Hi, I’m Doctor Rich, world-renowned robotic surgeon. Can a twenty-year-old make a surgical robot in his house during Covid? I don’t think so. Let’s check out Michael Reeves’s video.
Don’t have time to read this post? Watch the video here instead!
[In the video, Michael Reeves scrolls through a list of videos. He begins watching an infomercial about the da Vinci Surgical Robot.]
“The da Vinci Surgical System is the most advanced, streamlined surgical experience for minimally invasive surgery available in the world today.”
I can build that.
[Caption on the screen reads “No you can not dumba$$…but I’m going to try!”]
No, you can’t, dumba$$. Intuitive Surgical is the company that makes the da Vinci robot. There are thousands of robots, and tens of millions of surgeries that have been done for over two decades in this country. They’ve got a bit of a head start… but let’s check it out.
Global health crisis going on! My house is in full-on godd@mn quarantine — and I’ll probably be dead in a week anyway. What better way to spend free time right now than to help the medical industry? Now, I can’t do any chemistry or biology or, like, body stuff (yuck). But I can do robotics! And let me tell you, those da Vinci Surgery Robotics rat b@stards are ripping hospitals off! Look at this — two million for one sh*tty robot. They could spend that on a couple hundred bandages, or like one ambulance ride in the US!
We can build a better surgery robot for a lot less. Come on!
So on the one hand, surgical robotics is an amazing technology that’s completely transformed the way that we do surgery. It allows for surgeons to be more precise and give better outcomes for their patients. It costs money. Everything — every technological advancement costs money, and all technology actually goes down in costs over time. The price he’s looking at is from two generations ago for the robot. Despite the fact that we have a hundred times better technology, the newest robot is less expensive than the robot from two generations ago. Also, healthcare costs of medicine are crazy. You can spend $1,100 for a Band-Aid for an ER visit. The healthcare system is basically broken… but that’s a topic for another day!
The biggest flaw in da Vinci’s design is that it relies on these clunky, slow robotic arms for movement. Say you’re operating on a patient’s foot; he starts screaming out in pain. You gotta get up to his face, smack him around a little bit. Make him shut up. Good f#$%ng luck with these robotic arms. They’re slow as sh*t, and they don’t have any travel distance. Instead, we’re going to mount the surgical tools to a rail system that can move anywhere on the operating table.
[Footage from his robot-building attempt plays.]
Hey, look! It’s past-Michael. You know, it took him five whole days to 3D model?
This is what I’m assuming is a teenager/twenty-something with an extreme amount of expertise in building things — technology, robotics from a practical standpoint — with no understanding of how surgery would work or medicine (or to his own point, body medicine and biology). You actually want a technology that is capable of having ultra-precise, tiny movements. You want movements that you would do if you were operating with your hands to be reduced and miniaturized to tiny, little instruments that have tiny, little movements to amplify and give your own hands more dexterity than you could have if you’re doing open surgery.
Michael [holding a small, white box]:
Here’s what the final carriage looks like. I got the motor very professionally hooked up to the driver board, which is hooked up to my computer. So we can see what this thing can do. Okay, so this is the calibration sequence that it needs to do before it actually runs.
[The carriage moves along the rail as Michael controls it.]
Oh, that’s so f*#%^I^ sick! I think it should be a little faster though… The motor has default parameters, so you can just turn those up. Yeah, let’s try it out now.
[The carriage zooms along the rail at crazy speed. Michael ducks down and laughs.]
All right, so, and this is all fine and good and fun if you’re using robotics for manufacturing or trying to make a scary movie or something like that. A quickly moving apparatus on a rail system would have zero practical application in an operating room.
That’s good! That’s fast. [To his girlfriend] Can you just stand right there?
Whoa! It’s pretty cool!
[Carriage zooms past her unexpectedly and she screams.]
We just gotta put a few of these in… [Snaps his fingers and the scene cuts to a more completed model.]
It looks like this. I did the quirky little snap teleportation thing, right? That was three weeks ago. I’m ff*#%^I^ tired. But I built this test platform out of aluminum and wood that I stole from my girlfriend’s bed frame.
It’s not like I can go to Home Depot in quarantine; it’s just a prototype. You can make it do this… [Robot moves around jerkily, shaking the table.] Maybe not as stable as you’d want it to be, but yeah, it’s just a prototype.
So super unstable. I will say that I’m pretty impressed with his ingenuity, computer programming, and technical skills of being able to design something that can slide up and down — just not replacing a surgical robot anytime soon!
