Is robotics (and robotic surgery) just a big hype?

Image from Time
Is robotics all just a big hype? I would like to say yes, and no.
The Time magazine specials on “Health Checkup: Robotics” featured a story on robotic surgeries (read “Meet Dr. Robot” for the original article forwarded to me via @ciscogiii). I wasn’t surprised to see one of the most popular surgical robots of all time, da Vinci robot, being mentioned throughout the article. I figured that the article is probably just another written piece all hyped up about the expensive da Vinci robot, and reporting on how surgeons are loving it’.
The truth is, I’ve read quite a few articles sharing the reporter’s excitement about the coolest technology in today’s medicine, robotic surgery, and not all of them shed light onto the (actual) big picture.
But I was glad to find this particular article does justice.
A da Vinci robot is a surgical tool that enables minimally invasive surgery. For those curious engineering craving specs for these things (like myself), it has four robotic arms, seven degrees of freedom, and 90 degrees of articulation. It also comes with tremor reduction between the operator and the end-effectors (i.e., shakiness of the surgeon’s hands after her third cup of coffee of the day will be filtered out by the robot when she does a surgery on you). For more, but brief, information on the robot, you can watch the embedded video far below.

the da Vinci robot
The robot is best known for its usefulness in prostectomy (i.e., procedure to surgically remove prostate gland), but also used in many other surgical procedures.
Yes. It’s cool to have a robot do a surgery on you. In case of most surgical robots, you can feel assured that surgeons are the ones operating the robot(s) during the surgery rather than a fully autonomous robot. And you walk away with the coolness factor of having gone through a robotic surgery, and have less recovery time after the surgery. A sophisticated $1 million robotic equipment used for your surgery? The article says that yes, people are all over it.
But from an engineer’s perspective, the coolness factor has its dues. If it doesn’t have significant benefits over the costs, then it’s time to look for another creative solution, rather than being stuck in awe with the epic-ness of the current solution.
So the natural question is, do da Vinci robots bring out more benefits than costs? Many people have the impression that they do. But it is actually a matter of dispute:
Menon says candidly, and so he characteristically begins his answer by acknowledging that robots, thus far, have not improved his ability to cure prostate cancer. “It doesn’t matter what tools you use to cut, the cure rate will be the same.”…
Robotic-surgery patients begin to regain urinary control and, perhaps, sexual potency more quickly than open-surgery patients, says Menon. But after the first month or so following surgery, patients with longer scars begin to catch up, and the recovery paths of robotic and conventional patients tend to converge.
It is true that such surgeries result in less blood loss and faster recovery time. But to achieve the same surgical outcome as that of open-surgery (i.e., eventual recovery of the patients), a hospital has to equip itself with these million dollar robots. Some believe that this is a negative trend that makes a hospital sell surgery as the better option rather than seeking other treatments, because the hospital wants to see the return of investments.
More importantly, this investment may all be due to just a ‘big hype’:
A recent survey found that prostate-cancer patients who chose robotic-assisted surgery were more likely to report disappointment with their treatment than patients who opted for open surgery — which was odd, because their results were not worse. The obvious conclusion: their expectations had been raised beyond the robot’s ability to deliver, especially in one respect. “Regaining normal sexual function is still the issue,” says Menon.
The article, while reporting that more patients are choosing robotic surgeries over open-surgeries, asks a very important question:
Maybe the whole thing is a medical version of a Rolex watch: impressive and reliable, and yet an unnecessary extravagance. Maybe we can’t afford a Rolex
Is it really necessary to have robotic surgical tools if it really isn’t making that much of a difference? Or are we hoping that supporting these technologies, despite the big price tags, will result in better technologies in different application fields?
Most of us are under the impression that the newest one is probably the better one. However, such perspective of looking at technology has been implanted in us through the media and short-term benefits. Unfortunately, side-effects and social problems arise much delayed as long-term effects and we don’t always succeed in connecting the dots when we start to feel the negative effects. Nowadays, we invest so much money and time into technologies that may not actually be necessary, but simply really cool.

A giant promotional jukebox robot in a comic book – why a robot?
This is related to the dispute the Canadian government is trying to settle. Since the government pays for healthcare costs of patients going through robotic surgeries as well as open-surgeries, the former being significantly more expensive than the latter, should the government support the costs of robotic surgery that leads to the same desired end result as the cheaper option?
And as an engineer myself, I totally get the urge to develop something ‘cool’. When you have an epic idea that is probably the most useless thing on earth, but epic, you feel this huge urge to try it out and make the epic happen.
But is robotics really necessary in so many different application fields? Why is the world becoming so pro-robot? Or is it?
There’s nothing wrong with being pro-robot, as long as we weigh the pros and cons carefully. And I don’t think robotics is all just a big hype. Otherwise I would be doing research in a field other than robotics.
But we don’t need a Rolex watch if all we need is to know what time it is. Many robots are Rolex solutions, with unknown long-term effects.
Meanwhile, below is one of the always impressive, entertaining videos featuring the da Vinci robot:

.gif)




Hot off the (local) press from yesterday on the same topic…
“Patients who elect to have their operations by surgeons using the robot at Vancouver General Hospital will now have to pay anywhere from $2,100 to $3,500.
…
Indeed, Washington state hospitals (like Swedish Medical Center) are aggressively marketing robot operations (to local and B.C. patients) for extremely high prices. A radical prostatectomy, for example, costs $35,000, far more than the $2,814 B.C. patients will now be asked to pay at VGH.
…
Many surgeons prefer working on robots because they feel they have enhanced dexterity and precision when performing delicate procedures in small, complex regions like the pelvis. As well, the robot offers ergonomic benefits, since the surgeon sits at a console to operate the arms of the robot instead of being hunched over patients for hours at a time.
…
Goldenberg said the robotic movement is here to stay, so surgeons need to continue developing their expertise at the same time as they collaborate with others across the country on research measuring outcomes.”
The Vancouver Sun: Patients forced to pay for robot-assisted surgery
http://www.vancouversun.com/health/Patients+forced+robot+assisted+surgery/3943382/story.html
There is another way to look at this. There are other surgeries where precision is the cause for high failure rates. In such cases, use of a precise robot makes sense – its worth spending the extra money if it assures that the risk of loosing control over a limb is reduced by 50%. And to get there we need to put in the hard yards – build and field test the Da Vinci robot for example. Sometimes it makes sense to do science for the heck of it. That said, it seems fairly redundant in the above case.
I get asked this question alot. Robotic surgery cheaper in *overall* costs by $1200 from lap or open surgery Interesting freakanomics NY Times oped piece from Dr. Catherine Mohr (doctor and works at Intuitive). It’s more expensive in OR costs because of setup/robot but cheaper when you combine the healing time in hospitals.
http://nyti.ms/cvlvAN
Just another commentary on the topic of the ‘hype’ talk shared by @pfanderson: http://opinionator.blogs.nytimes.com/2012/05/27/in-medicine-falling-for-fake-innovation/