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[deleted] t1_ir2w2y1 wrote

[deleted]

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Lunchmoneybandit t1_ir2xx5k wrote

DaVinci System saved my dad from prostate cancer. Robots may not be there for everything, but there’s applications that seem to be near perfect

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iemailrobi t1_ir3m36s wrote

Great point and for soft tissue work, Da Vinci is unparalleled. Unfortunately to make it so, it is nimble and agile and completely useless for the manual labor that defines orthopedics. It is a testament that if you design something well you often also define it / pigeon hole it. And in the case of orthopedics and spine, these tools aren’t up to the job.

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Blakut t1_ir4cgot wrote

But orthopedic surgery is more like construction work anyway from what I've seen

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PsychoEngineer t1_ir4zhea wrote

Correct. But that’s also why there are other medical robotics similar that are specifically for orthopedic applications.

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iemailrobi t1_ir5176l wrote

I know. Unfortunately that’s what the large scale papers and research are showing that they worsen the results of surgery. At least at this point. One day you’d imagine that’ll change.

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bewbs_and_stuff t1_ird5dh3 wrote

Is your end goal to create singular robot that can perform all varieties of surgery? I never understood that to have been the design intent of the Davinci. My assumption was that the development of care using such a robot would eventually provide the invaluable resource of expert surgical care irrespective of you local. Who cares if it takes a specific robot to do each specific surgery? (Being fastidious here) But Fill the room with 100 robots and still all you have to do is save 1 Jeff Bezos, 1 bill gates, 1 Warren Buffett, 1 Elon musk and the it’s a net positive to the gdp.

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WasatchSLC t1_ir5cyo8 wrote

Statistically they aren’t any better than a surgeon who does the same thing all the time, like a surgeon who only hip and knee replacements. It’s kind of like trying to make a robot to do HVAC or plumbing, they just aren’t there yet.

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PsychoEngineer t1_ir5fdxq wrote

Can you link to the study showing this overall?

The one linked by the OP was only a small study in the UK done by 3 doctors with barely over 100 patients with limited data used to determining the effectiveness/differences.

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WasatchSLC t1_ir5go1c wrote

Schemitsch, Emil H. MD, FRCS(C). In Younger Patients with End-Stage Knee Osteoarthritis, Computer-Assisted Versus Conventional Total Knee Arthroplasty Did Not Improve Function at 15 Years. The Journal of Bone and Joint Surgery: November 21, 2018 - Volume 100 - Issue 22 - p 1982 doi: 10.2106/JBJS.18.00917

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8142057/

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WasatchSLC t1_ir5grn7 wrote

I think you’re going to find a lot of limited sample size and lack of long term outcomes.

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PsychoEngineer t1_ir5i3uj wrote

And that’s where I have a hard time agreeing with your broad claim of not being any better.

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WasatchSLC t1_ir5jubu wrote

I mean if we had the data it was significantly better, we’d be doing it. Just like if injections of stem cells into an arthritic joint cured arthritis we would do that. They just aren’t simply there yet. One day I’m sure they will be, but don’t underestimate a skilled human either.

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WasatchSLC t1_ir5k7w7 wrote

But if you look at the knee outcome scores (which have been extensively validated), they aren’t better. So that’s why I make the statement.

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DarthFishy t1_ir2zia1 wrote

I got to play with their bot at a local fair earlier this year. They manufacturer them not far off. They had a semi trailer set up and demoed the unit for the public in groups, then let us give it a go. Things got the most intuitive controls I've ever used. And it's setup so the doctor can just walk up and look through the eye peices and grab the controls but also disengage from it in a mere second to be physically back with the patient.

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SAYUSAYME007 t1_ir3tmnx wrote

Da vinci does excellent hysterectomies too. Only 4 little 1 inch scars on the belly.

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MD4Bernie t1_ircu6wu wrote

Are you aware that vaginal hysterectomies have zero outside scars? None!

And can be accomplished entirely in less time that it takes to dock the robot, let alone start the surgery?

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SAYUSAYME007 t1_ird8hbc wrote

Maybe since mine was for cancer, they couldn't do it vaginally. I dont even remember an option being given. I was just happy not be cut open like my c-sections. But, vaginal does make the most sense, since they removed the cervix, uterus and fallopian tubes. I wonder why it wasn't done that way..I honestly never even thought about it.

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Talkat t1_ir3zuo5 wrote

Yah I just had robot surgery. 1000÷ preferred over human surgery

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Notreallyonreddityet OP t1_ir48fuo wrote

Very cool. Curious if you would share why? I haven't had much surgery, and all of mine were done by humans with terrific outcomes.

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Talkat t1_ir50bra wrote

Sure. Stage 3 colorectal cancer. Had to remove the tumor, 19 lymph nodes, and a section of my colon. They had 2 surgeons operating on me.

Had a few incisions from up top which are super small and a larger one lower down.

Recovery was quick (like 6 days in the ward) but I had made sure I was in top shape before I went in.

So that is why I had surgery. Why I prefer robot?

Well the incisions were very small (like 2cm) and healed very quickly. There were like 4 of them I think?

I'm not an expert but I think it also gives them finer control and they have multiple hands so they can do multiple things are once.

Plus I like robots so thats just a bonus.

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Oldtimerowcoach t1_ira91rv wrote

So you preferred the robot because it had the same sized incisions as a human doing laparoscopic surgery?

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SEND_PUNS_PLZ t1_ir48skk wrote

The prostate it but da Vinci ally they will learn to accept it

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MD4Bernie t1_ir2ylrh wrote

Sorry, your notion that the robotic prostatectomy is better than a regular prostatectomy is about 15 years out-of-date.

Yes, they tried to make "function-sparing prostatectomy" the killer app for the insanely expensive operating robot. (And to be clear, the "function" we are talking about is potency, the man's ability to maintain an erection after surgery.) Maintaining potency is, of course, and admirable goal.

Problem is that maintaining potency also ended up maintaining the cancer cells. Yes, a higher percentage of "targeted resection" patients maintained their potency; but they also still had cancer.

The da Vinci is a dangerous, expensive cure in search of a disease. It makes bad surgeons even worse. Excellent surgeons rarely (if ever) need a gee-whiz marketing angle to prove to patients that they are up-to-date on all the expensive gizmos.

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brickmaster32000 t1_ir5baq4 wrote

>Excellent surgeons rarely (if ever) need a gee-whiz marketing angle to wash their hands to prove to patients that they are up-to-date on all the expensive gizmos. are cleanly.

That is what your rant reminds me off. Treating surgeons as if they are perfect and shouldn't be asked to use tools that can help them do their jobs better.

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