Is it the San Francisco robot?

I’m glad if this helps with esophageal cancers. It’s my understanding that they have to really tear up your throat and associated anatomies to treat those cancers. It would be so amazing for patient quality of life if these cancers could be treated with out as much collateral damage

Don't do this. Heavily increases the risk of multi-modality treatment.

[removed]

I think a lot of people think automation is coming for the factory line jobs. While that may be true, some of the lower hanging fruit, especially in terms of cost savings is specialized medicine. If a robot can replace one doctor making $800k that is a heck of an upgrade

This robot required two surgeons to operate. I had surgery a few months ago and my surgeon used a robot.

It will shoot you but will also remove the bullet and stitch you back up.

Surgery is still very far away from true automation. But diagnostics, especially in pathology. A scanner is set to replace a whole pathology department and instead transition to one head of pathology just confirming it is working.

They did surgery on a grape

How so?

It goes in from the bottom??

Wow, the picture makes it look so human!

Did the grape live?

[deleted]

Smh, they are making it harder and harder to tell the difference between biological man and machine. Just look at that cold calculating mechanical force behind those soft fleshy features.

yes

I can name several departments across the country that are extremely short staffed, specifically with Pathologists. Their solution is to improve the efficiency of their current staff through these semi automated solutions. If you aren’t concerned about automation coming for these jobs, you probably are not talking with your finance department.

If you combine that with the automated nature of NGS and how it just spits out a report, this is where the industry is heading. Multiplexing is a similar story - no pathologists wants to look at these crazy complex slides all day scoring and counting. They can barely manage single color stains always complaining it hurts their eyes. At some point, the limitations of human diagnostics is going to be seen not just as a cost savings measure but a benefit to the patient. When that switch happens, although it can be gradual, it creates a profound shift in the industry that can spread rapidly.

It is always funny reading comments like these as someone who is in the medical field. As the other comment stated, No, computers will not be replacing any pathologist or radiologist anytime soon. Medical imaging goes beyond just identifying a lesion on an image (and even that is very difficult cus lesions can look different from person to person). Clinical context is very important. AI will help streamline their work/make things a bit faster but it will not be replacing any specialists anytime soon.

AI has not even replaced truck drivers or McDonald’s workers fully and you think it can replace specialists that take a minimum of 10 years to train?

Robotic esophageal surgery is already pretty common using the Da Vinci platform. Not sure if this is a new surgical approach or just using a new robot to do the same procedure

Then murders patient on wanted list in San Francisco.

Looks just like a human, crazy.

Wow. Looks stunningly human

Throat bot?

Lol. The robots are 0% autonomous. They are completely controlled by a surgeon sitting at a station with hand and foot controls and a 3d view screen.

Couldnt talk afterwards tho

[removed]

I think if you were to go into your average hospital, you would obviously be right. But if you go to a more prestigious, larger, more specialized institution you will see a massive push with big money being spent on automation. This doesn’t mean they will be firing, or as you put it, replacing anybody.

This does mean there is a shift in how clinical labs and departments are trying to drive more throughput. They would rather spend on capital than headcount. This trend is reflected in the market report data.

Short version: The throat surgeons who use this technology rarely remove the whole tumor. Then the patient needs radiation and/or chemotherapy to fix the residual. This happens in nearly 80% of those patients who undergo the robot surgery.

So, 3 treatments instead of 1 or 2.

Throat gouging machine .

Surgical you are totally right! Clinical chemistry, pathology, and even aspects of oncology, not so sure I agree there is 0% automation.

Also the very fact that the robot in this article is operating in the patient is the definition of semi-autonomous which I would think is the first step

>> semi-autonomous

No. I'm an anesthesiologist. I went to medical school. I spent months scrubbed into surgeries, often with robots. I've sat at the control stations. I literally spend all day in operating rooms.

They are not semi-autonomous. They are zero autonomous. You don't know what you're talking about, at all, and you need to stop defending your 100% uninformed statement.

Jesus. You are literally just making up whatever you think sounds good.

Stop.

I’ve read that doctors can actually remove more of the tumor using robotic surgery.

Buddy just stop. You clearly don’t know what you’re talking about.

It looks like a new robot doing the same thing. The article doesn't have a ton of detail.

It used to, but it doesn't now. Not without better pay and benefits.

You're literally lecturing a physician about his own job.

They even added glasses! Nice touch.

