Operating robots: How machines help improve quality of care in medicine.

Healthcare with operating robots

Robots can be used in a wide range of medical fields and contribute to more efficient patient care. Operating robots can be of great help, particularly in surgery. They are considered accurate assistants, but do not replace the surgeons performing the procedures. One example of the use of robots in surgery is for minimally invasive procedures: The surgical instruments are only introduced into the body through a fingernail-sized incision. 3D cameras allow doctors to look into the area undergoing surgery. Robotic interventions have a gentler effect on patients, primarily by reducing surgical trauma.

In addition, the risks of manual human errors are minimised. Operating robots can also be useful in other areas in ways that are set to become essential in future.

Robotics in surgery: How robots are used in the OR

Robots are used in medicine in a variety of different ways. In addition to minimally invasive surgery, Nemat presents three other areas of application:

• Supermicrosurgery: In supermicrosurgery, doctors tested the “Musa” assistance robot developed at the University of Eindhoven on humans for the first time. As part of a pilot study, a treating physician created lymphatic-venous connection ducts (anastomoses) in a total of 20 patients. The influence of human tremor plays an important role, especially in vessels smaller than 0.5 mm in diameter. In addition, “Musa” may also potentially be used to set up anamostoses more safely and securely in deeper-lying areas of the body.
• Laser surgery: Robots with special laser devices are used, among other things, to cut through or into bone. Using lasers, it is possible to precisely calibrate patient-specific incision guides. In addition, compared to conventional methods, there is no need for drills or saw blades that can break or bend. Operating robots therefore also minimise risks in this area.
• 3D RoboticScope: It's not just the robots that are involving – it's how they are controlled, too. The 3D RoboticScope is a digital microscope for surgery which is controlled using a pair of glasses. If surgeons wish to change their field of vision, they simply move the heads in the direction they want to look – the robot then automatically steers to the desired position. This means surgeons no longer need to bend over their patients in a rigid position as before.

Are there risks when working with operating robots?

The use of robots in medicine entails risks as well as many advantages. For instance, there is the possibility that robots, like all machines, may fail due to lack of power or other technical difficulties. In these situations, it must be clear how the operation can be continued without technical assistance. Hospital management should not invest too much in robots, either, says Nemat. Simultaneous savings in personnel would offset the positive treatment effects created by the use of robots in the long term.

However, some people fear that one day robots will take over everything and that everything will be automated. Nemat counters this concern, likely fuelled by science fiction stories: “In other industries, this is already being implemented, especially in the automotive industry, where there is already a very high degree of automation.” However, there will be no full automation in the OR. Visionary Nemat can well imagine that there will be more automation in the case of operating robots, but “operating by themselves, with no surgeons involved or present – that's not something we surgeons want to leave up to the robots".

Progress in the OR requires courage and an innovative spirit

Nemat is open to digitalisation in medicine and the use of operating robots, but also sees the challenges in automating surgical workflows.

The advantages of using robots in areas such as the operating room of the future are obvious to him, but he also knows that progress also requires the courage to change. Nemat therefore calls on all clinicians to help shape medicine.

 „Let's not become dependent on digitalisation. Don't leave medicine to corporations in the US and China. Maybe we, the medics in the institutions, need to be the driving force ourselves!"

Nemat is the founder and managing partner of the Institute for Digital Transformation in Healthcare at the University of Witten/Herdecke. Prior to his theoretical work, he gained more than 15 years of clinical experience as chief physician of thoracic surgery at hospitals with maximum levels of care and as the founder of two interdisciplinary lung centres. In the trend report on digitalisation in clinics and hospitals, you will find further suggestions on how technological advances can improve and facilitate work in nursing and operating rooms