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Robotics United Kingdom Science

Surgical Robots Cut Training Time Down From 80 Sessions To 30 Minutes (theguardian.com) 113

From a report: It is the most exacting of surgical skills: tying a knot deep inside a patient's abdomen, pivoting long graspers through keyhole incisions with no direct view of the thread. Trainee surgeons typically require 60 to 80 hours of practice, but in a mock-up operating theatre outside Cambridge, a non-medic with just a few hours of experience is expertly wielding a hook-shaped needle -- in this case stitching a square of pink sponge rather than an artery or appendix.

The feat is performed with the assistance of Versius, the world's smallest surgical robot, which could be used in NHS operating theatres for the first time later this year if approved for clinical use. Versius is one of a handful of advanced surgical robots that are predicted to transform the way operations are performed by allowing tens or hundreds of thousands more surgeries each year to be carried out as keyhole procedures. The Versius robot cuts down the time required to learn to tie a surgical knot from more than 100 training sessions, when using traditional manual tools, to just half an hour, according to Slack.

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Surgical Robots Cut Training Time Down From 80 Sessions To 30 Minutes

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  • GOOD! (Score:3, Interesting)

    by 50000BTU_barbecue ( 588132 ) on Sunday July 08, 2018 @09:06PM (#56914174) Journal

    As someone who needs surgery in the deranged health care system in Quebec, anything that can remove these arrogant human doctors from the loop and make surgery perhaps a nurse-practitioner thing is GOOD.

    I've had it with the arrogant ignorant incompetent condescending doctors that fill the system here and anything that can threaten their hegemony is GOOD.

    Bring on the AI diagnosis, remote-viewed autosurgery please.

    Anything to kick these complacent doctor's asses!

    • And if I survive the system here and I'm done suing the series of buttfuck ignorant motherfuckers that didn't do their jobs, I'll use the money to start my own doctor-removing technology!

    • As someone who needs surgery in the deranged health care system in Quebec, anything that can remove these arrogant human doctors from the loop and make surgery perhaps a nurse-practitioner thing is GOOD.

      You had a healthcare system?

      We used to *dream* of having a healthcare system!

      (Still do, actually...)

      • Be careful what you wish for. I don't know what the solution is, but the larger a system becomes, the more rot sets in.

        • by phantomfive ( 622387 ) on Sunday July 08, 2018 @10:51PM (#56914460) Journal
          That's why I think the arguments about "public" or "private" are rather silly...... It's better to evaluate individual proposals to see what is better. Some people think "single payer" is magic that will make everything, better, but it's not. Some people think the free market is magic that will make everything better, but it's not. Clearly we need regulation, but what type of regulation exactly? Each regulation needs to be evaluated on its own merits (and good luck with your health problems).
          • What we need is for Government to stop deciding what "health care system" ought to look and be like. Because what works for you, may not work for me, and visa versa. Government can't provide flexibility that individuals want. But then again, the "one size fits all" approach is exactly what the idiots who love and crave for Government Controls think is appropriate because it is "fair" (it isn't fair, it isn't even close to being fair).

            My proposal for health care would give the greatest flexibility to the gre

            • My proposal for health care would give the greatest flexibility to the greatest number of people

              I'm not entirely sure what you mean here. How would you make it more flexible?

          • by Kjella ( 173770 ) on Monday July 09, 2018 @02:19PM (#56918522) Homepage

            That's why I think the arguments about "public" or "private" are rather silly...... It's better to evaluate individual proposals to see what is better.

            No, that's exactly why a public system works better - they're your patients whether you like it or not, always and forever. The primary reason the US needs to spend twice as much to have the same level of healthcare is that everyone is trying to cherry pick profitable patients and get rid of unprofitable patients, with hospitals billing for things you don't really need while insurance companies work to avoid paying claims. Health insurance is not like fire insurance or auto insurance where you either had a fire/crash or you didn't. Bad health comes crawling with risk factors, precursors, complications, good and bad periods and chronic issues people live with and insurance companies are trying to pick up the warning flags and get rid of you.

            In the public system, single payer basically means it's a single bill. Doesn't matter if it's now or next year, at this hospital or that hospital, if you've got cancer we're going to end up paying for treating that cancer. The whole system is geared towards what's medically the most efficient way to treat it, we have a pool of money and it's constantly being evaluated if we spend it on the right things - from the patients' perspective. If there's a cheaper generic medicine we just decree it's the default and you only get other brand medicine if you experience side effects. The pharmacy industry hates this. There's still huge debates on say placements of hospitals and what treatments to support, but it's mostly based in medicine.