[deleted]

yeah my grandma was diagnosed a year ago and the treatment is genuinely awful. I can’t remember exactly why but due to her treatment she can no longer produce saliva, meaning she will most likely never be able to eat dry foods again, as well as having a bunch of other issues now. It’s always so uplifting seeing advancements to really help patients :)

I don’t think anyone is projecting AI/automation to replace pathologist wholesale, but it can certainly increase efficiency so fewer are needed per x number of patients. So while no one’s job is threatened currently, that’s the trend the other person is pointing out.

And I think you are grossly underestimating the difficulty of AI replacing drivers.

It may be a lot easier to train a human truck driver than a clinician but it’s far from trivial to make that same comparison for AI drivers and clinicians.

Ultra precise maps, real time software response with no slowing or freezing, pattern recognition in dark lighting, inclement weather, worn road signs, communications between AI vehicles, hackability are just a few that comes to mind. It’s much more like a generalist. The 10 years of education is probably an easier problem to solve than millions of years of evolutionary response.

Sorry, but no way doctors are replaced anytime soon. As someone designing these robots, I can guarantee you we very far away from that. These robots help surgeons be more precise, make surgeries quicker and help with planning, but they will not run surgeries by themselves in the foreseeable future.

That’s a very life-like robot

robots assisted surgery is considerably more expensive than open or laparoscopic in most cases, the robots also require additional training and are operated by surgeons, they are not autonomous

The comment I replied to SPECIFICALLY talked about AI replacing an entire pathology department. I also mentioned in my comment about AI increasing efficiency.

If you wanna convince yourself that it’s easier to train AI to the level of a specialist physician than it is to drive a bus then go ahead. My point was that these problems are very complex even for AI. What exactly do you think pathologists and radiologists do exactly? I think YOU are grossly underestimating what it would require for AI to be as good as a trained specialist

Identifying a particular lesion on an image is just the bare minimum and even that is incredibly difficult even for AI. They still need huge amounts of understanding to decide whether we should treat now or wait. I can’t even begin to type out how essential these specialist are. AI will need real physicians for the foreseeable future because you need someone to make clinical judgement, something no AI is capable of doing. Imaging going to an AI to make a judgement about whether to treat your mothers cancer or not. Would you take that risk?

[deleted]

That is incorrect.

With all due respect, that is the opinion of actual surgeons. I tend to trust them in matters regarding surgery.

Hope they named it the Throat GOAT

/shrugs/ Surgeons generally will say whatever the hell they want.

The only thing that actually matters is the pathology report.

And the pathology reports for patients treated with robotic trans-oral resections of throat tumors leave residual tumors a large proportion of the time.

To be fair, so will people on the Internet.

/shrugs/ Read the papers yourself.

https://pubmed.ncbi.nlm.nih.gov/34699271/

https://pubmed.ncbi.nlm.nih.gov/31416685/

https://www.sciencedirect.com/science/article/abs/pii/S0360301621028121

Which is what I do for my job lol

It’s going to take a while, but it is happening and the increase in semi-autonomation across all areas of a hospital will only increase in pace.

One small correction to the above comment, the interpretation of NGS data is already being done by algorithm. A pathologist is only needed to view the report.

How so? I work in automation in Clinical settings. Your comment is really alarming to see from a random Reddit user,

What did I make up?

If a robot is doing a task under control of a human that is the definition of semi-autonomous.

Are you telling me there is and never will be automation in clinical workspaces because you went to medical school? Or are you saying the robots you worked with medical school are not autonomous? Did you work with every robot in the hospital or just one or two boxes?

I read them but didn’t find anything about it.

Versius is getting peddled pretty hard but it is doing the same surgery just with a different ‘robot’. Its probably the closest competitor to Intuitives machines but they also probably have an unassailable market share till peoples machines come to the end of their working life.

You read the actual papers?

My understanding is (and I could be totally wrong so anyone else feel free to correct me) is that radiation treatment targeted at the throat often times kills the salivary glands

I read the abstracts you linked.

I think that person is talking about “replacing the department” with ONE pathologist, so the repetitive, tedious portions can be automated, and a human specialist to confirm or mark exceptions - not have AI determine my grandmother’s cancer treatment.

I’m not saying it’s easier to train a bus driver, but I am challenging the notion that AI will replace blue collar worker first (or only them), and that somehow will free us up to pursue more white collar or professional careers.

