. IMHO, obfuscation is the only thing that guards the console unless someone can point otherwise.
Re:I hope the control computer is not networked (Score:2)
Instead, explain me why it is impossible? If the control console has any interface it is likely that tbere exists something that you can plug into it. And there probably is some interface for doing maintenance tasks. There's bunch of off-the-shelf gadgets which allow you (simulate running) about anything over anything, for example serial over wlan. IMHO, obfuscation is the only thing that guards the console unless someone can point otherwise.
That's just silly! (Score:2)
Hmm... (Score:3, Funny)
Re:Hmm... (Score:2)
You may be able to continue normally. Press any key to continue.
*presses key*
General Protection Fault in module SuperiorVenaCava32.dll
You may be able to continue normally. Press any key to continue.
*presses key*
WARNING!!! System Resources Dangerously Low. It is reccomended you save your work and restart the system.
Ironic?? (Score:2)
Anyone else find this random quotes appearing at the bottom of stories today ironic? I haven't looked at Slash, but it looks like two quotes are randomized daily maybe?
Re:Ironic?? (Score:2)
No more "lost" watches .... (Score:2)
"the robot left a servo in the patients chest, DOH!"
Robotic Surgery Link - CSTAR (Score:5, Interesting)
They seem to have quite a few robotic surgery firsts. Pretty neat stuff.
Our men in Uniform (Score:2, Interesting)
This is definitely only the beginning, while most of us
[ADV] Robot Insurance, because you never know! (Score:3, Interesting)
For when the metal ones come for you...
I would like to ask a favor (Score:4, Funny)
Robotic surgery may cause brain damage (Score:3, Interesting)
They thought it might be due to the time spent on the heart-bypass machine or that time spent with the body cooled might be affect the brain in some unknown way yet. Thuse when reading this article and it stating that the surgery takes much longer but the hospital stays are shorter might in fact be hiding the fact that the rate of cognitive damage might go up and not be detected until months afterwards.
Re:Robotic surgery may cause brain damage (Score:2)
So you're saying that because there's no evidence of something, it must be true? My freshman year logic instructor would not approve.
Re:Robotic surgery may cause brain damage (Score:2)
Correlation != Causation
It could be something else entirely. For example, the decrease in cognitive ability could be due to the invasiveness of traditional surgical methods or from ingesting too much hospital food - I jest, but the fact remains that one study does not prove anything, especially when it only establishes correlation (which is weak) instead of causation (which is strong).
Human in the loop? (Score:2)
Yeah... assuming the doctors notice that anything is wrong. As pointed out in the Risks Digest [ncl.ac.uk] recently, a surgeon-controlled robotic surgery in Tampa went terribly wrong [sptimes.com] in October; while attempting to remove a patient's cancerous kidney, the surgeon (or robot - the root cause hasn't been identified) cut the patient's aorta, an accident which went unnoticed until an hour and a half later! The man died two days later from complications related to the surgery; no mention of whether the complications are a result of the accident. But if they were, would the hospital or doctor admit it?
--Jim
Lower risk of Staf Infections? (Score:4, Insightful)
He had a triple bypass, and was up and around his room the next day. We were like "way to go dad!".
The day after that he had a fever. Within a week he was in a coma, and 2 1/2 months after the operation he was gone. It was horrible. And all because he caught a Staf infection.
It could be that maybe a surgical implement wasn't as clean as it sould be... more than likely, he just caught it from bacteria floating around in the air. He was on the table for more than a few hours.
I hope to god that advances like this can keep someone else from going through the hell that he (and we) went through. The way I see it, the less invasive the procedue it, the less likely it is that an infection will occur.
Re:Lower risk of Staph Infections? (Score:2, Informative)
A slightly different problem occurrs to me, though:
In the UK recently in the light of nvCJD there've been moves to make surgical implements which are used in high-risk procedures (in this case those on lymphatic tissues) strictly single use. Even including things like cauterising irons. It seems likely that this is going to be an increasing trend as we get progressively more paranoid about this kind of thing... so, how much of this robot is disposable? What does that do to the cost-balance and to the quality of the parts being used (in the case of the cauterising irons the rule has been repealed as cheaply imported 'disposable' irons were killing patients)?
I assume all the parts that actually go inside the patients are fully sterilisable at the very least, but this does add extra wear to the parts and increase the risk of a mechanical failure...
Re:Lower risk of Staph Infections? (Score:2, Interesting)
Doc (Score:3, Funny)
On the next season of Junkyard Wars .... (Score:5, Funny)
Each team will do three surgeries tomorrow in a head to head competition. The team who spills the least amount of blood and has the most living patients at the end, wins!!!
