One of the hot topics in surgery these days – whether it’s for surgery on a spine or anywhere else – is robotic surgery. My patients are often curious about the benefits that the robot manufacturers are claiming, and they want to know if their surgeries might be done with the help of a robot.
According to the web site for the most popular spine surgery robot, Mazor Robotics Renaissance™, using their robot during certain procedures, including operations for scoliosis, degenerative disc disease, or a herniated disc, offers a lot of benefits. They claim that its use increases accuracy and precision, lowers complication rates, reduces pain, enables a faster recovery, and sometimes even allows for minimally-invasive surgery!
It sounds like a great choice, doesn’t it? Unfortunately, it doesn’t really work that way. Even supporters of robotic surgeries are concerned about the lack of consistent training among the surgeons who use them. There’s no standard for training. The companies who sell the robots provide some lessons, but then it can take hundreds of cases before surgeons are considered “consistently good” at using the robots. Those patients who are among the “practice cases” can’t always rely on the surgeon’s expertise at using the robots.
In addition to a lack of consistent training, there just haven’t been enough studies to realistically determine the effectiveness and safety of surgical robots. Although the robots’ popularity is growing quickly, as their use in operating rooms increases, so do the numbers of complications associated with them.
Performing surgery with a robot also requires a set of specialized skills that many surgeons haven’t trained for. When a surgeon operates with a robot, he or she is across the room from the patient, using what amounts to a fancy remote control. It requires a different type of spatial and eye-hand coordination. A surgeon can no longer feel the tissues when cutting, cauterizing, and suturing, and those sensations are, in my opinion, paramount for a skilled surgeon’s ability to operate well.
There may well come a time when robotic surgery is more practical or feasible. Right now, however, the current state of robotic surgery is version 1.0 and I’d prefer to wait until it is more extensively tested and its benefits clearly proven. Until then, we still have lots of great options to minimize the impact of surgery and provide patients with excellent outcomes.