And those careers are not immune, IBM’s Watson has been advising lung cancer treatment at Sloan-Kettering nearly 10 years. AI’s playing GO or Jeopardy may seem trivial but represent accelerating change in AI space and thus real challenges for many career fields. And the higher salary jobs represent that much greater incentive for automation.

I wasn’t making a jab that doctors, but the complexity of your job is no guarantee that it will be replaced only long after truck are driving themselves.

And who knows, maybe in 10 years I will be comfortable having an AI provider deciding my grandmas treatment - and I may not be the minority.

article author was confused when someone said "Dr Higgs is a surgical machine"

this is obviously a big advance in medical science, but I'd be lying if I said I was totally comfortable with the idea of a robot with chopping blades shawshanking its way down my esophagus

Throat Goat

It looks just like a human. Tech has come so far, wow.

Yeah. That's why I said the papers. This is a complicated area of oncology and requires some in-depth knowledge.

I’ve worked with robots so I know what I’m talking about. You clearly don’t so just stop.

The problem with these robots is that they are mega expensive. This results in other related problems. Namely, A hospital cannot buy a lot of them. This means that the surgical residents at these hospitals can only log so many hours on the machine (at places Ive trained, it was mostly reserved for senior residents. So training is limited. Hospitals also cant really afford to have two different brands, and residents also dont really have time to learn two different brands. So again, training becomes limited.

Why is this a problem? Because training in surgery is massively important. Stuff has to become so second nature that unexpected issues need to be semi-familiar or at least things you can deal with since the main issues are happening almost in the background of your head. So by making training so difficult, it actually limits the usefulness of these robots as you have fewer people who can allocate time (sufficient time) to learn one, and even fewer that can allocate time to learn more than one.

As a total aside, Im not in surgery, so take with grain of salt, but I dont see the actual present day utility of these machines. Every robotic Ive observed in school was basically something you could do in probably half the time manually. I could very well be missing the nuances and underestimating problems that arise with manual vs robotic. And it also could be a more preparing for the future, when these machines are more useful and need ready users. But as they currently stand, I dont get the hype about robitic surgeries.

from the images, I wonder if versius is meant to be a single-arm robot versus the multi-arm-options of davinci? like, smaller and more affordable?

[deleted]

[removed]

[removed]

No, you're off the loop. The police chief said it won't have a gun, just bombs.

It blows the cancer away.

Your subreddits are mostly teenagers, Pokemon, dota, and crypto. I think we're done here.

Makes sense. That way any collateral damage would be considered preventative ontological care. A win for society!

Surgery is one part of specialized medicine.

[removed]

He looks like a real human, so wonderful😭

The robot has massively changed the game in oropharynx cancers. Before the robot we would have to split the mandible or do a lingual release to access these tumors. Especially with the healthier, younger HPV-related population, we have been able to cure their disease with limited impact on quality of life.

I’m not sure what is special about the robot in the article. I suspect it’s mostly for marketing.

I’m sorry where do I say automation is going to replace the whole department? I say incremental increasing of headcount will be curtailed due to automation increasing efficiency of current staff. You just would rather invent my words to argue against a point I never made.

You say it’s easier to replace truck drivers than doctors, but it’s not that simple. You need to think about the task being done. Is it easier for a robot to read off a genetic sequence data file or drive a car?

[removed]

It's controlled by the surgeon

Any of those specialities you’re naming as ‘on the chopping block’ due to automation…that automation will still have to be verified by a set of human eyes. AI can have a massive databank of scans but nothing has replaced the eyes of experienced doctors when it comes to discrepancies or additional testing.

It’s this 100%. This is being driven by several factors but the main one is cost. Finance departments are targeting high paying jobs and looking at what they can do without.

Think about it, you are a hospital having a horrible time with staff turnover in your breast pathology group. You have 5 headcount open for a team of 10 (15 total headcount). You have had these job openings listed since the pandemic. To meet your patients needs you have been sending out to another lab.

Now a sales rep for a medical automation company comes in and shows you examples of how you can increase your overall throughput with your current staff by switching certain tests and protocols to a digital scanner, as well improve TAT for your HEME testing to 24-48hrs.

Are you going to continue holding capital in reserve to add incremental headcount? Or are you going to outlay capital for a more efficient solution? Different HCO’s make different decisions, but the largest clinics are all diving into automation headfirst not toefirst.

