Robots Replacing Doctors in Operating Rooms

Many science fiction writers have dreamed of it. But not even Phillip K. Dick would have imagined the day should come so soon ― robots are replacing doctors in operating rooms.

The world is seeing a craze for robotic surgery, where machines take care of precise sewing, clipping or other procedures. Patients undergoing operations and doctors performing them claim they are safer and less painful, and more and more people are expressing their willingness to go under the knives of these machines.

Amid the craze, there is the Da Vinci surgical system, which is said to be the best in the business.

Da Vinci Robot: Epitome of Medical Robots

Robotic surgery involves making three to five 0.5-1 centimeter incisions near the affected are instead of cutting and opening it up, and then using robot arms inserted into them to perform the surgery.

The idea for the system came first from the military. The United States government thought robots could conduct basic combat surgery in the field remotely operated by doctors.

The basic idea was for robots to repair wounds and injuries using micro-tools controlled by doctors in urban medical centers ― certainly one of the most fascinating ideas at the time.

The prototype was developed in 1992 and was first introduced to the public in 1997 in Belgium after winning U.S. Food and Drug Administration approval.

The machine consisted of two-lens endoscopes with attached articulated instruments having a full-range of three-dimensional movement. The operator, sitting at a consol, puts his or her arms through two armholes and manipulates the instruments as if they were actually performing the surgery.

The endoscopes send three-dimensional images to the operator and the power and directions of the robot hands can be controlled by several pedals. Doctors testified that once they get used to the images, and the feel and sense of the instruments, the process is easy to use and convenient.

In 2000, the Da Vinci system was used in about 10 cases in the U.S., but this jumped to more than 40,000 cases in 2007.

In Korea, Yonsei University's Severance Hospital first adopted Da Vinci in 2005 and has conducted successful operations on gall bladders and prostate glands. Since then, the hospital alone has conducted more than 500 surgical procedures using the robot. Now, there are 13 robots in the country and more institutions are planning to buy them.

Da Vinci Lessens Pain, Increases Comfort

Surgeons and their patients admire the machine as it brings about a win-win effect for both groups.

Prof. Lee Young-goo of Hallym University Medical Center, Kangnam Sacred Heart Hospital said Da Vinci is the best operating tool to date. Lee, also the chief of the Da Vinvi Robot Surgical Center at the hospital, said because the surgery requires smaller incisions in the abdomen, patients do not bleed so much leading to faster recovery times.

``If we have to perform open surgery, patients lose about 900 ccs of blood, but with the Da Vinci incisions they lose only about 150 ccs,'' he said. Therefore, the body receives less shock and the period for hospitalization is shortened, he added.

``It lessens patients' pain, which also leads to a shorter hospitalization period. It also has less possibility of contamination or infection, and leaves much smaller scarring,'' he said.

Kim Young-joo, who had a cancerous prostate removed in January, said he was very satisfied with the result. He said the shock of his disease and all the talking added stress to his heart beforehand.

``But I was really happy to get the surgery,'' he said. He showed his wound where only a small scar remained.

``I was able to move the day after the operation, which I never imagined. I even joked that it was a relief I was diagnosed with the disease late enough meet the robot,'' he said.

For the doctors, the robot is convenient, too. The arms move in a micro-scale and doctors say they are more articulate than human hands. Also, while human hands can shake in the middle of a procedure, the machine compensates giving a consistent performance.

``And because it is very small, the tip of its hands can move a lot and reach to a very small space in the body rapidly,'' Lee said.

Lee, an authority in urology, said the robot is especially good for prostate cancer. ``One of the side effects of the prostate cancer surgery is that incontinence often happens because surgical scalpels can cut veins. But with the robot surgery, it doesn't happen. Also, the chances of being accidentally made impotent are dramatically reduced,'' he said.

Da Vinci Taken up by Major Hospitals

Since its successful launch in Korea, the robot has been rapidly adopted by many hospitals in Korea. The Severance Hospital, Samsung Medical Center, Youngdong Severance Hospital, Korea University Medical Center, Asan Medical Center, Kangnam Sacred Heart Hospital, Bundang Seoul National University Medical Center, Donga University Hospital and Kyongbuk University Medical Center have all bought machines.

The Severance Center opened an educational institute for the robot for Asian countries while the Sacred Heart Hospital opened its own robot center.
``Because Korean surgeons have sensitive hands, teaching techniques are getting better and better,'' Na Gun-ho, a surgeon at the hospital, said.

Bundang SNU Hospital has recently started main arterial surgery with its robot. Surgeon Lee Tae-seung said the procedures were difficult, but with the Da Vinci system exceptionally precise surgery was possible.

Da Vinci Has Ups and Down

While Da Vinci surgery is successful, the high price is something that holds patients back. The Severance Hospital spokesman Lee Sung-man said the surgery costs between 7 million-20 million won.

The high costs is due to the eye-popping price of the robot itself ― 2.8 billion ― and the fact that its arms must be changed after every tenth procedure.
``It is why some people back out at the last moment,'' he said.

However, Lee Young-goo said the good outcome outweighs the cost and the pain a patient has to endure.

``I say it's the best surgical method yet,'' he said.

According to hospitals, the price is cheaper than in the U.S. and other countries ― ``I say about 20-30 percent,'' Lee said. He added that many foreigners have actually come to Korea for surgical procedures.

``For Koreans, there is no need to go abroad as surgeons here are catching up with the skill and are ready to perform,'' he said.

http://www.koreatimes.co.kr/www/news/nation/2009/05/242_21380.html