All That Glisters…

The next big thing

There is a revolution going on in the world of medicine.  Robotic surgery equipment is being installed in operating theatres across the western world.  The robots allow surgeons to make far smaller incisions and operate much more precisely.  The surgeon doesn’t have to contend with slippery instruments and the robot has a steadier hand.  So surgeons can carry out “minimally invasive” or “keyhole” surgery.

This is good news for patients. Advantages include:

• Shorter hospital stays
• Less pain post operation
• Reduced scarring
• Lower infection risks
• Reduced need for blood transfusion.

Besides which, the surgeon can operate the robot remotely.  He could be anywhere in the world.  This means patients can visit their local hospital and not have to travel to the surgeon.

Since 2000, more than 5 million robot assisted procedures have been performed.

Why wouldn’t you want a robot surgeon?

…technology should enhance your ability and help you make better-informed decisions. Da Vinci® systems give you precision, flexibility, and control to perform many types of procedures, while offering real-time feedback so you can operate with confidence…

Intuitive ~ The Makers of the Da Vinci Surgical Robot

All that glisters

There are unfortunately a few problems with Robots…

• They are exorbitantly expensive.  A robot can cost upto $2.5 million.
• Surgeons need to relearn their craft as using a robot is nothing like doing the job by hand. It can take 250 procedures to learn how to use the robot.
• They can only be used for certain procedures
• There is a huge debate raging about whether the clinical outcomes are actually any better.

I am not a Ludite.  There is a role for robotics in nearly every profession (medicine, the law, insurance, banking and…). But, as a way of improving performance robotics is far from a slam dunk.

The low tech end of the spectrum

There are alternative ways to improve medical performance that are much more pedestrian.  In his book The Checklist Manifesto Atul Gawande argues the case for the use of checklists in medicine.  You know the sort  of thing, a list of things that need to be done, a clip board and an HB pencil…

Checklist have yet to take off in medicine. They are seen as a failure to be able to memorise simple tasks and pay attention to what you are doing.  The years of studying that go into a medical training ought to negate their use.  Besides which, in an emergency situation checklists are simply a hindrance.  Or so the logic goes.

Does low tech work?

Their have been many successful studies into the use of checklists in medical care.  A study by the World Health Authority in 2008 looked at the use of Checklists in “safe surgery” across a range of procedures and countries.  The simple checklist (see it here) called out tasks that should be done before anaesthesia, skin incision and leaving the operating theatre.

The results were impressive:

• The rate of medical complications post surgery dropped from 11.0% to 7.0% 
• The in-hospital death rate dropped from 1.5% to 0.8%

The overall rates of surgical-site infection and unplanned reoperation also declined significantly

How about focusing on what works?

This is a story about robots, but it applies everywhere.  We get dazzled by the next big thing. And the bigger, more expensive and sexier that big thing sounds, the more likely we are to give it a spin.

Just because it sounds sexy doesn’t mean it will work. Why not find out what does work, and do that instead?

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Photo by Rock’n Roll Monkey on Unsplash