Doctors are not going to be replaced but their efficiency will be improved so we will be able to do more testing with fewer headcount. If you design these robots, you already know this happening. Easiest example is NGS workflow. A pathologist in a thread above said “obviously NGS is automated, what are we going to do count every sequence” Tens years ago (maybe 15) that’s literally what they did lol

I've had a play with Versius- the arms are separate units which means you can use as many or as few as you want, and you can share them between operating theatres if e.g. your hospital has two 'brain' units. It also means you can get rid of one arm without having to move the whole robot. I haven't played with the DaVinci, but found the Versius very intuitive.

I seen this in a movie, I think it was Roadhouse.

That makes sense, don't want to end up a vegetable after surgery.

I’d call that robot Dalton. From the movie Road House.

[deleted]

[removed]

[removed]

[removed]

[removed]

[removed]

That robot is only as good as the operator.

This robot is used throughout Europe, but not for sale in the U.S.

Thought it’s a picture from GTA at first 😂

There isn’t anything particularly special about this system, it is mostly marketing. There are other systems that surgeons can use to complete the same minimally invasive procedure that have been around for a couple decades.

They removed a grape from a throat with robots?! Techmology these days. Incredible!

Nice. I have Barrettes Esophagus and am risk for esophageal cancer. This is great news.

Unfortunately, this robot can only cut grapes.

They did surgery on a nape

There are not that many surgical robots on the market...

There are many autonomous machines (which I guess you could call robots) in a hospital. Autoclaves, scrub machines, blood sample analyzers. But there is a big gap from that to the work physicians perform.

By that definition we've had semi autonomous robots since the first car in the 1800s.

Sanger sequencing was invented in 1977 and according to Google the first commercial automated system using this method was brought to market in 1987.

NGS was not a revolution in robotics. It was a revolution in biotech that enabled new and faster ways to sequence

[deleted]

I am facing this surgery plus fu stomach renoval. Having spoken to others who have gone through it many are doing well, some return to an active lifestyle including Jujitsu...of course I am only speaking to the ones who survived.

Wow, it looks so lifelike!

Can’t wait for nurses to get replaced by robots so they can stop striking

New robot. Presumably a Da Vinci could do the same procedure the article isn't clear. There are a lot of hospitals Da Vinci wouldn't be suitable for though as you essentially need to build an operating theatre around one.

Definitely. My cardiothoracic surgeon was worried my cancer had spread to my esophagus, in which case her thought was that she wouldn’t be able to treat it surgically but using radiation only.

It is a modular unit. You have the endoscope (camera) plus as many arms as you need which is typically two or three. It is smaller and portable so you can move it easily between theatres or even different hospitals.

Make sure your surgeon is doing a lot of pre-surgery teaching. Ours are bad about it and patients often come out of surgery saying “what do you mean I can’t eat or drink” or “I didn’t realize this was such a big surgery.”

Make sure you’re working hard every day even when it feels hard. Too many patients that I see do poorly want to lay in bed and do nothing, get pneumonia and that’s what sends them to the ICU. Make sure you’re getting out of bed to a chair, walking in the hall as soon as you can, make sure you do your incentive spirometer and coughing hard even when it hurts. The patients I see do well are the ones who do all of that and have strong family support. Sadly, nursing and therapists are kept too busy in modern healthcare to push patients and support them as much as they need so if you can have a family member to help you during your recovery that would be a huge asset. I’m not saying anything in the previous comment to be negative, I see a disproportionate amount of cases that go poorly and don’t remember the cases that go well because they’re gone quick and don’t come back.

This robot has a VR trainer so you could even practice at home

Robots will be able to replace anyone. My wife was arguing there are some things that need a human touch. I'm in social work. She argued no way a robot can do that but there are already crude but improving chat bots for therapy.

[deleted]

We still do the Ivor Lewis when we use the Da Vinci…similar complications with it.

The glasses were a nice touch

It’s called the throatbot!

My dad died from this in January this year. The side effects of the treatment left him largely unable to eat, he lost a lot of weight and then didn’t survive follow on surgeries.

I wouldn’t wish what he went through in anyone.

So your point is that NGS is just as automated as Sanger sequencing? Tell that to the tech who has to hybridize every single codon on their early aughts Hitachi hahah

What makes this robot different ?