            It's still not funny... your child is going to die, there's a medicine that could help extend their life but it costs $1 million dollars. At some point somebody has to consider if not 100 $10k treatments or 10000 $100 prescriptions are better for the public health. But if we're doing it with the public's money at least we are considering it, not by what insurance plan you have. Unless you're in the small minority that has private health insurance that lets you get certain surgeries quicker or could afford crazy money out of pocket. But for the money you're getting good care in the public system. And it turns out fixing poor people's simple health problems often avoid big expenses later, we want you healthy enough to be a tax payer. Otherwise some other part of the system will get stuck with the bill.

            • No, that's exactly why a public system works better - they're your patients whether you like it or not, always and forever

              OK, let's see your specific proposal.

              The primary reason the US needs to spend twice as much to have the same level of healthcare is that everyone is trying to cherry pick profitable patients and get rid of unprofitable patients, with hospitals billing for things you don't really need while insurance companies work to avoid paying claims

              Oh, I see you haven't actually looked at data: you're just guessing and wishing.

              • by Kjella ( 173770 )

                Oh, I see you haven't actually looked at data: you're just guessing and wishing.

                No, those are the facts. You just don't like them.

                • ok, let's see if you are irrational or not, as well.

                  Can you name any way the US system is better than Canada's?
    • by Aero77 ( 1242364 ) on Sunday July 08, 2018 @10:28PM (#56914408)
      Surgical robots are electro-mechanical systems that are manually controlled by the doctor using controllers. They dampen movements to turn human hand movements into finely controlled robotic movements. This isn't Star Wars and surgical droids don't perform the operation autonomously. For the google-impaired: https://en.wikipedia.org/wiki/... [wikipedia.org]
    • Re:GOOD! (Score:4, Insightful)

      by grep -v '.*' * ( 780312 ) on Monday July 09, 2018 @05:34AM (#56915344)

      Bring on the AI diagnosis, remote-viewed autosurgery please.

      Agree, but:

      SystemW: Knife cut last muscle holding heart in place.
      SystemW: Remove knife.
      SystemW: Automatic WSS snapshot.
      SystemW: Hand successfully grasped, removed heart.
      SystemW: Old heart released over receiving bin.
      SystemW: New heart picked up.
      SystemW: New heart placed in patient.
      SystemW: Windows forced updates occurring. ETA: 20 minutes.
      SystemW: Windows forced updates occurring. ETA: 22 minutes.
      SystemW: Windows update failure. System restore in progress.
      SystemW: System restore successful, resuming operations. ;-)
      SystemW: Hand out of place! Reoriented.
      SystemW: Hand successfully grasped, removed heart.
      SystemW: Old heart released over receiving bin.
      SystemW: New heart picked up.
      SystemW: NOTE: heart is lighter than expected.
      SystemW: New heart placed in patient.
      ...

    • by dcw3 ( 649211 )

      Personally, I could give a shit if my doctor is an arrogant asshole, as long as he's a top notch surgeon, he can autograph is work of art for all I care. I'm not paying to have my him kiss my ass, I'm paying for as close to perfection as I can get, and there are a lot of arrogant perfectionists out there.

    • As someone who needs surgery in the deranged health care system in Quebec, anything that can remove these arrogant human doctors from the loop and make surgery perhaps a nurse-practitioner thing is GOOD.

      Tell me that again when you are coding on the operating table. You don't need a surgeon for many routine surgeries. That's not why you want a surgeon. The value of a surgeon is for when something unexpected or particularly serious happens. And the fun thing about operations is that you never quite know when that is going to happen. So go right ahead and have someone less qualified do your surgery and pray nothing goes wrong. Frankly I think the arrogant one here is you.

      I've had it with the arrogant ignorant incompetent condescending doctors that fill the system here and anything that can threaten their hegemony is GOOD.

      As opposed to the arrogant, know

  • according to Slack (Score:5, Informative)

    by phantomfive ( 622387 ) on Sunday July 08, 2018 @09:08PM (#56914178) Journal
    If anyone read the summary and is wondering why Slack is mentioned as an authority here, Slack is the last name of one of the doctors involved, not a crappy IRC replacement.
    • If anyone read the summary and is wondering why Slack is mentioned as an authority here, Slack is the last name of one of the doctors involved, not a crappy IRC replacement.

