Imagine going to the hospital for a health issue and being diagnosed by a machine with artificial intelligence, or surgeons no longer having to perform surgeries on patients with their own latex-gloved hand. This may sound like an excerpt from a science fiction novel, but it is closer to reality than most people think. Robotics in the medical field was initialed research funded by NASA and military to develop technology for remote operations especially for injured soldiers on the battlefield. However, Robotics has shown massive amounts of potential when innovators shifted to the scenery of civilian health [3]. One ongoing field of research in robotics is how they can help improve the mortality rates of certain high risk surgeries by assisting doctors in making minimum appropriate incisions or even helping patients heal faster in post-surgery [1]. Yet, this new form of robotics is still in its infancy, and that is why it is crucial for bioengineers to continue and increase their efforts and investment for the output may indeed save an unlimited amount of lives in the future. From remote surgery to pharmaceutical automation, Robotics is changing the medical field as we know it and everyone from doctors to patients alike will be grateful for it.
In 1999, the company, Intuitive Surgical, started the race with their FDA approved surgical robot called the “da Vinci Surgical System” [1]. This machine has three to four interactive arms equipped with endoscopic cameras and other instruments required by surgeons [2]. The purpose of the da Vinci system is to help improve on laparoscopic operation, also known as keyhole surgery [3]. These surgeries are valuable because they are minimally invasive therefore patients have a lower chance of complications in post-surgery recovery. Recent data analysis shows that the da Vinci system and other similar models have gained a significant amount of popularity for robotic assisted surgeries such as the increase from 5,000 in 2002 to 73,000 by 2009. According to Paul Levy, chief executive at Boston’s Beth Israel Deaconess Medical Center, hospitals without a surgical robot are losing prospective clients [1]. With proper use, the machines provide less harm to patients due to its high precision and 100 % tremor elimination [3]. The slightly higher success rate is what patients may need in surviving high risk operations.
Telesurgery is a concept that would not have been widely used if it weren’t for surgical robots. Since most of the surgery models work on an either a controlled system or a semi-autonomous system, they do not require a surgeon to be directly present in the operating system [5]. A practitioner is only required to be present at a control monitor to make sure the surgery is going smoothly, and to make any required adjustments if needed. In theory, the distance between the controls and robot is unlimited [2]. That’s why in 2001 with 151 million dollars of funding to achieve necessary bandwidth and transmission delay, Dr. Jacques Marescaux completed the first transcontinental surgery from New York to a patient in Strasburg, France. The 4,000 mile surgery also known as “Operation Lindbergh” was a successful gallbladder removal surgery that shows the possibility of giving quality medical care almost anywhere on the global [1]. Current research still shows evidence that making long distance telesurgery is still unpractical for everyday use due to cost; however due to the advancement of technology, Dr. Satava believes remote surgery will become a common practice in 40 to 50 years [5]. On a personal level, I find this information exciting because my grandfather has gallbladder stones, and despite having medical care, does not have the ability to undergo minimally evasive surgery because such training and technology does not exist in countries like India. With remote surgery, he would be able to receive the same quality care he would have if he had the ability to travel to the United States for the surgery. Not only him but millions in India would benefit too. Within the next 40 years, I hope to be a certified engineer that could help contribute to this development that can help people from India, my homeland.
Surgical robots are not the only thing that is changing the medical field; other developments are occurring as well. There is ongoing research at University of Brunei Darussalam for the creation of a low cost robotic medicine dispenser. This form of technology is also known as a pharmaceutical automation [4]. It is designed to speed up a time consuming process, eliminates contamination and reduces errors upon measuring and distributing prescription drugs to patients. The basic design of the dispenser includes servo-based cells that store, count and dispense the tablets, and a belt/pulley system that run in an x and y axis movement to retrieve and transport the drugs [3]. The research is very promising because the prototype model has produced excellent results. After 400 tests with 10 different types of tablets/capsules, the machine produces 90% efficiency. Out of all the errors, 98% of them were only off by one or two tablets. The orders are also considerably fast since most of dispensing process is completed within one minute [3]. With more development, the first design entering the market should be almost flawless. The medical dispenser is highly useful due to the fact that people would be able to get their medication in areas with a limited amount of space and workflow such as urban places or third world countries. Also the device has the ability to pull up client’s medical information if they require a custom order
Although robotic implementation in health may seem amazing and highly beneficial, it does raise some issues that are concerning for certain groups of doctors. Still in its infancy, ethical application has not been fully explored. Jane Johnson and Wendy Rogers have developed four important challenges which are: compromised informed consent, possible harm to patients, crossing over medical ethics, and unfair allocations of healthcare [1]. Consent from patients on the use of the new techniques should be required because surgery robots can provide a new list of complications such as a possibility of the robot malfunctioning during the operation [2]. Harm to patients may become an issue because there is no required amount of training needed to use the robot and many doctors have little to no training. Even though the instrument is designed to reduce complications, it can be a concern if used improperly. There have been some cases of patients winning lawsuits due to the surgical injuries done by the robot [1]. An easy fix for this is simply making sure a doctor has prior experience with using the robots. Training can be given when people are still at medical school so that when they enter the workforce they are fully prepared.
Crossing over medical ethics between countries came about after the first telesurgery done between France and the United States. Both countries have medical rules that slightly differ from each other. Questions may come into play, like: How will both sets of rules be respected? [5] A standard international medical guideline could be established to help overcome any differences between country’s ethics. Lastly the allocation of funds to use robotics can be a problem due to the costs. The da Vinci system cost around 2 million dollars with 180,000 dollars in annual maintenance fees [1]. This is a considerable amount of funds required by a hospital, most of which buy only one to keep up with their competition. Even the low cost medical dispenser would require a large amount of initial investment before its output starts to pay off.
Despite the several amounts of ethical questions, many people must remember that medical robotics is an emerging field. As it continues to develop, a standard set of guidelines and ethics will be established. Anything to keep a patient from harm and compromise in trust should be considered.
Throughout the research I have done and the examples that I have seen, it is clear to me that embryonic stem cell research has great potential for the future of medicine and biomedical engineering. I believe that it is very important to continue funding for research in this field in order to fully recognize what these cells are capable of and the impact they could have on our society. There are strong arguments for the two sides of the ethical debate, but I think that the world should see the bigger picture of saving millions of people from suffering. This research is not only important to engineers, but to anyone that has ever known a loved one, or themselves, that has a serious disease. These diseases may be cured through the use of embryotic stem cells.
I would like to thank Mrs. Brink the librarian for helping me search for articles about my subject to use of the paper. I would like to thank the writing instructor at Writing Center for helping me improve my paper. I would like to thank my engineering writing instructor for help me during my confusion on bibliography