Using robots in surgery may become a reality. Years ago, no one could imagine that using robots would become a reality and be sufficient so the patient can trust it. Many types of research have been published, and experiments have been conducted to test the robots and know the advantages and disadvantages of using them. However, there are some arguments about the efficiency of using robots or not, as using robots is a must or perfect choice in cases like the Covid-19 pandemic, as it prevents direct communication with patients, reducing the infection spread and protecting the frontline worker. Alternatively, the other opinion on the efficiency of using robots as using robots may be just as surgical tools, but not to do surgery as the reasons for that is. Robots are insufficient due to expensive costs and lengthy-time duration, and lack of technology and experiments that make patients confident in robots. Additionally, if there is a human error, there is also a mechanical failure. From research and analysis, three fundamental questions arise. First, is the use of robots in surgery a good technique in the medical field? Second, are there limitations to the use of robots in surgery? Finally, is using robots accurate or not?
The first argument is about whether using robots is a good technique in the medical field or not. The supporters believe that using robots is a must or perfect solution in a crisis like the epidemic like Covid-19 as the world seeks to prevent direct communication between people. The frontline workers face many challenges to introduce medical care besides protecting themselves and their families, so using robots will reduce the direct connection and the spread of infection. According to the rising number of patients, like in an epidemic of Covid-19, this puts medical staff under stress, affecting their performance. So, using robots will be helpful. Interacting with robots reduces direct communication between the patient and the surgeon. During the period of Covid-19, it was found that many doctors and patients contracted the infection despite the procedures and precautions due to their admission to the hospital and dealing with its staff. “The integration of a robot as a shielding layer, physically separating the healthcare workers and the patient is a powerful tool to combat the omnipresent fear of pathogen contamination and maintain surgical volumes” (Zemmar et al., 2020).
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The other group opposes using robots. The reasons for that are that it will be expensive and impractical. “The main disadvantages of robots are the higher costs, increased surgical time and the total loss of tactile sensation” (Elkak, 2017). They also show that it lacks knowledge and experience, so it cannot deal with different cases. They claim that the use of robots today exposes them to many risks, and it requires a lot of knowledge and training to become a powerful tool in surgery (‘Robotic Surgery: Risks vs. Rewards’, 2017). During a surgical operation, doctors discuss taking the appropriate action and what is safer for the patient’s life, and God cannot achieve this. God only carries out orders, cannot make decisions. “To further complicate matters, every robotic surgical tool must comply with the safety requirements that may include anticipating sensor and actuator redundancy, implementing a safe operational speed cap, complying with testing protocols such as ISO 9000, etc.” (Surgical Robotic Tools, 2016).
The second argument is about if there is a limitation on using robots in surgery or not. The critical points of this argument include instrument, cost, and surgical flow. The supportive team argues that in terms of cost, robotic surgery, like any technology in its infancy, is expensive until, after a certain amount of time, it becomes affordable and provides the desired benefit. We will find that competitive companies are seeking and provide that service with good quality and reasonable prices. Over time, the cost will not be an issue at all. “New robotic technologies may produce cheaper systems, and new developments such as haptic and tactile sensing and force feedback technology could potentially solve one of the real drawbacks of robotic surgery. The emergence of competitive companies may indeed contribute to tackling the high-cost issue. Future developments aim to decrease variability of performance” (Elkak, 2017). Concerning surgical tools, they fall under the principle of need. When starting to use robots, it opened thinking about designing accurate and appropriate surgical tools to make robotic surgery successful. Concerning the operation of the surgery, the doctor cannot be dispensed. However, if the robotic surgery voluntarily complies with the usual surgery, it will make a big difference, especially since it reaches micro-places that conventional surgery cannot. Therefore, robotic surgery remains attractive. “If current barriers can be addressed and systems are specifically designed for microsurgery, surgical robots may have the potential of meaningful impact on clinical outcomes within this surgical subspecialty” (Tan et al., 2018).
The other team argues that the absence of microsurgery tools is a limitation for the robotic surgery system where microsurgery still needs many instruments that make dealing with micro-tissue hard and takes a long time. This entails limits and restrictions also in dealing with micro-sutures and surgical operations such as vascular surgery. Therefore, traditional surgery becomes better in this case. According to cost, the costs of buying his wills robotic systems are high. Studies have shown that the cost of one robot exceeds one million dollars, in addition to the indirect costs, as this system will require employees to check it constantly to ensure its use (Tan et al., 2018). Regarding surgical flow, when comparing traditional surgery with robotic surgery, we will find that robotic microsurgery takes longer. Besides, it is impossible to set a straight line and step for a single operation, as each patient has his condition. Therefore, it will always remain a point of uncertainty to determine the appropriate treatment plan for him. “Absence of bespoke microsurgical instruments, increases in operating time, and high costs associated with robotic-assisted provide a barrier to using such systems effectively for reconstructive microsurgery. Consequently, surgical robots provide currently little overall advantage over conventional microsurgery” (Tan et al., 2018).
The third argument is about whether using a robot in surgery is accurate or not. The supporter of using robots believes that surgical robots are very accurate and mechatronic devices can make a big difference for surgeons and the patient, as they help carry out tasks accurately, especially the CIS technique ‘contact imaging sensor’, which has breast implants improving the quality and accuracy of robotic surgery. In addition, there are many robotic systems under development, and their effectiveness has been proven recently, such as laparoscopic surgery. They hope that innovation in robotics will solve many medical problems, such as handling a delicate level of tissue accurately and smoothly. They claim that robotic surgery with the help of technology will facilitate the surgery and make it highly accurate, ensuring that the surgical tools are inserted at the correct depth and angle. This level of accuracy is difficult to achieve in conventional surgery due to involuntary tremors in humans. Robotic surgery has already proven its effectiveness in surgeries such as neurosurgery and tumor removal and also n general surgery such as thoracic, abdominal, urologic, gynecological, and colorectal (Ahmad et al., 2016).
On the contrary, opponents believe that robotic surgery does not constitute the great accuracy that some images, or not in all cases, considering the error of the machine. “Multiple risk factors can increase the possibility of complications and errors, including patient factors (e.g., obesity or underlying comorbidities), surgeon factors (e.g., training and experience), and robotic factors (e.g., mechanical malfunction). The reported complication rate related directly to robotic malfunction is very low (approximately 0.1% to 0.5%)” (‘Robotic Surgery: Risks vs. Rewards’, 2017). They suppose that this makes it unreliable and suspicious of many patients. It is necessary to consider the patient’s psychology and acceptance of the surgery, which constitutes a large part of the treatment.
Health care is necessary for survival and comfortable living. All worlds seek to improve healthcare life either by improving medication or put therapeutic protocols or improving surgical techniques. Using robots in surgery or the surgical tool is a good technique in the medical field as robotics can be used in microsurgeries as robotics will be excellent and accurate. The human element is undeniably important, and I support the claim that robotic surgeries must be under the supervision and control of doctors due to different cases and situations. Making patients trust these robots is not easy; because of lack of knowledge and experience, perhaps all hopes aspire that robotic surgery in the future. Technology makes life easier, but the expensive cost became an obstacle. This will not remain for a long time because, like any technology, it starts expensive and then become affordable to anyone.
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