      That didn't bother me as much as reducing 80 sessions down to 30 minutes: How to compare two numbers when they measure different things?

      Slashdot is apparently not a tech-oriented website.

      • by Anonymous Coward

        couldn't even make it to the first bit of the tfs which uses 'hours' instead of 'sessions'? a knot-tying training session is, apparently, about an hour long.

        but, regardless of the 'unit of measurement' of the length of a training session... this does not account for the fact doctors will still need training in how to do things the 'old' way, PLUS this fancy 'new' way, PLUS for emergency procedures for when the fancy 'new' way goes wrong or breaks or there is some other complication that the 'new' way can't

      • by dohzer ( 867770 ) on Sunday July 08, 2018 @10:58PM (#56914482)

        That didn't bother me as much as reducing 80 sessions down to 30 minutes: How to compare two numbers when they measure different things?

        Slashdot is apparently not a tech-oriented website.

        They used to have eighty 20sec sessions. Now they need 30min, but we sold them a new bit of hardware so that's the important bit.

      • by dcw3 ( 649211 )

        They should have gone with 15 colors, 42 flavors, and 93 gallons/second.

  • ... Versius, the world's smallest surgical robot,

    Still under development: Nano Doctor [youtube.com] ...

  • by demonlapin ( 527802 ) on Sunday July 08, 2018 @09:15PM (#56914202) Homepage Journal
    Cutting and sewing is the easiest part of being a surgeon. Knowing when and where to cut, what to sew, and what to do when you cut or sew the wrong thing - that's what's hard about it.

    I'm an anesthesiologist. i've watched a lot of surgeries, and I could do a few of them - if I had a surgeon on the phone to walk me through them. There's a reason that a general surgery residency is five years long, and it's not because it takes that long to learn how to tie a knot.
    • and they're getting better every day. Eventually we'll have Star Wars style medical droids. If our civilization doesn't regress I'd say within 100 years tops.
    • by raymorris ( 2726007 ) on Sunday July 08, 2018 @09:30PM (#56914262) Journal

      Your comment does not surprise me at all.
      It reminds me of people who mistakenly think that learning the vocabulary words of programming (a programming language) makes one a professional programmer. Lile most subjects, learning the vocabulary words (language) is rather a prerequisite to learning the art and science of what it's used for.

      In my field, reducing the time required to learn the mechanics means people can instead spend that time on learning the hard parts. Some languages are very consistent, and rather small, so they are easy to learn. Some are inconsistent, with functions like AddArray() paired with array_remove(). Time spent memorizing the eccentricities of the language is time not spent learning design patterns, or anti-patterns, or algorithmic analysis.

      I suppose if surgeons can spend 60 less hours learning to tie a knot blindfolded, they can instead spend that time learning something else.

      • by demonlapin ( 527802 ) on Sunday July 08, 2018 @09:55PM (#56914334) Homepage Journal
        My point is that it doesn't take anything like 60 hours of training to learn how to tie a knot blindfolded. Surgical "robots" (really, they are just manipulator arms, or waldoes) make surgery a lot more expensive, but they really don't offer much. Standard laparoscopy is much faster and just as good for the vast majority of procedures. There are some cases where the extra expense might be justified (prostatectomies come to mind here), but usually? No.

        It's all about billing. Example: hysterectomies are a pretty common procedure. Unless you have abnormal anatomy, you can have your uterus removed through your vagina. Zero visible incisions, and it's a quick procedure. But it doesn't pay at all - the surgeon can get more money for doing it laparoscopically and leaving you with scars (and usually taking longer to do it). It also costs the hospital more money in supplies (and they don't get paid extra for that).

        Just an FYI, if your wife wants her uterus out (let's face it, if there ever were women here, they're almost all gone), find someone who will do it transvaginally. Easier recovery, no scars.
        • Re: (Score:2, Interesting)

          by Anonymous Coward

          My point is that it doesn't take anything like 60 hours of training to learn how to tie a knot blindfolded. Surgical "robots" (really, they are just manipulator arms, or waldoes) make surgery a lot more expensive, but they really don't offer much. Standard laparoscopy is much faster and just as good for the vast majority of procedures. There are some cases where the extra expense might be justified (prostatectomies come to mind here), but usually? No. It's all about billing. Example: hysterectomies are a pretty common procedure. Unless you have abnormal anatomy, you can have your uterus removed through your vagina. Zero visible incisions, and it's a quick procedure. But it doesn't pay at all - the surgeon can get more money for doing it laparoscopically and leaving you with scars (and usually taking longer to do it). It also costs the hospital more money in supplies (and they don't get paid extra for that).