Okay teams, you have 10 hours to complete your robots. Get ready, set
See this one in comp.risks, issue 22:36? (Score:2)
As just a matter of information... (Score:5, Informative)
In no way is this a "robot" it is a motion transference device. It reproduces your motions with multipliers applied to them (either greater than or less than 1 multiplier) for increasing or decrease the distance traveled of the instrument. It is progress when compared to plain laparoscopy because you are no longer as limited to the angles and degree of freedom.
Trademark (da Vinci™) (Score:2)
Dr. Bender, Heart Surgeon (Score:2)
Alternative title for article: (Score:2)
I just attended a conference on this... (Score:2)
not a robot (Score:2)
Could it be used for the Big Dig? (Score:2)
Re:Hmm (Score:5, Insightful)
What do you think is scarier, having your chest peeled open like a book, or the alternative. As someone whose father just recently went through open heart surgery, I can say the process would be nerve racking either way.
And while the surgery is bad, the recovery is probably worse. Painful, long, and frustrating. Anything that can shorten the recovery process is a wonderful thing, IMHO.
Re:Hmm (The Dr. McCoy Problem) (Score:3, Interesting)
Just like Star Trek. Which brings me to my concern. I can't really envision Dr. McCoy jumping in there. Once such systems are commonplace, will the doctor eventually become a mere medical technician? In 50 years, will the guy watching the surgery know what to do when MS Surgery blue screens?
Not that the percentages might be better, humans make mistakes too, but I'd hate to see the profession suffer. If nothing else, it will decrease the demand and even the perceived need for highly skilled surgeons (well into the future, of course). This could cause a shortage in which it really is just a sys-admin watching Dr. Roboto tinker with your innards, ignorant of what the hell is going on.
Re:Hmm (The Dr. McCoy Problem) (Score:2)
McCoy was a bad example. Take the holographic doctor from Voyager. His role was to diagnose patients and reccommend treatment. If something went wrong with his instruments, Torres or Kim were brought in to fix it.
Re:Hmm (The Dr. McCoy Problem) (Score:2)
Re:Hmm (The Dr. McCoy Problem) (Score:2)
My original posting was done at work, so was limited, but to expand on the idea, it goes like this. Robotic/machine/semi-automated surgery becomes commonplace (and I'm talking many decades here). Because of this, demand for a fully trained doctor decreases. People can use computer programs and home diagnostic equipment, standard operations are now mostly automated, with many procedures not even requiring an atending physician (those where an error or complication would not introduce greater risk and need not be dealt with immediately).
This wouldn't mean that we wouldn't still need doctors, it would mean that doctors don't get paid as much. Insurance is already through the roof and many doctors routinely refuse to deliver babies or perform certain procedures where the likely hood of a suit is much greater. If machines speed up procedures, then even with greater reliability, the overall incidence of complication (especially since many complications are due to patient factors) might not decrease, and the net effect would be a wash (I'm assuming the doctor population goes down).
Why does the doctor population go down? Because insurance costs and costs of doing business are unlikely to decrease (indeed, with all this equipment, they'll likely increase), while pay, respect, and power decrease.
Certain types of doctors will still be in high demand, but, I'm saying that there are certain scernarios where the overall number of doctors decreases to problematic levels.
Re:I would LOVE to see MD's put out of a job by SW (Score:2)
As are lawyers, plumbers, dentists, and many of the professional professionals. I'm only talking a scernario, and a long term one at that.
Re:Concern: Time Under Anaesthesia (Score:2)
Could well be. It's the right brain that's pessimistic, if I recall correctly, so perhaps damage to the left brain caused this.
On the other hand, pychological stress resulting from the heart disease or the surgery might be to blame as well. In my case, since having a heart attack, I'm rather more pessimistic (realistic?) about my chances of living a long life.
Of greater impact on a daily basis, however, is that I tend to worry over any shortness of breath, heartburn, angina, or upper back pain, wondering if it is the onset of another attack. As these symptoms are also symptoms of common and negligable problems, I end up spending more time than I'd like, wondering if I'm about to die or end up in an emergency room. That tends to make a man a little less cheery.
Re:No thanks. This kills (Score:3, Insightful)
You're joking, right?
Look, this thing isn't a "robot" in any real sense -- it's not taking away control from the doctor, it's a sophisticated tool which has the potential to do as much for surgery in the next few decades as the laproscope did in the last few.
If the doctors start skipping steps, it's their fault, not the tool's. Like certain other people in this thread, you're applying Windows logic ("It should have done this for me and covered my ass!") in a UNIX situation -- the tool is meant to be used by someone who understands it and knows what they're doing.
If some newbie rm -rf's his filesystem, it's his fault, not the OS's.