#8 Innovation in Robotic Surgery

Overview

Most surgeries performed today are the least time consuming and least invasive that science will allow. This innovation in surgical methodology saves patients and surgeons time and distress and is brought about by the integration of robotics. Robots, computer programmable machines, are being used widely in society today. Portrayed by the media as high-tech malicious machines, robots have received a bad rap. In reality, robotic systems are fueling innovation in a peaceful manner.

Though popular for the automation of simple, repetitive tasks or those tasks harmful to humans, robots can be used to enhance certain human practices as well. Today, robots are increasing productivity and aiding in the conduction of several medical tasks. Popular in nearly all medical specialties, robotics is finding its niche in the operating room.

Advances in robotic surgery range from the development of more accurate planning tools and software, to increased automation of tasks during surgery. Specific examples of robotic surgical progress include the successful robotic planning and guidance of surgery on the spine, and the near automation of the process of bronchoscopy. In robotic spine surgery, robotic platforms are used for 3D surgical planning and intra-op guidance. Many platforms also include precision surgical arms designed for proper instrument positioning and implantation during surgery. The robotic assistance provided by these systems increases surgeon precision in rather challenging surgeries. The market for robotic spinal surgery systems has grown exponentially in the past four years. Several popular platforms are FDA approved, CE marked, and in operating rooms around the world.

Systems for robotic bronchoscopy are also becoming mainstream as they are automating the rather tedious and unpleasant process. Unlike traditional bronchoscopies, robotic bronchoscopy systems avoid incisions via insertion of flexible tubes through the body’s natural openings. The new concept of robotic bronchoscopy is increasing both accuracy and safety of the procedure while decreasing both invasiveness and cost. The world’s first robotic bronchoscopy platform received FDA clearance in 2016, but a new and improved platform was released and cleared in the spring of 2018. Integrating the latest advancements in robotics, software, and data science, the new robotic endoscopy platform utilizes a controller-like interface that physicians use to navigate the endoscope with improved reach, vision, and control.

Endovascular procedures are perhaps the newest field feeling the effects of robotization. Now able to be performed remotely, procedures like percutaneous coronary intervention (PCI) and peripheral vascular intervention (PVI) are lower risk for both the patient and surgeon. While the traditional approach to vascular intervention requires heavy lead protective equipment that impairs surgeon control, remote endovascular procedures via robotic platforms allow physicians greater control for improved outcomes. Though not yet fully integrated into practice, new robotic and telecommunication technologies are bringing remote vascular intervention closer to reality.

Minimally invasive robotic procedures are attractive to healthcare professionals as they offer significant cost savings in terms of pre- and post- operation care costs and length of stay at hospitals. But most importantly, the aforementioned advancements in robotic surgery qualify as an innovation as collective growth in the field yields significant improvements in patient outcomes and safety. Shortened recovery time and limited pain after surgery are just a few of the patient benefits seen with minimally invasive robotized surgery. Continued advancement in the space will only yield more precise and effective surgeries for patients requiring intervention in the coming year.

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