          FYI: It is about billing--however, it's about billing insurance, which often doesn't believe in whatever newfangled surgical technique--it doesn't matter to them if it's better in every single possible way, change scares them so very much that they refuse to, and health care providers generally won't even bother mentioning a procedure your insurance won't cover.

          So, if you're trying to find, for example, a surgeon who'll do a transvaginal hysterectomy? Either already know your insurance will cover it (have

      • by dcw3 ( 649211 )

        It reminds me of people who mistakenly think that learning the vocabulary words of programming (a programming language) makes one a professional programmer.

        Crap, I've been memorizing Gray's Anatomy, and was expecting to open my practice soon.

    • Knowing when and where to cut, what to sew, and what to do when you cut or sew the wrong thing - that's what's hard about it.

      Sounds like something that would be easy for a computer, if it has the data. Inventing new procedures and methods is another matter, hopefully when the day comes the machine doesn't decide it's best to grab a replacement part from the anesthesiologist.

      • Sounds like something that would be easy for a computer

        Not really. The variation in human anatomy from person to person is substantial, even before you account for the changes that are due to prior surgical interventions. Not saying that it's impossible, but self-driving cars are a far simpler problem.

  • this is what they should be talking about. Robot helpers that take high skilled jobs and make them rather trivial. I saw this with wood workers too. I used to do IT work for a cabinet company where nobody was a carpenter. They had a CNC machine and they punched measurements into it and it cut the wood to the right shape. Then a couple of guys with screwdrivers would install it.
  • Doctors and experts who cant work an ER.
    How to do a great ER:
    A day and night, all weather helicopter service. Educate your helicopter crews to fly at night.
    An ambulance service with experts.

    That gets a nations citizens to the best hospitals in shorter time.
    Once in such a hospital all doctors and staff should be selected on merit. Did not pass your exams to the best standards and cant study and learn? Try a different area of medicine.
    A university system should only accept a nations very best t
    • People will generally choose the surgeon who graduated with a C+ over having no surgeon at all.
      • by AHuxley ( 892839 )
        Given ER use that might be who is on duty that shift. Most advanced nations can staff their ER system with the best graduates selected on merit.
        That is usually set by only allowing the very best to enter medicine every year.
        • by dcw3 ( 649211 )

          Carlin said it best - Somewhere out there is the world's worst doctor. The scariest part is that someone has an appointment with him tomorrow

  • I have no doubt that when this device is used, the license will be something along the lines of $100 per stitch. This will get billed to insurance, which will then either be declined or reduced, then the recipient is on the hook for the rest. I love the health care system in the good-ole USA.
    • If it cuts the surgery time down significantly it is money well spent, as the surgeon will then be able to do more surgeries and hopefully be less overworked (ha!), less fatigued and less likely to make a mistake on each surgery. Of course, ultimately it's probably a good idea to make the robot disposable and just have the robot BE the stitches, since it's inevitably going to get left in the patient some of the time anyhow.
  • I would have thought that a robot would find it easier to fuse the suture with heat or maybe bond it with glue or otherwise fasten it without using a knot.
  • 1) At this time and for the foreseeable few years. Robotic surgery for the most part it is a hyped up gimmick. Especially when a competent surgeon can do the same laparoscopically in less time, smaller incisions, and much cheaper. Only a few specific cases where it has merits. 2) There is no such thing as âoesimple surgeryâ. All surgery has an inherent risk and the number of deaths attributable to any specific surgery is greater than ZERO. 3) Everyone can be trained to tie a knot, but not everyo
  • Two things occur to me as I read about this.

    It isn't 'robotic surgery'. It's robot-assisted surgery. There's still a trained human performing the surgery itself. The intention is to perform more types of surgery using less invasive, time consuming processes.

    The other thing is the concern that the doctors won't be able to perform the surgeries in this manner if they don't have the robot assistance if that's the only way they've been trained to do it.

    Overall the concept is great - less stress on the patient,

    • by Anonymous Coward

      The implications of being completely dependent on the robot to do the procedures this way is scary.

      Why? Surgeons are completely dependent on all sorts of tools to do their surgeries. This is just a new tool.

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