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Robotic surgery coming to T&T?

Monday, April 8, 2013

The Ministry of Health recently held a seminar and workshop on robotic surgery. In the popular imagery, robots are normally associated with the car assembly industry or science fiction movies. The reality is that robots are being used in a vast array of human endeavours, including surgery. The first robot-assisted surgery was recorded as having being performed in 1985. 


It was in 2000, however, that robotic surgery really entered the mainstream with the da Vinci robotic system with its improved arms (manipulators), instruments and vision systems. This robotic platform is the world leader with nearly 2,500 installations worldwide with some 1,878 located in the United States. It was estimated that last year, over 450,000 robotic surgeries were performed by the over 3,500 trained robotic surgeons.


Robotic surgery is used in a wide range of applications including, urology, gynaecology, cardiothoracic and general surgery. Benefits include reduced trauma on the body, minimal scarring and faster recovery times as it is a minimally invasive procedure.


It is important to note that robotic surgery is not what the general population might think it is—an autonomous robot performing surgery on a human being. Actually the robot is under the control of a trained surgeon and thus serves to enhance the operating skills of the surgeon and is less invasive in that the opening made in the body to facilitate the hands of the surgeon entering into the body is reduced or removed totally in some cases. 


The layman may be tempted to ask how is this then a robot if it is under the control of a human being—the surgeon. Well, by definition, a robot is a device that has memory and can sense and react to the environment. Very rarely, if at all, a robot is allowed a free range to do as it pleases. In the movies, yes. In real life, no. Even those robots that perform repetitive tasks in the industrial environment are under the control and oversight of a human agent. 


What the robots provide the surgeon with is a clearer and more precise picture and greater accuracy and constancy of movements and operational procedures. On viewing recordings of robotic surgeries and human-only surgery, one cannot but help notice the precision, repeatability and assurance—yes, a very human term—of the robot movements.   


The movement to introduce robotic surgery into the public health sector is a step in the right direction as medical care worldwide is incorporating the use of technology to improve patient care. The projected growth areas lie in the developing countries. In India, several robotic surgery centres are being set up.  


The proposal to first introduce robotic surgery training in T&T by installing a simulation station might be the best way to introduce robotic surgery as the local surgeons can be trained. This can be extended to the Caribbean and Latin American region. So when the robotic platform is eventually introduced, a critical mass of trained robotic surgeons would be available thereby facilitating a smooth incorporation of the technology.


While medical robots may be new here, both postgraduate and undergraduate projects on robotics have been in progress for some time now at both UWI and UTT. In fact, the Mechatronics Group at UTT has well-equipped robotics labs and its researchers are actively engaged in quite novel and interesting R&D work. These local engineers and scientists can be utilised to provide the critical technological and engineering support that would also be required if robotic technology is to be installed and maintained. 


The Minister of Health should be lauded for this venture and the universities, particularly the science and technology faculties and departments, should see the need to be more proactive in their efforts to be engaged in this venture and national technological development generally, through the strengthening and deepening of their research efforts.


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