Robots

ImageBoys and their toys. We just can’t help it. We love to play. And we love to score. Put a group of surgeons together around a million-dollar robotic surgery console, and we start competing and comparing skills and trying to get the highest score. I don’t see that as a bad thing. As long as the score is the patient outcome.

As a surgeon, the highest score we can get for the patient’s benefit is a good quality of life, disease free. It is no longer enough for a Head and Neck Cancer Surgeon to say “We took out your cancer”, and leave the patient PEG or tracheostomy dependent with a poor quality of life. To that end, we need to employ every means possible.

We used to take out cancers with massive, deforming, debilitating head and neck surgeries. Then radiation and chemotherapy came on board, leaving them with organs, but with poor long term functions. Then endoscopic surgery came along. Then laser surgery, then laser-assisted microscopic surgeries. And now, robots are on the horizon. The urologists have been using this for some time, but ENT surgeons are a little slow in adopting. In 2007, 60% of all radical prostatectomies in the US were done with robots.

Why not? This is yet another weapon in our armamentarium to provide better care for our patients. Experience are mounting that with TransOral Robotic Surgery (TORS) the morbidity is lower, time to oral intake shorter, airway is safe, length of stay shorter, but more importantly oncological clearance is same or better than traditional methods.

There is a lot of skepticism. Of course. But a good surgeon should research, investigate, study, assess, experiment and come to a conclusion. There is more than one way to skin a cancer. The robot will be great for some things, but not others. And there’s evidence for that. Probably not so good for thyroid, but excellent for parapharyngeal, supraglottic and tongue base pathologies. We wait for the evidence to declare itself.

I am not concerned about the shape, size and challenges of today’s robot. I’m more interested in tomorrow’s robot. It will be sharper, smoother, smaller, and much more surgically accurate. But how can we make those robots better? By using today’s robot, and improving them. Today I practiced on a 10 year old robot, and I was impressed. In 10 years time, I may well be using robot to do tonsillectomies because it may be deemed a more superior method.

Robots will not replace surgeons. Rather, robots will enhance the surgeon’s performance. And what’s the point of enhancing performance? So patient outcomes are improved.

Surgeons, for the sake of our patients, should be on the cutting edge of technology. We should use all manners of technologies to provide better outcomes for our patients. Even using Apps and Social Media!

What technologies are you using to better your patient outcomes?


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