As we know, the intense focus on safety for any surgical procedure seems to compromise training for new robotic surgeons. A group of researchers found that between January 2000 and December 2013, robotic surgical procedures killed 144 people, injured 1,391 and had 8,061 malfunctions in out of more than 1.7 million procedures performed in that time period. These news raised important questions and heated conversations about the safety and effectiveness of robotic surgical procedures.
A growing number of studies were made to the point where we’re starting to learn when and why this technology can actually work and when does it causes trouble. A lot seems to be clearer about how frequently a procedure is performed at a particular hospital and by a particular surgeon. This can clarify and make the dialogue safer and more effective when the main topic is robotic assisted procedures as the years go on.
This study was concluded after two years of field research, which took a thousand hours of robotic and open surgery at five different hospitals and interviewing surgeons and residents of robotic and open surgery from ten teaching hospitals. They’ve collected data only on surgery involving Intuitive’s da Vinci system and primarily on urologic procedures.
They noticed that surgical learning can be compromised in surgery involving the da Vinci system, mainly because the technology allows a single surgeon to perform the bulk of each procedure. “Most often, residents watch robotic surgical procedures unfold on TV screens in the operating room, which likely has limited learning.”. According to the AAMC, surgical demand is growing significantly faster than the supply of surgeons, which means the reduction in medical residents work weeks (from 120 to 80 hours in the USA) has also contributed for the number of surgeries that remain medical residents get to perform. The da Vinci has made it even harder for a lot of students to get sufficient, safe, legitimate opportunities to learn how to use it.
Every time we ty to move forward we always find challenging deeply held norms, laws and techniques related to surgical work – “It’s tempting to suggest that senior robotic surgeons should allow medical residents ten times the opportunity to struggle on their own during surgery… until you watch an expert remove potentially cancerous lymph nodes in ten minutes and on a different day watch a resident struggle to do the same in forty.”
Many believe that there’s nothing we can do and that surgery itself will evolve to the point where cutting into patients will be less and less necessary and others hope that surgery isn’t going away for at least several decades and robotic surgery is going to expand itself to other methods, allowing fewer surgeons to perform surgery with less trauma to the patient.
It does not matter how safe we make robotic surgical procedures, they will eventually become a luxury available to a very few. We fail to address the sustainability of the practice. Some hybrid of the options above on a large scale will likely to be required to address the constraints that “best practice” with these systems places on surgical training.
Be prepared for the lens to the next wave of development in surgical technology! It can extend the benefits of minimally invasive surgery to many more at decreased cost.