The Revolution and Future of Surgery: Ready to Let a Robotic Arm Operate for You?

The Da Vinci Surgical System, a combination of AI and robotic arms to assist surgeons in surgery, is often seen in American and Japanese dramas. Not only does it provide a wide field of vision and a small post-operative wound, but it is also extremely stable, which avoids the problem of trembling hands and reduces the burden on the surgeon, but is it really a foolproof system?

High-tech devices like drones with navigation-like capabilities are now available in hospitals, along with a combination of clever AI and robotic arms to assist physicians in surgery, and it's the famous 'Da Vinci Surgical System'.

In the past few years, major medical centers in Taiwan have purchased the Da Vinci robotic arm, the density of which is supposed to be one of the highest in the world. The main advantage is that the post-operative wound is small and the recovery is fast, the disadvantage is that the price is expensive.

Da Vinci surgery is characterized by a computer system navigation, through the clever artificial intelligence computer program for the surgeon to establish a clearer 3D map, and to assist in the positioning of the robotic arm, in the narrow body cavity can still move freely, to complete the complex surgical procedures, so in the Department of Obstetrics and Gynecology, urology is the most widely used, and in recent years in the general surgical, otorhinolaryngology is also gradually being widely used, in particular, some minimally invasive surgery, such as regenerative medicine, the use of the body's own body. In recent years, it has also been widely used in general surgery, ear, nose and throat, especially for minimally invasive surgery, such as surgery related to the prostate gland and prostate cancer eradication.

Over the years, minimally invasive surgery has replaced most of the open surgeries in the past and has become the mainstream surgical procedure in China. As the name suggests, minimally invasive surgery utilizes endoscopic instruments instead of the surgeon's hands to achieve surgical results with minimal wounding, which not only reduces post-operative pain and shortens recovery time, but also minimizes the appearance of the surgical scars left behind. The most famous minimally invasive surgery is the da Vinci procedure, which uses advanced laparoscopic surgery and a computerized system to manipulate the robotic arm and instruments, replacing the usual endoscopic surgical instruments.

The most unique feature of the da Vinci system is that the surgeon does not have to stay in the operating room with the surgical team and the patient during the surgery. Instead, he sits in a remote control pod several meters away, like a drone pilot, and operates the computer system to allow the robotic arm to perform the surgery. Because of the high stability of the robotic arm, not only can you avoid the problem of the surgeon's hand shaking, but also reduce the burden on the surgeon, reduce fatigue, in addition to the AI technology to establish a clear dozens of times the 3D stereo field of vision, the layers of tissue can be seen more clearly, increasing the precision of the operation.

In addition, the computer-controlled surgical instruments are as dexterous as a surgeon's wrist, and can be used to suture in the abdominal cavity as desired, or to precisely peel away tissues and blood vessels, etc. General endoscopic instruments are subject to a lot of constraints in narrow body cavities, but the dexterity of the DaVinci arm can almost overcome these constraints; for example, a surgery to remove uterine fibroids, which used to take between one and two hours, would take about two to five hours if the surgeon used the da Vinci arm. With the da Vinci arm, a surgeon familiar with its operation can claim to perform the delicate procedure in just over 10 minutes.

At this point, readers will inevitably wonder if the da Vinci Surgical System will replace physicians in the future. In fact, the system's primary function in medical use is to be a tool that assists the physician in performing surgery, rather than replacing him or her. From the description above, we can understand that the AI system with a robot arm only enhances the surgeon's ability to reduce the prognosis of some of the human factors in the surgery; just like the general airplane now has the function of auto-pilot, but the key landing, take-off, often still need to rely on the professionalism and experience of the pilot to ensure the real safety.

