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Outside the Lab Public health, Policy

Medical Robotics Are the Future

Both public and private healthcare providers are feeling the strain of spending cuts. The austerity that followed in the wake of the 2008 financial crash has led to drastic cutbacks and, in-turn, a healthcare crisis. According to the World Health Organization (WHO), there will be a global shortage of more than 14 million healthcare workers by 2030, if current trends continue (1).

And it’s not just staffing that will face a crisis. Surgical equipment, the latest imaging technology, infrastructure – every aspect of healthcare is feeling the strain. At current funding levels, we will likely see the quality of healthcare decrease unless a solution can be found and embraced. Certainly, there are efficiencies to be gained, but the question is: how do we realize them? Other industries have used new technology to innovate and economize, and so too must healthcare.

A leading example of modern healthcare technology is medical robotics. Taking many forms – from intricate surgical systems to robotically-controlled camera operators – medical robots are already hard at work in our hospitals. One of the most complex, the da Vinci Surgical System, combines a magnified 3D, high-definition camera with tiny, flexible instruments that are far more precise than human hands. Not only can robotic systems lead to better surgical outcomes, they can also help speed-up surgeries as well as reduce the reliance on operating theater staff.

So robots are the solution and the future? Well, there is a problem: cost. Despite having been around for some years now, systems like the da Vinci are expensive to acquire and run (the system itself can cost over $2 million, and the running and maintenance costs are also significant). In reality, such high costs make robotic surgical systems uneconomical for the majority of hospitals. Fortunately, some businesses – including OR Productivity – are specifically addressing the issue of cost. Our FreeHand system, for example, is similar to the da Vinci in some senses, but strips back the more advanced surgical components to provide a solution that is more cost-effective.

By using minimally invasive access to organs and tissues, robotic tools can help to reduce trauma, speed up recovery and minimize costs

Medical robotics are a particularly good match for laparoscopic surgery (also known as minimally-invasive or keyhole surgery), which involves a small incision through which a camera and surgical tools can be inserted, and it has led to a quiet revolution in healthcare. Because the incisions are so small, recovery times tend to be shorter, surgical scars smaller, and the risk of infection lower. Quicker recovery times also mean shorter hospital stays, helping to free-up beds for other patients.

Project team leader Sanja Dogramadzi researches the use of robotic technologies in the repair of complex joint fractures at Bristol Robotics Laboratory, University of the West of England. She believes robotic tools have the potential to aid orthopaedic, abdominal and cardiovascular surgery: “By using minimally invasive access to organs and tissues, robotic tools can help to reduce trauma, speed up recovery and minimize costs,” (2).

Well over 10 million laparoscopic surgeries are estimated to be performed every year (3), but robots like the da Vinci assist with only a small percentage. I hope that, with more cost-effective devices entering the market, the number of robotically-assisted laparoscopic surgeries will increase dramatically. In fact, the global market for laparoscopic devices is estimated to reach $12.3 billion by 2024, owing to both the growing popularity of keyhole surgery and a greater reliance on robotic assistants.

Aside from laparoscopic robotics, there are a number of other technologies that are being developed to help with surgeries and healthcare more broadly. Google, for example, is working with Johnson and Johnson’s medical device company, Ethicon, to develop robotic surgical assistants with artificial intelligence (4). Google hope to apply the imaging technology they have developed primarily for self-driving cars to invasive surgical procedures, using the machine vision to assist surgeons. The AI assistant may be able to identify and highlight blood vessels, nerves, tumor margins, or other internal structures that can be hard to make out with the naked eye. Such advanced imaging will then be combined and overlaid onto a surgeon’s vision using augmented reality (AR) to make surgery quicker and easier, while reducing risk.

It will also be fascinating to see how 3D printing advances in the coming years. Not only will we be able to 3D print medical equipment for a fraction of the current cost, but a number of researchers have been experimenting with 3D printing actual body parts. If we are able to combine 3D printing with AI surgical robotics, I believe we will see a complete revolution of what is possible in the operating room.

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  1. World Health Organization, Health workforce requirements for universal health coverage and the sustainable development goals (2016). www.who.int/gho/health_workforce/en/ Accessed October 12, 2018
  2. University of the West of England, Robotic tools push forward healthcare boundaries (2018). www1.uwe.ac.uk/research/researchhighlights/successstories/robotspushforwardhealthcare.aspx Accessed October 12, 2018
  3. NS Blencowe, R Waldon and MN Vipond, “Management of patients after laparoscopic procedures”, BMJ 8;360:k120 (2018). PMID: 29437677
  4. The Guardian, Google teams up with health firm to develop AI surgical robots (2015). www.theguardian.com/technology/2015/mar/27/google-johnson-and-johnson-artificial-intelligence-surgical-robots Accessed October 12 2018

About the Author

Jeremy Russell

CEO, OR Productivity, Guildford, UK

CEO, OR Productivity, Guildford, UK

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