Robotic head and neck surgery is routine at major medical centers all over. Da Vinci has been around for many years and it is human controlled.
I’m glad this patient was helped but there is absolutely nothing interesting otherwise about this.
I’m glad this patient was helped but there is absolutely nothing interesting otherwise about this.
The kind of amazing where untold millions of people can't afford basic healthcare in the same country that we have a robot surgeon?
If DaVinci hadn’t developed the robot, would more people be able to afford health care?
Da Vinci is famously not better. There isn't a single study showing its better. It's also not less expensive, and doesn't reduce staffing needs in the OR.
What is it? A marketing tool. Surgery centers and hospitals can drive increases in patients and patient throughput, improving their bottom line. It's marketing and throughout.
They have a classic razor razor blade model. The surgical instrument are proprietary and locked in with eeprom chips in the disposables. They only last a handful if cases and then must be replaces. Intuitive made something like 80 billion last year and has had no real competition in their market for decades. As a result they've been able to pretty much write their own checks, choosing how much stuff costs and achieving huge margins on lots of very expensive equipment and supplies.
Source- I've worked on and lead the design teams for surgical robots for several companies in the field.
I have questions though.
Is the davinci amazing? I have heard that it is.
Why doesn’t someone else make a similar product? Is there technology that is hard to replicate?
Others have been trying for years. The latest big player is J&J who faces an existential threat due to robotic surgery overtaking conventional surgery, and therefore one of J&J/Ethicons core business. They bought Verb and Auris and a few other smaller companies in the space and smashed them together. There are others in the space trying to do the same.
Ultimately Intuitive has a pretty big moat. They have a lot on the technical/IP side, but also just business wise. These hospitals and surgery centers pay millions for a robot, then need to keep it busy doing cases for several years to pay it off. There is a lot of risk and not really any clear advantages to changing to a new challenger. That new challenger would need to demonstrate some key advantage, which they have yet to do.
It's hard, its akin to trying to compete with space x or similar, starting now.
Not better than surgeons with competing devices, or not better than surgeons without these tools?
From a patient point of view it is a big difference. Hospital stay is really expensive even if you have insurance. Hospitals charge like 10000$ per day and copayment foe hospital stay is usually hundreds of dollars.
Of course, it means that hospitals can process more patients and generate more profit, but it also reduces surgery wait times, which is critical for a patient with a tumor, because the longer your wait, the more likely for the tumor to spread
That's the rub, what I'm highlighting. We all just automatically assume the robot is better because it's a robot. The proof is in the pudding.
Yes, there is no statistically significant evidence yet that it is better, but there is no statistical evidence that it is worse. I don't think it is beneficial to stop using this technology based on cost effectiveness.
I happened to had a tumor on my kidney 6 month ago, so I actually had to make a decision between regular laparoscopy and Da Vinci. Tge surgeon who did not have access to the robot system said that robot is just marketing BS and he would do a surgery just fine. However, because the tumor was on the back side of the kidney it would require rotating kidney out of the place and would be a bit challenging. But he was confident that it could be done
THe surgeon with robot said that tumor position is not a problem for a robot whatsoever. So I went with the robot.
So, back to OP, the robot is better because it allows to perform surgery in places where it is not possible to go with non robotic instruments.
I also have plenty of anecdata from people who had similar surgeries performed on them with different techiques. It terms of post op recovery da Vinci wins unanimously. I had surgery on Tuesday and was back to work next Monday
Many of the positives you highlight are true for any modern laporoscopic surgury, not just Da Vinci. In most indications, manual laparoscopy is by far the market volume leader for lots of reasons. Reasons like big surgical systems like Da Vinci are huge and require dedicated large ORs that are expensive. Meanwhile they still need to get surgury done in the smaller, more common, more cost effective ORs. Don't get me wrong, Da Vinci is a modern marvel, as I've said in other comments here it's truly a remarkable work of engineering. Its also a monopoly that makes a ton of money, and also far from how every surgery is done or should be done. Those two things don't go together, monopoly and shouldn't be the whole market. That's all I'm saying. It's not the panacea it's made out to be often.
All kinds of things have been designed to "specifically give to an X profession a better instrument".
That's just a mission statement at best, marketing promo at worst. Doesn't preclude them not meeting that target.
"it's better because it has been specifically designed to be better" is circular reasoning.
First you have to trust the surgeon not to be shilling in his report.
The link you provide below says
"When it comes to prostatectomies, urologists have found the outcomes for da Vinci robotic surgery to be much better than for laparoscopic surgery and use this method in more than 90% of these procedures [...] Robotic surgery also appears to provide clinical benefits for some, but not all, types of head and neck surgery."
It also reports negative value overall for gynecological surgeries.
The evidence you provided suggests it's better for some things and not others, which seems like the expected case.
Good stuff happening shouldn’t make you miserable.
Of course.
There are many things in a person's emotional life that a person does not have any control over (at least not in the short term and without spending lots of time and money on, e.g., psychotherapy). I think it is commendable that you understand your own emotions well enough to perceive this self-hatred, and I do not think any less of you because of it.
If there are many people who share your emotional reaction to inequality, that would have explain a lot of things that so far have been puzzling to me.
What is your opinion of those who have things that others lack, but do not hate themselves for it? Is there something wrong with such non-self-hating lucky one in your eyes?
Da Vinci is telecontrolled. The robot does nothing but imitate the exact motion its commanded to by the surgeon.
The headline should read " Surgeon saves patients life using surgical tool that has been widely available an on the market for decades"
The medical professionals deserve the credit. If this was 20 years ago, yeah, we should celebrate the technical achievement and advancement, but there isn't one here. It's old news.
Source- I've designed several (surgical robots)
Not a new concept by any means, but still worthy of continued praise and admiration.
Times change, technology advances, and when those advances become 'old' they cease to be interesting for the most part.