This new report has prompted some to wonder whether robotic surgery will lead to deterioration of surgeons' skills.
In my opinion, that is not likely at this time because the robot is not really doing the surgery by itself. It is simply a tool that helps the surgeon and is under the surgeon's complete control at all times (except when it runs amok).
However, ever since the advent of laparoscopic surgery over 20 years ago and its popularity for many of the common procedures surgeons do, there has been concern that surgeons may eventually lose proficiency for open procedures. And a number of other open operations have been done less frequently due to alternate ways of treating patients such as non-operative or interventional radiologic techniques.
Here are some examples from the ACGME resident log data for the academic years 1999-2000 and 2011-2012.
We are approaching the critical lower limit for open gallbladder surgery expertise especially when you consider that only the most difficult cholecystectomies will be done as open cases from now on.
What will happen in 20 years when few surgeons will have sufficient skill to do a very inflamed open gallbladder?
Does anyone really believe that a surgeon can confidently remove an enlarged spleen having done fewer than 2 such cases during training?
This is a bigger problem and far more pressing than the possibility that automation will render human surgeons obsolete.
There's another issue too, which is the predicted shortage of general surgeons in the near future. How are more surgeons going to be trained if there are not enough open cases to train the current number of graduating residents, of which there were 1092 in 2012?
Has anyone else thought about these questions?
