The past few years have brought an influx of artificial intelligence, and with it, a warmer human reception to technologies that seek to make life easier and better for us. The days of fearing a robotic uprising are perhaps gone, replaced by a cautious optimism that robotic assistance seeks to change a variety of industries in ways that are out of reach for humans unaided by technology.
Nowhere is this truer than in medicine. While the medical field has experienced inevitable progression, we’ve long been burdened by the imprecision of our flesh, slowed down by that which makes us human. In order to match the capability of the human brain in medicine, artificial intelligence and robotic involvement are necessary components of future growth in patient care.
A Question of Art vs. Science
While there are still people who fear that robots will replace the need for humans in a variety of industries, there is a continued need for the two to work together, especially in medicine. Though there are some “robotic” devices that operate independently of people (like defibrillators), most rely on human physicians for direction.
Scientific American recently asked whether or not artificial intelligence removes the art in medicine—the uniqueness of patients, the variety of conditions and medications, etc., pointing out that the demand on physicians to see more patients in less time in higher than ever. Physicians must keep track of their patient in a more holistic way, including whether or not they’re attending appointments and adhering to their treatment plan. The system seems to ask for less art in medicine than science, and robotics seeks to close the gap.
The article’s author argues that artificial intelligence helps in such value-based programs, providing current information to all providers, making predictions, assessing patient risk factors. Additionally, there’s room for AI in the delivery of care (Scientific American specifically calls out the da Vinci system).
Physicians continue to be responsible for decision-making in medicine, and autonomous devices are far from capable of this sort of action. Robots are being used to assist physicians, but not replace them, offering a higher standard of patient care, including the opportunity for higher levels of precision, more informed decision making, and better diagnoses.
The relationship between man and machine is symbiotic—a doctor limits their effectiveness by refusing technology in certain circumstance, while the robot is useless without the human who puts the “art” in the medicine.
But, robotic assistance in surgery is only useful if it seeks to improve patient satisfaction, reduces cost and clinical outcome, and reduces pain.
Case Studies in Precision
Robots are being used widely in medicine, particularly surgery, in part because they are improving outcomes. Just last month, robots helped perform spinal surgery to remove a tumour in Noah Pernikoff’s neck. He’s the first patient in the world to undergo such a surgery, which took place over 20 hours in three parts. Doctor Bert O’Malley developed the robot because his hands were too large to get down the human throat. “The excitement about the robot is it allows us to do the operation with less trauma, less collateral damage,” he said.
While the Transoral Robot has been used for throat cancer, this surgery marked the first time a robot was used to remove a tumour at the top of a spine.
Earlier this year in a hospital in Dubai, U.A.E., a robot assisted in total knee replacement for two patients, a significant feat given that short-term survivorship for robot-assisted partial knee replacement is up, as compared to surgeries without robotic assistance. Two years after the operation, there’s only a 1% revision rate, which is four times lower than conventional surgeries. Studies also show that patients are in less pain during the first 60 days of recovery.
The knee surgeries rely on the NAVIO Surgical System, which works with the human hands of the surgeon to garner the most precise positioning of the knee implant. Using a computer program, information about an individual patient’s knees is communicated to a robotic handpiece used by the surgeon, who now knows his or her specific surgical boundaries.
Such is the growth of robot-assisted surgeries that the technology is even being used to detect the source of seizures in some patients. Doctors at Stanford School of Medicine used a robotic assistant called ROSA (Robotized Stereotactic Assistant) to help a child with a seizure disorder. The device allows more precise movement, which allows doctors to identify seizures happening within the brain without opening the skull—or even shaving the patient’s head.
And it doesn’t stop there–with growing regularity, robots are also being used within hip surgeries, abdominal and OB/GYN procedures, heart surgeries, cancer removal, kidney and gallbladder removal, and kidney transplant, among others.
Paving the Way With Powerful Components
Companies like Portescap are paving the way for these surgical robots, creating their own motor solutions for those seeking to improve the performance of surgeries everywhere.
“Our Surgical Motor Solutions are custom engineered to your needs,” Portescap writes on their website, “providing high speeds and high torque while maintaining efficiency for increased hand tool power and shorter surgery cases.”
These components can even be optimized for higher speeds, higher loads, or other custom performance needs.
With components companies like this one on board, there is little in the way of surgical robots.
Questions of Legality and Effectiveness
Of course, there are areas of medicine that haven’t figured out how exactly robots can be used to positively impact patients. And, where the research suggests that robotic involvement increases costs and not outcomes, we should, of course, delay the use of artificial intelligence on a large scale in lieu of research and development.
While there are a lot of promising outcomes from robot-assisted surgery, there are some surgeries in which outcomes are less promising—bladder cancer, for example, where robots are increasing costs with no discernable difference in outcome or complication rates. Robots in the operating room are still relatively new, and there’s work yet to be done.
Furthermore, critics of robot-assisted surgery often wonder, in the case of a poor outcome, who is liable—patient or robot company? It’s a complicated question without a clear answer. And then there are the HIPPAA concerns, since robots, surgical and otherwise, have access to a wide variety of private data that requires sharing.
The question of legality as it relates to artificial intelligence is not limited to the medical realm—as robots appear throughout our lives by way of self-driving cars and smart homes, there’s an ongoing discussion about who exactly takes responsibility for their actions. Currently, there isn’t a clear answer, but, with the excessive growth of artificial intelligence in consumer products, there is no time like the present to formally discuss a course of action.
Finally, how might robots delivering care be regulated? The Food and Drug Administration regulates devices, but medicine falls to boards of medicine who issue and oversee medical licenses. But, as robots become less novelty and more standard of practice, this may—and should—change.
The Future of Healthcare
Right now, startups and universities alike are searching for ways to combine human and machine for optimal patient care, and when medical professionals and consumers fight back against the inevitable, we delay progress. The presence of AI and robotics in healthcare and surgery isn’t up for debate—as technology continues to progress, it becomes a question of how exactly it will happen.
Right now, New York University is developing software that helps predict a variety of diseases. A company called FDNA is using facial recognition technology to identify rare diseases and genetic disorders. The Apple Watch is being used to detect cardiac arrhythmia.
AI is opening up new opportunities for physicians and patients alike, making it possible to live longer, healthier lives. From diagnosis and surgery to patient recovery, robotics stand to make a significant difference in medicine. Of course, the goal now is to find ways to make the increased initial cost of robotic-assisted surgeries worth it—and by all accounts, it looks like we’re getting there.