But the robot is not perfect, surgical robots even have some fairly obvious shortcomings, such as no sense of touch, the physician can not sense the patient's skin touch, pulsation; in addition to the machine arm instead of the physician knife, may increase the degree of tension lying in the hospital bed patients; and surgical team of health care workers need more professional training. The U.S. news media even devoted an article to Davinci's surgery a few years ago, with the sensational headline - "Are you ready to let the one who does not hesitate and will not shake the robot arm to open the knife for you?

No surgery is risk-free. Although the U.S. FDA approved Da Vinci robotic arm surgery has been nearly two decades, alone in the United States, hospitals will conduct nearly 600,000 times a year Da Vinci robotic arm surgery, there are physicians admitted that in fact, is in the experience of hundreds of surgeries, only really adapted to the operation of the robotic arm, which also implies that there is no real familiarity with the robotic arm, but the use of the Da Vinci Surgical System for surgery and not a few doctors. There is a learning curve inherent in the various procedures in surgery, and the inherent difficulty of the surgeon's skill in operating the robotic arm warrants an even more complex learning curve. If a surgeon operates a robotic arm for surgery without adequate training, it may increase the chance of post-operative complications.

Data released by the FDA in 2015 showed that more than a hundred patients have died from accidental failure of surgery using the da Vinci robot between 2000 and 2013. In addition, according to several large studies published in JAMA (Journal of the American Medical Association) in the U.S. and U.K., it also shows that although there are some small studies that consider minimally invasive surgery superior to open surgery, the five-year survival rate of minimally invasive robotic surgery for the treatment of colorectal cancer is not significantly different from that of traditional open surgery, which is a bit ironic, as it may sound.

As for the Asian medical market, robotic arm surgery in medical treatment has a different look, such as Japan, China, South Korea, Singapore, and Thailand to robotic arm development based on the country, in the *** support, not only continue to a large number of foreign purchases of robotic arms imported into hospitals and research centers, but also combined with their own technology, the robot can also be used for the treatment of colorectal cancer and other diseases, such as diabetes. With the support of IDC Health Insights, not only have they purchased a large number of robotic arms from foreign countries and introduced them into hospitals and research centers, but they have also combined their own technologies to develop wider applications. According to IDC Health Insights, medical institutions in the Asia-Pacific region, excluding Japan, will spend about $3.7 billion on robotic arm surgeries in 2019, but it is predicted that the amount will double by 2022; the report also made a financial analysis of Intuitive Surgical, a California company that develops the Da Vinci robotic arm, predicting that the company will have a market capitalization in 2025, and that the company will have a market capitalization in 2025, and that it will have a market capitalization in 2025. The report also did a financial analysis of Intuitive Surgical, a California-based company that developed the da Vinci arm, and projected its market capitalization in 2025 to be around $15 billion.

These Asian countries in the development of AI systems equipped with robotic arm medical surgery, take different strategies, to China, for example, to date, da Vinci robotic arm surgery about 60,000 times, but in the past two years there have been 30 various medical upstream, midstream and downstream of the local manufacturers are undergoing mergers and acquisitions and consolidation, predicted that there should be at least two winners, and enter the domestic market of the continent under its own brand; as for the da Vinci robotic arm, the domestic market of the mainland, the company's own brand, the company's own brand, the company's own brand, the company's own brand. The domestic market; as for patient testing, currently only in a small number of dozens of regional military hospitals in the test. Japan *** is to support and combined with five university medical centers, the development of the next generation of surgical precision control robot arm. As for Singapore and South Korea, most of the AI computer systems combined with robotic arm-related industry start-ups, including South Korea's automotive giant Hyundai Heavy Industries also has a lot of investment, which is mainly in robotic arms and high-level imaging equipment manufacturing. From these market trends, we can see that the Asia-Pacific region has a goal of promoting AI robotic arm surgery equipment in the medical market, basically to grab the gap in the market for small and low-cost medical surgical equipment manufacturing, and wait for the opportunity to cooperate with the U.S. major manufacturers or to be merged and acquired.

* Authorized content from From AI to Smart Healthcare by Jiang Rongxian, published by Business Week.