Exploring possible applications of robotic surgery

Robotics has been gaining importance in many areas of life for years, not least in medicine. Robots are already being used in the operating room today, but they do not always play the leading role – a circumstance that will certainly change in the long term. 

Dr. André T. Nemat moderated the "Smart Robotics – How to Build Intelligent Machines for Healthcare" panel at the MEDICA Health IT Forum. He has been the chief physician of several thoracic surgery departments for many years. Before he started his esteemed career in medicine, he also studied engineering. In this MEDICA interview, he describes the trends and challenges of robotics in healthcare settings.

Dr. Nemat, what is a robot and what are important trends in robotics?

Dr. André T. Nemat: What comes to your mind when you hear the word "robot" is shaped by the way they have been depicted in science fiction literature: we think of humanoid or android artificial beings that are more or less human-friendly in nature. But when we look at actual surgical robots, they are drastically different from illustrations in works of fiction.

The meaning of the word "robot" has also radically changed since the term now also includes software applications and the associated algorithmic intelligence. As we continue to embrace digitization, these technologies and evolutionary developments are permeating every aspect of our lives and will play a significant role in transforming medicine and especially surgical procedures in the near future.

Are there any problems or challenges as a result?

Nemat: You always have challenges in a transition phase whenever a technology is comparatively new and slated to replace outdated processes but has not yet reached the maturity level that makes it convenient for everyone to use.

For example, one issue is that certain technologies only reach a particular standard when they become part of the training of young doctors, both during their medical studies and later in specialty training. We must create access to these new opportunities in continuing education and training, while the instructors themselves still follow a learning curve. That is why I see a certain challenge when it comes to transforming training and education and creating new standards.

There are also limitations in terms of the technology itself. We are still far from an intuitive operation of these devices or a maturity level that promotes an intuitive use for all users. This means that for now we are still faced with technology deficits that we must first address and continue to develop.

Last but not least, we must also consider the amount of data that is generated by robot applications as part of digitization. This results in critical data security issues and challenges. Data safety, security and privacy concerns play a big role, especially in healthcare and medical environments, which always entail sensitive, personal data. This goes along with legal, regulatory, and ethical challenges that we are only just beginning to understand, identify and deal with.

How will robotics change in the future in your opinion?

Nemat: This is where the so-called hype cycle comes into play, which pertains to life cycle stages a technology goes through from conception to maturity and widespread adoption. As a result, certain innovations tend to initially stay beneath the radar for some time and are only known to an expert audience. Then we see a sharp rise in demand, which reaches a peak and then often declines again until it reaches a pragmatic plateau.

I expect to see a similar robotics development trajectory. Experts who have used robotic technology in surgery for several years have gained a high level of expertise by now. However, limited economic resources still curtail a widespread use of these systems. Having said that, we see a slow but steady increase in robotic surgery as more and more hospitals embrace the option, explore possible applications and are willing to experiment. That is why I am confident that robotic surgery systems will become more commonplace in the medium term.

It’s highly likely that robotic applications will look differently in the future. This means we won’t see an elusive one-size-fits-all device or a surgical robot that can do it all. Instead, there will be increased diversification – including more robotic surgery specialties or robot-assisted systems that are compact but help surgeons increase precision. When we consider healthcare staffing in hospitals, I can picture surgeons specializing in performing robotic-assisted procedures in only one particular area. I am certain that the true potential of robotic surgery will be explored and realized in the future.

Circling back to the MEDICA Health IT Forum: What were your key takeaways from the event? What did you like most about it?

Nemat: I very much enjoyed its format where specialists are interviewed by other specialists. MEDICA is a specialized trade fair that can and should also be interesting to a demanding expert audience, which means questions by the expert audience should be taken up and subsequent discussions should create valuable content.

The condensed, virtual format is very well suited to include a multitude of interested parties and to get a comprehensive overview of a subject within 45-60 minutes. It also made our panel stand out: the panel members were renowned experts in their respective fields who normally don’t necessarily capture people’s attention. I found the panel to be very entertaining thanks to its engaging, strong informational content.