Comment by Cerium | Hacker News Reader

Comment by Cerium | Hacker News Reader

This study is right that for the same operation manual laparoscopic is currently more efficient than robotic surgery. The issue here is that robotic surgery does not seek to displace manual laparoscopic surgery- it seeks to displace open surgery. Example from the article:

>65 percent of patients with kidney tumors that necessitated the removal of the entire organ underwent an open surgical procedure. About 34 percent had their kidney removed using a laparoscopic procedure, and only the remaining 1.5 percent of cases

That 1.5 percent is growing by reducing the 65 percent open, not the 34 percent laparoscopic. Surgical robots are able to complete cases where laparoscopic is not an option due to the complexity. Additionally, they are able to increase the pool of operable patients. Many patients that are not candidates for open surgery and have a case that is too complex for laparoscopic are able to be successfully operated on roboticly.

Disclaimer: I work in this field, and believe that it is going in the right direction, but do acknowledge that the technology does currently lead to increased cost and time.

This reminds me of the time YouTube introduced a more lightweight version of their video page code and were distraught to find that the average load times for the lightweight page were drastically higher than the standard page. They eventually figure out that this was because most of the people switching to the lightweight page were people on very slow internet connections, since people on fast internet connections didn't find the video page slow enough to bother switching.

This is the classic Simpson's Paradox

https://en.wikipedia.org/wiki/Simpson%27s_paradox

AFAIK it was even more drastic. People were timing out before the change. It went not from slow -> quick but from unreachable to reachable.

But this article and research is about laparoscopic surgery vs robot assisted laparoscopic surgery. If a case is too complex for manual laparoscopic does the robot assistance suddenly make it operable? It seems like we aren't quite to the point where robot assistance (in laparoscopic surgery) would make a procedure less complex.

"The issue here is that robotic surgery does not seek to displace manual laparoscopic surgery- it seeks to displace open surgery. "

Yes, it makes a proportion of cases that would have required open surgery amenable to laparoscopic surgery.

I agree when I was in the royal free renal ward (London UK) one of the guys in the bed next to me was in his mid 80's and had robot surgery to remove a problem kidney - his doctor had told him that he was the oldest patient in the UK to have this op I suspect that the older style of surgery might not have been possible.

Could be that, or the doctor trusting the machine to do the job, the availability at the hospital, etc.

Actually the royal free is one of the leading hospitals in the UK for transplants - as this 80+ guy was the oldest patient they had performed this op on.

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