I'm the robotic coordinator for our operating room. We have two robots and you're right, they're very expensive, but we have no shortage of doctors who are trained in robotic surgery. One of our newest surgeons did 2 years of nothing but robots at USC in his fellowship. I have more doctors wanting to do cases then I have time to do them. They would operate 12 hours a day, 7 days a week if I let them.

Doctors don't have to be trained on robotic surgery during residency. It's nice if they can be, but Intuitive has extensive training programs and proctors. I'm sure other robotic surgery companies have similar training programs. About half of my current surgeons didn't train in residency or had minimal training when robotics was new.

The robot does nothing without human input.

What part is the autonomous part?

Yes, I think that is obvious. Did you think someone thought robots were wandering around crawling down random people's throats?

There is a DaVinci single arm robot

You don’t actually have to build the OR around the Davinci however. The consoles and robot itself are all able to be worked out of the room and stored elsewhere if needed. And it fits through normal OR doors that would also fit a regular bed.

If I ever need surgery again, I sure hope it is a surgical robot and not a narcissistic meat-bot who had a grade-inflation GPA and who drank its way through some weak-tea medical school and now works on human beings as if they were chattel.

[deleted]

The next version is likely to keep the throat in the human too!

It’s white

Throat goat

Used to? What does it do now?

That's what she said

As an OR nurse you can absolutely move a DaVinci from room to room.

Wish my grandfather was alive to see this

Throatbot

It could only whine audibly

You don’t need to now with da Vinci…..

I designed a new DaVinci OR in an existing hospital this year. FGI has minimum guidelines for the room, the issue becomes robot positioning and use for staff. Trip hazards for the circulating and patient nurse are a major concern from the wires from the patient cart, vision cart, and surgeon console. You’re able to better contain them with overhead boom coordination that gets them off the floor. There’s also concerns about the robot approach to the patient because the operating table’s head isn’t going to do a 180 if you have a floor fed anesthesia machine / medgas. You have to plan for the robot to have good positioning at both sides. Other concerns were MEP related to make sure the robot would perform correctly in the room / not hit the overhead boom system when fully deployed.

What I’d personally be interested in is how easy it is to clean the new robot’s arms. Current DaVinci’s take a long time to be sterilized compared to conventional instruments. If the new robot can be sterilized quicker it would allow for more either more cases to be preformed or allow your sterile processing department to have some breathing room in their workflow.

Ok. So if that's what it used to do, what does it do now?

So THATS what happened to Chandler!!!

Great, now you've gone and taught the robots to cut our throats!

They look SO human-like these days- amazing!

/s

This rendered on my phone as "New type of surgical robot used to remove throat"

Oh damn, robot uprising is not messing around.

[removed]

This is true more for tongue base tumors than predominantly tonsil tumors. You really don't need a robot to do a proper radical tonsillectomy, though a robotic platform may enable more surgeons to do a proper radical tonsillectomy.

I think what's novel about this robot is its modularity and much lower profile. It also has an open console, as in you're not tunnelling your head into a console when operating the robot - you're wearing glasses but have an open view of the OR including the patient's bedside.

I think this might confer an advantage for those who do transoral robotic surgery because with da Vinci you are still dependent on the quality of your bedside assistant to know when and how tools and the camera are colliding with the patient's teeth and with each other. With an open console you can see the patient without taking the camera view out of your field of vision.

The post-residency training is still training. For people like surgeons whose baseline residencies are already very long, without getting into the medical field pushing for fellowship post-residency, any extra time is often a bigger investment than it seems.

Also, "intensive" training can be fine as catch up, but (if I had to guess) probably depends on users having some baseline understanding and ability with the machines. A 40yo who never touched one like will feel pretty wonky at the controls and a 1-3 month course likely wont fully fix that. Also, again, comfort needs to be there; you cant just use a machine to do surgery if youre not super comfortable with your mastery of it.

This is not necessarily true. This new robot is modular while the older models have all instruments and camera coming from one giant unit.

It also has an open console as in the surgeon controlling the robot arms can still directly look at the patient without having to completely give up control or visualization of the machine's camera view.

This is a great point and a considerable advantage over older robot systems. The older robot systems require you to use the actual operating console that's used in the OR to use their virtual reality training modules. That means you either do your VR training in the OR, or the hospital needs to purchase a separate robot console strictly for training.

This new system lets folks train using an Oculus, which is probably 1/1000th of the cost Intuitive charges for a standalone VR simulator.

