Surgical robots: the future of medicine?

There has been an accident and you’re being rushed into the ER. Lights are flashing, words seem to be just gibberish and not much makes sense, and you are asked to consent to being treated by a machine. How would you feel, going into surgery, knowing that you’ll be operated on not by a doctor, or even a person, but a robot? The first thing that comes to mind is a vision of a dystopian future where human beings are at the mercy of another species. Although that is becoming more and more true, in medicine this reality could prove to be one of science’s greatest advancements.

Robotic surgery, or more accurately, robot-assisted surgery, is an innovative approach used by healthcare providers to ensure minimally invasive procedures with enhanced precision, flexibility, and control. Machines typically consist of robotic arms that hold surgical instruments, high-definition cameras that provide magnified 3D views of the treated area, and a surgical console where the surgeon controls the machine’s every move. These robots are tools that can overcome many physical challenges of human nature – such as limited sight or shaky hands. The exceptional knowledge of an accomplished surgeon, paired with hands that are pre-programmed not to make mistakes, makes for a significantly reduced risk factor in operations that require immense accuracy.

Although initially postulated in 1967, the idea of using robotics in surgery was first put into practice in the late 1980s with “Robodoc”¹, an image-guided system used for orthopedic procedures. In their early stages, medical robots were intended to be used in combat settings by bringing the “operating room” to the patient in order to minimize battlefield casualties, as specialized care can be impossible to provide amidst the chaos of a combat zone. The first prototype of such a system was The Green Telepresence Surgery System², which became a gateway to bringing surgical robots to hospitals around the globe.

Currently, the most prevalent amongst technological surgery systems is the Da Vinci system³ , which was created by Intuitive, a pioneer in robotic-assisted surgery, in 1999. A common misconception is that robots are the ones that perform surgeries when in reality, they are only instruments that act as the surgeon’s hands. The robotic arms are controlled in real-time by translating the hand motions of the medical professional but with improved flexibility and a wider range of motion. At the same time, the doctor is provided with high-definition close-ups of the surgical area that allow for a superior visual assessment to regular eyesight. The surgeon’s comfort is also put into consideration, as the console is adjustable, allowing them to stand or sit according to their preference.

The Da Vinci system has been improved over multiple models and it is mostly used in single-port urological procedures (requiring one incision), lateral oropharynx ectomy procedures (removing cancer), and tongue base resection (removing tissue or part of the organ). Due to such procedures often happening through smaller incisions, the recovery time can also be shorter than with traditional surgery. With over 15 million procedures having been completed using these systems and with over 66,000 surgeons having been trained in using them around the world, they are sure to become even more accessible and versatile in the coming years⁴.

Despite their widespread use, surgical systems like these have drawbacks. Their cost, averaging at around $1-2 million per unit without maintenance and disposable instruments, makes it difficult for them to be implemented in most hospitals and many low-income countries. Additionally, the price and time-consuming process of training a surgeon to mastery is extensive and still not widely accessible. While less physical contact with the patient during an ongoing procedure reduces the chances of a human mistake, the lack of tactile feedback makes it more difficult to detect tissue resistance. The set-up and operation times are also often longer than with standard surgery, therefore reducing efficiency in high-demand settings such as warzones.

A major obstacle in the future of robotic surgery is ethical concerns relating to both patients and healthcare providers. Ensuring informed consent is one of the leading issues. With planned procedures, a patient could be informed about the benefits, risks, and workings of robot-assisted surgery. However, in the case of emergency surgery, complications resulting from the inexperience of a surgeon or system malfunctions could happen without patient consent to the unpredictability.

Another problem is the evaluation of accountability in the event of an error to which the system contributed. Would the fault lie with the surgeon, the hospital, or the manufacturing company? Some people worry that robots could one day entirely replace surgeons. The answer, however, lies in the name of robot-assisted surgery – systems currently being developed focus on providing additional aid by being a tool, not by performing procedures by themselves. It is difficult to say how advanced they will become in a few decades however in the near future they are unlikely to supersede human surgeons.

The Da Vinci system and other forms of robot-assisted surgery have transformed the field of modern surgery by enhancing precision, reducing invasiveness, and improving patient outcomes. Despite this, there are difficulties that come with the fact that such methods are still relatively new in the field of medicine. Recent rapid advancements in artificial intelligence indicate that AI may one day find its way into surgical robotics, but only time will tell how independent and precise these machines could become. One thing is certain, with its continuous developments, robot-assisted surgery is very likely to be the future of medicine. The question remains: if one day you were asked to be operated on by a robot, would you feel safer or more apprehensive?

Sources:

https://my.clevelandclinic.org/health/treatments/22178-robotic-surgery access: [07.03.2025]

https://pmc.ncbi.nlm.nih.gov/articles/PMC6261744/ access: [07.03.2025]

https://www.sciencedirect.com/topics/medicine-and-dentistry/da-vinci-surgical-system#:~:text=The%20da%20Vinci%20Surgical%20System%2C%20introduced%20in%201999%20by%20Intuitive,cart%2C%20and%20a%20video%20tower. access: [08.03.2025]