The use of robotics in surgery has sometimes provoked a certain amount of controversy. Ever since the concept was introduced in the UK in 1990, people have been wary about the idea of involving anything that might take away an element of control from the surgeon performing the operation.
But in reality, as Lord Ara Darzi explains in Kevin Lamb’s In Your Hands podcast, the robots used in surgery have nothing in common with the autonomous machines that make cars in factories. Robotics used in surgery simply translate the hand movements being made by the surgeon sitting at his station into another set of movements using the robot’s arm, meaning that the surgeon is still fully in control of the operation at all times.
The big advantage of using robots is primarily one of size and movement. Robots can be equipped with highly sophisticated movements, far more than the human wrist can manage, and they can be made extremely small; if need be, just 5 millimetres long compared to the size of a human hand. That means the surgeon using them can perform extremely complicated surgery through a small keyhole sized incision, which removes the need to open the patient up, with all the potential complications that can entail.
Lord Darzi was a pioneer in performing robotic surgery, performing the first robotic procedure in 1990, and for the first seven years his centre was the only one in the country that had a robotic surgical system in place. He is quick to reassure people that robotics have not come in to either replace the surgeon or to change the procedures which are carried out.
He is also quick to reassure that using robotics will not in any way diminish the skill set of medical students and surgeons, who are still just as capable of performing traditional surgery when required. He says that we are right at the start of what is possible using robotics in surgery and that there are many more developments in the pipeline.
Lord Darzi points out that there has always been a lot of technology phobia when it comes to using new tools and techniques in the treatment of patients. He highlights digital applications as another area where technology has the potential to help advance patient care, by giving patients greater control over their medical pathway.
He admits that in the UK there have sometimes been challenges in providing patients with integrated care, as they move through the medical system from GP to consultant to surgeon and back again. There is therefore a big potential role for digital applications and other technology tools to play in giving patients greater understanding over their route to receive medical care, which will ultimately enable the medical profession to deliver better patient centred care.
Lord Darzi firmly believes that the balance of power between patients and doctors needs to shift so that patients feel empowered to take back control of their own health, and suggests that the use of digital technology as a tool to drive this could be extremely beneficial.