This new system lets surgeons practice VR using an Oculus headset, which is way cheaper than an entire da Vinci console.

Not a substitute for real surgical proctoring, but makes a huge difference early in the learning curve.

Intuitive wants more surgeons to use their machines but doesn't do any real competence based training to make sure their devices are used properly - they put all that burden on hospitals so the company can't be sued for improper use or inadequate credentialing.

not sure why you're getting downvoted... you're not speaking with the intent to insult pathologists, you're just stating your experience. You're getting downvoted by people who are actually potentially insecure about the effect of AI on their profession. It's a touchy subject for sure. AI is not going to suddenly replace pathologists but an AI platform might enable 1 pathologist to do the work of 5.

This screams insecurity and fragility.

Open surgery is faster, but patient outcomes are much better with robotic-assisted surgery. Additionally, reimbursement is typically higher for minimally invasive surgery (i.e. laparoscopic or robotic).

The Versius robot is ZERO percent autonomous during actual operation on a patient. There are elements of instrument orientation/calibration that are automated but that technology has been around a long time for operating microscopes and, wait for it, autofocus cameras.

My dog died 3 years ago because he had a throat tumor and no one wanted to operate, as they were afraid of accidentally cutting an aorta due to the location of the tumor. This news is bittersweet, as we probably could have used it back then. But dammit, if this isn’t good news! FOR BEAR!!!

Did it wine appropriately for it’s age?

Versius arms are draped. Obviously the instruments need to be sterilised but you have multiple sets of them since they are consumables.

That’s a great move and exciting to hear. DaVinci arms take so much more to process in SPD since you can’t cram multiple arms into a sink basin or ultrasonics due to their size.

These aren’t the huge benefits that CMR sells them as. The footprint of a modular robot is massive and the single-unit isn’t as restrictive as it would seem. From the care team perspective, OR footprint is a huge deal, if your hospital isn’t new with huge ORs.

I’m also not sure what the benefit of an open console is- all the MDs I’ve spoken with don’t feel disconnected in a console that they can pop their head out of quickly. It’s not like they’re in a different room than the patient?

Not sure what CMR is selling to end users, I'm just speaking from seeing that modular robot in an OR and how much less space it takes up compared to the booms of the newest da vinci models. Wheeling the Versius arms around a room is faster and less burdensome than driving the massive da vinci patient cart doing 18 point turns in an OR that already has tons of other equipment. Remember with a modular robot you can choose to bring in a camera and 2 arms if that's all you need, save the space of a 3rd arm.

MDs aren't aware of what they're missing when they're buried in the da vinci console because they've been conditioned to value its "immersion". It depends on your specialty but for procedures that have the instrument arms potentially colliding, the console surgeon can't see that. They can't look at a patient scan without taking their head out. They can't see patient vitals or other activity in the room without disengaging the robot. To "pop their head out quickly" versus not pop your head out at all and use the same room awareness you'd have in an open/laparoscopic surgery has value. It's like looking through 4K binoculars instead of a 1080p panoramic view when you're captaining a ship, but the binocular manufacturer keeps selling you the fancy 4K visuals.

I hope it’s not that exploding San Francisco police robot.

I just downvoted your comment.

#FAQ

#What does this mean?

The amount of karma (points) on your comment and Reddit account has decreased by one.

#Why did you do this?

There are several reasons I may deem a comment to be unworthy of positive or neutral karma. These include, but are not limited to:

• ⁠Rudeness towards other Redditors, • ⁠Spreading incorrect information, • ⁠Sarcasm not correctly flagged with a /s.

#Am I banned from the Reddit?

No - not yet. But you should refrain from making comments like this in the future. Otherwise I will be forced to issue an additional downvote, which may put your commenting and posting privileges in jeopardy.

#I don't believe my comment deserved a downvote. Can you un-downvote it?

Sure, mistakes happen. But only in exceedingly rare circumstances will I undo a downvote. If you would like to issue an appeal, shoot me a private message explaining what I got wrong. I tend to respond to Reddit PMs within several minutes. Do note, however, that over 99.9% of downvote appeals are rejected, and yours is likely no exception.

#How can I prevent this from happening in the future?

Accept the downvote and move on. But learn from this mistake: your behavior will not be tolerated on Reddit.com. I will continue to issue downvotes until you improve your conduct. Remember: Reddit is privilege, not a right.

Is it called the Throat Goat?