Thursday, June 7, 2012

Folding a paper airplane. Amazing feat by the surgical robot?


A number of people have tweeted about a video that shows a surgeon using a Da Vinci robot to fold and throw a paper airplane.

Watch for yourself.




On Twitter, I commented facetiously that there is finally a use for the robot.

Then I watched it again and realized that the video is actually a good illustration of what I’ve been saying all along about what is wrong with robotic surgery.

Even with the apparent use of several edits, it takes the surgeon over two and a half minutes to fold the airplane, a task which might take about 30 seconds by a human hand. Also despite the edits, there are several shots of missteps and fumbling. Finally, the airplane does not fly. When thrown, it drops like a stone.

Rather than convincing me that the robot is great, it makes me even more skeptical about its utility.

20 comments:

Anonymous said...

You're not impressed even on that scale? It drops like a stone because of the ratio between the weight of the paper and the surface area. There's a sweet spot where a paper airplane will fly and when it just becomes too heavy given the surface areas in play.

It looked clumsy and unimpressive to me until I saw the penny. I guess I've got sausage fingers though.

--and I'm not a surgeon.

Edward Presswood said...

Probably a pointless toy at the moment. Am I optimistic or foolish to expect that robots will be doing more surgery in the future? In 20 years time robots/computers will be doing far more than merely throwing paper aeroplanes & flying real aeroplanes.

Skeptical Scalpel said...

Thanks for commenting. I was impressed that it could be done on such a small scale but equally impressed at how useless it was. Also, I thought it was supposed to eliminate the tremor that some humans have. It didn't seem to totally do that.

Antonio said...

In my (very modest) opinion at the moment robots cannot be used because of the incredibly high costs. In future, the costs will drop (patents are close to expire) and maybe they'll be more used. Compared to laparoscopic surgery, I think (underline that I thik, because never used a DaVinci) the learning curve is shorter.
Anyway is impossible to say that the transaxillary thyroidectomy is just cool!!! Even if the pure talented italian surgeon, Hüscher, did it on '97...

Khoi Le said...

As a 4th year surgery resident, it's interesting to see how the young and the old surgeons respond and react to the robot. I'm still skeptical about it's use, but I'm sure that as surgical technology progresses, the robot will find more utility in technically difficult situations. Just as mobilizing the splenic flexure of the colon can be much easier in many cases laparoscopically than open, the robot may have some uses.

Is it cost-prohibitive? I think so. Does it improve outcomes? No. So...does it have a place in general surgery? Eh...time will tell.

Skeptical Scalpel said...

Learning curve may be shorter or it may not be. My last post on robotics reviews a paper that claims a shorter learning curve for gallbladder surgery without proving it.

I agree that the jury is still out on outcomes for the robot. I hope someone publishes a good paper on this subject some day.

Unknown said...

Who cares if it can make a working airplane or not! What I care about is using the da Vinci it to decrease the invasiveness of surgeries such as the prostatectomy (removal of prostate) that decreases complications and the post opp recovery time. True, there's a lack of studies that indicate long-term results of robotic surgery is superior to results following traditional laparoscopic surgery and there is a steep learning curve for surgeons that chose to adopt it BUT what in medicine DOESN'T have a lack of studies and other drawbacks. With time, resources, and advances in technology, I think robotic surgery could be easily justified.
Check these robotic Urology surgeons:
http://www.minnesotaroboticsurgery.com/
I was fortunate to shadow Dr. Knoedler and Gaertner and was amazed with what they can do. Maybe seeing is believing for all those who are skeptical about robotic surgery!

Skeptical Scalpel said...

mjdemay, thanks for commenting. The outcome numbers displayed on your link are unlike most in the literature. Also, is the robotic surgery learning curve steep or not? You say it is and Antonio's comment above says it's not.

From Heels To Houseshoes said...

As a patient, I am in love with the robot. I had a tubal ligation (laparoscopic) with about a month recovery time. I felt like poo. Then I had a radical hysterectomy, with adhesions EVERYWHERE, intestines re-sectioned...and I was disc golfing through the woods four days later. Also, there was no blood loss. I cannot say enough about this robot as a patient vs laparoscopic procedures. My surgeon has a zero conversion rate.

Anonymous said...

MS3 here,
I have to agree with you on this. The other thing that scares me is what I view as the overadoption of robots when not needed. I think the previous poster's case is a great example. Something as small and easy to do as a tubal(had the chance to assist plenty of these in OB) is now being done with robotics. I have yet to see papers in the literature analyzing the use of robotics to account for the added setup time of the robot and the added cost of the robot, especially in a smaller case such as a tubal. That's where I see the real problem with robotics.

Skeptical Scalpel said...

Thank you, MS3. I agree. Some of my other posts on robots address their use in cholecystectomy, which is strictly a marketing gimmick.

Dr Skeptic said...

On robotic surgery, Skeptical Scalpel, I am completely on your side. You prompted me to do some literature searching of my own, which I have just posted (http://doctorskeptic.blogspot.com.au/2012/06/invasion-of-robots.html)

Skeptical Scalpel said...

Dr. Skeptic,

Thanks for the link. We indeed are in agreement. And thanks for the mention on your blog.

Anonymous said...

I can tie my shoelaces in a couple of seconds, for a minumum cost OR I can do it in two-three minutes at a cost of 2000-3000 USD (+investment costs of the Robot,maintenence etc etc).

My choice is obvious.
The Robotniks keep choosing to spend the funds of the patients (private and/or communal) with this unproven toy.

Keep revealing this crazy scam

Skeptical Scalpel said...

Anon, good analogy. I agree.

Anonymous said...

Wouldn't the fair comparison be to see how long it would take an open surgeon to make the same paper airplane with traditional surgical instruments? I understand your point about the lack of comparative effectiveness data for some robotic surgery... so lets see some posts of making a paper airplane with pickups, and then Ill comment about the edits and timeliness...

Skeptical Scalpel said...

I'm afraid I must disagree with you on this. Why in the world would anyone want to fold a paper airplane with traditional surgical instruments? I'll do it with my hands and it will fly a lot better than the one made by using the robot in the video.

By the way, what does folding a paper airplane have to do with surgery anyway? It reminds me of those articles about robot demos in malls where kids who have never seen the robot can use it to pick up buttons just as well or better than surgical residents.

I don't want a kid who can pick up buttons operating on me.

Anonymous said...

Robotniks unable to perform traditonal safe surgery with their fingers, are a ticking bomb. Once taxpayers and people with honest fiscal intentions gets a hold over this boulevard circus and the whole matter gets down to sound economics, then hospitals worldwide will face a major problem. The dismantling of the Robotic freak show will have grave consequences. Unsecure, untrained and frightened Robotniks with their pants down. Who is then supposed to deal with all the major surgical and clinical problems we face on a daily basis?

DavidP said...

The fair comparison is folding a paper plane with manual laparoscopic surgery tools. I'd like to know how that would go.
I'm pretty happy that I only lost 50ml of blood during my robotic radical prostatectomy, so I was eating that evening and feeling well, taking nothing stronger than Tylenol 2 days later.

I would have liked to have the option of manual laparoscopic, but couldn't identify a surgeon in my city in Australia who used that as their main technique.

Skeptical Scalpel said...

As I said before, what does folding a paper either using a robot or laparoscopic tools have to do with surgery? Interesting that you couldn't find anyone to do it laparoscopically. I think that's true here in the US too.

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