The role of medical robots

What are medical robots?

When we think of robots, we automatically think of industrial robots. Are medical robots similar? No! For industrial robots, the basic premise is:

Lots, fast, cheap. A good industrial robot proves its worth by saving on human workers in an assembly process.

This is not true for medical robots. Here the basic premise is: precise, safe, redundant. The aim of the medical robot is to support the surgeon in those procedures where the robot is clearly and measurably superior to the human hand.

The industrial robot replaces a human; the medical robot helps him.

Future fields

Medical robots have taken over the first steps in telemanipulation (Zeuss, Da Vinci, Aesop). In this area alone over 10,000 operations have already been performed.

A further evolutionary milestone is the use of robots in osteosynthesis. The first task to be successfully accomplished by robot systems was to learn to walk in large artificial joints (Robodoc and Caspar).

In osteosynthesis, the success of the treatment depends greatly on the accuracy of the diagnosis planning and implementation of an implant. In future most osteosyntheses will be performed by medical robots. The advantages of exact kinematics in surgery are already being exploited for screw fixation of vertebral bodies, for example (Evolution I, Neuro-Mate).

In future, diagnostics and treatment will merge into one procedure. Interventional radiologists have already done pioneering work in this field. They have demonstrated that treatment can often follow on directly from diagnosis (in biopsies, application of analgesics, implants, catheter insertion etc.). Interaction between a medical robot and a diagnostic computer in this field will make online planning, simulations and treatment possible.

The next evolutionary milestones will be when robots begin to interact. Scientists today are already calling this shared autonomy. Expert systems will help the robot to monitor its steps (sensor technology). This will mean that organ movements can be compensated for, bone thickness measured during a cutting process, implant components tested for strength and emergency procedures trained in advance with robots so that they can be carried out automatically in an emergency.

Epilogue

Medical scientists have taken up the challenge that computer scientists, engineers and programmers have posed. Surgeons are increasingly becoming operation managers, rather than skilled craftsmen. When planning treatment, a surgeon must make use of every medium available to optimise its course.

Does it seem likely that doctors in future will make a precise diagnosis on the basis of an NMR tomography, CT or PET, then use high performance computers to plan and simulate an operation optimally, only to operate manually in the end?

It is virtually inconceivable that the surgery of the future will go ahead without the assistance of robots.

Gradually, as more and more international scientific publications appear and the results of robotic surgery improve, doctors who do not offer their patients this option, will be forced to explain why not.
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