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Health & Wellness // March 29, 2017 MAAC Staff

Robotic-Assisted Surgery and What It Means for Cancer

Advancing technology has always been an important aspect of healthcare, and in some cases, these developments are changing our approach. Wearable technology has become more prevalent, with researchers developing a device for doctors to better monitor cancer patients’ side effects from treatment. Researchers are studying how to use 3D printing as a means of manufacturing living, working organs. Traditional surgery has also started to transform with the use of robotics becoming more commonplace.

Since the early 2000s, the applications of robotic assisted surgeries have ranged from knee and hip joint replacements to more complex surgeries for cancer patients. We reached out to practicing medical professionals in various fields to learn what they thought about robotics in medicine today and the potential for the future.

Advantages of Robotics in Medicine

Robotics-assisted surgeries today consist of a surgeon operating beside the patient. They can view the patient’s anatomy through a 3-D screen and operate handpieces and foot pedals to control the robot’s “hands.” The surgical instruments on the robot’s arms are small, allowing for minimally invasive procedures. The robot is essentially an extension of the surgeon, who has complete control over the movement of the surgical instruments.

Dr. Jessica Ritch

“It helps allow surgeons to accomplish complicated procedures using wristed motions similar to those of the human hand, but through small, laparoscopic incisions less than a centimeter long,”explained Dr. Jessica Ritch, a gynecologic surgeon at the Florida Center for Urogynecology. “This helps patients recover faster with less pain, less scarring and less risk of wound infections.”

Currently, robotics surgery has been used in several areas of the medical field including orthopedics, oncology, and gynecology. In many cases, like head and neck surgeons operating on the throat, such technology has made it easier to navigate and access hard-to-reach areas of the body. It can also reduce the amount of time some operations take, making them less taxing on the surgeon – which in turn reduces the potential for errors.

Dr. Jonathan Vigdorchik

“It’s like technology in everything. Robotics is similar to the Google Maps or Waze navigation app of hip replacement surgery,” —Dr. Jonathan Vigdorchik

“It’s like technology in everything. Robotics is similar to the Google Maps or Waze navigation app of hip replacement surgery,” Dr. Jonathan Vigdorchik recently told us. He currently works as the Co-Director of Robotics in Orthopaedic Surgery at NYU Langone’s Preston R. Tisch Center for Men’s Health. “Do we know how to get home without navigation? Sure we do, but this makes it done faster. The robot is NOT performing the surgery. It is making sure that I perform the surgery perfectly.”

Obstacles in Robotic Assisted Surgeries

A big disadvantage around the use of robotics is training. There is no national standard for how much training is required to use this equipment in practice. Instead, it comes down to the hospitals that have this technology, the manufacturers, and individual physicians to ensure they are adequately trained and have the knowledge and experience necessary to keep patients safe.

Dr. S. Adam Ramin, a urologist and the medical director of Urology Cancer Specialists in Los Angeles, explains extensive training is essential to ensure patient safety.

Dr. S. Adam Ramin

“Robotic surgery [is] technically very difficult to perform…In order to obtain maximum benefit in terms of cure of the disease as well as optimization of quality of life, it is important that robotic surgery be performed by highly skilled surgeons.”

Without proper training, it can be difficult to maintain full control of the device, which could lead to inadvertent injury. Using robotics to assist surgery doesn’t mean the operation always goes perfectly either. Just like with traditional surgery, there are still the risks of injury and complications.

In general, studies have also found robotic-assisted surgeries to cost several thousand dollars more than traditional laparoscopic surgery.

Just as surgery is not the best treatment option for every patient, neither is robotic-assisted surgery. It’s important to speak with your doctor about all of your treatment options and the best course for your own case.

The Future of Robotics in the Medical Field

Overall, there is a great sense of optimism for the future and how these technologies will continue to improve and allow for even more applications. Robotics have already allowed surgeons to overcome certain limitations, like accessing hard-to-reach areas of the body, and they believe further advantages will come over time.

Dr. Benjamin Domb of the American Hip Institute

Dr. Benjamin Domb

“I see robotics becoming the standard of care.”—Dr. Benjamin Domb

“I see robotics becoming the standard of care,” Dr. Benjamin Domb, orthopedic surgeon and founder of the American Hip Institute, recently told us. “The improvements in accuracy and the ability to individualize the surgery to the patient are undeniable advantages which will displace the more error-prone ‘human eye.’”

One interesting problem robotic surgery could help solve is the location of specialists and expert surgeons. For rare cancers like mesothelioma, specialists are few and scattered throughout the country. While surgeons today perform robotically assisted operations in the same room as patients, it’s thought in the future the procedure could be done remotely and help remove such barriers.

“In the future, these robotic platforms could be centralized for expert surgeons, allowing them to perform surgeries on multiple patients throughout the globe with the assistance of bedside surgical assistants at the locations with the patients,” said Dr. Ritch. “Imagine a surgeon in New York operating on a patient in India in the morning and Alaska in the afternoon. This could change the whole structure of surgical treatment and patient access to care, potentially streamlining the process and reducing costs.”

Robotics can also become an invaluable teaching tool. Expert surgeons could not only possibly remotely perform these procedures, but also be able to share their skills more widely with such tools. Junior surgeons could also gain experience with a more experienced surgeon essentially guiding their hands and motions through the surgery with this technology.

“Applications of robotics technology will also extend into non-surgical aspects of medicine, such as patient evaluation and preparation for final diagnosis and recommendations by the physician,” Dr. Ramin suggested. “Therefore in the future robotic technology will continue to flourish in medicine and improve patients’ lives.”

It will be interesting to see how robotics and other healthcare technologies will continue to improve and overcome the current obstacles faced. These technologies coupled with ongoing research efforts, like the Cancer Moonshot, will hopefully lead to better treatment options for patients and continued advancements in the future.