[Video shows a top-down view of the robot moving.]
So I’m controlling it with my mouse right now. It looks jerky and awful… but it’s actually got a really good amount of precision to it. It’s kind of going in a circle from the top-down view. Like I said, this is not the final surgery robot.
So, I’ll just clarify. Precision in terms of some industrial equipment (moving boat containers from a dock to a truck,etc.) is a different definition of “precision” than the millimeters you would need as you’re dissecting a lymph node off the aorta. And if it’s off by one millimeter to one side or the other, you get a catastrophic, life-threatening event. So “precise,” but not in the terms of what you need for surgery.
Michael [shaking the robot carriage]:
Behold, the superior surgery robot, you da Vinci sh*ttertins! It’s got the carriage utility mechanism. It’s got the cable management.
But Michael, does it even work? Does it work? Does it work? I don’t know if it works. I haven’t turned it on yet.
[Hesitating before turning it on.]
Oh, God… Oh, please… Please don’t break… YEAH! Are the machines working? We can start to control it. But Michael, where’s the controller? You ARE the controller! [Moves the controller by waving his hand.]
I got this weird hand-tracking camera off of Amazon that works super godd@mn well. So you just take the hand coordinates from this, pipe it in the surgery robot, and bing, bang, boom!
That, I mean, that’s pretty amazing! So purely just from an innovation/knowledge/technical (and wanting to get something done and having the stamina to do it because during Covid, everybody had needed a hobby) ability to put this together is just miraculous. Nothing short of amazing. And I love how it works by moving your hand and translating those into the movements of the machine… but it’s still not ready for surgical robotics.
Oh, boom! F*ck you, da Vinci Robot!
[In the video, Michael is wearing scrubs and there’s a pineapple on the operating table. The robot has a huge knife taped to the arm.]
Commencing the operation… [The robot drags the pineapple across the table.]
Doctor Rich [laughing]:
He’s got the scrubs! Again, if you’re in a fruit processing plant and you have to build an expensive piece of equipment to use a knife to open a pineapple — maybe a reasonable innovation.
[Michael and his girlfriend attempt to paint using the robot]
Michael [to his girlfriend]:
Draw the Mona Lisa. Draw the Mona Lisa!
[His girlfriend tries her best…]
I’m not gonna pressure you, but this is supposed to show how accurate my machine is.
[Video cuts to another scene, where a mannequin is prepped for surgery under Michael’s robot.]
We’re gonna go for… like, a laparoscopic appendectomy. So if we just make a small incision above the chest here…
[The robot violently stabs the mannequin.]
It’s a little bit more difficult for some procedures…. You can see you still have a lot more accurate control than a lot of surgical systems… f$%^!
Doctor Rich [laughing]:
That’s… horrifying! But it actually brings up a very good point because what is a surgical robot for? So in this example, he actually takes a giant kitchen knife and does a huge laparotomy to expose the appendix to remove it. That’s actually not what robotics are for. Robotics don’t have anything to do with skin incisions. You still (as the surgeon) make little, tiny skin incisions with a scalpel on the abdominal wall. And then you use the robot to manipulate these long, tubular instruments that have little hand graspers on the inside. Then your finger movements at the robot console are translated into smaller movements at these little instruments at the end of the robot arms. But that brings up a great point. I mean, the general public may not have any understanding of what the surgical robot’s for!
So robots are designed to KEEP you from having big open incisions! So Michael’s robot is just attaching a knife to an arm and just doing a huge movement. If you were going to do that, you could just do it with your own hand! The point of robotics is to keep you from having a big open incision with a lot of blood loss, a long recovery, tissue trauma. It only uses little, tiny keyhole incisions that you make with your hand and put the robot instruments through those incisions.
Michael [doing a mock presentation to a “doctor”]:
So, would you add this to your hospital? Do you think hospitals could adopt this?
Seems a little dangerous…
Okay, I appreciate the feedback. You’re wrong.
[Video cuts to another mock surgery. Michael’s girlfriend sits at the controls of the robot.]
This study is to see if we can bring someone from zero skill level all the way up to the ability of a surgeon.
[Coaching his girlfriend on how to use the controls]
So just put your hand out. Could you just put your hand out above the thing? Higher up controls the knife position. You can move it further closer, and it’ll get further away from you. We’re gonna make a small incision right above the ear.
[The knife stabs down into the mannequin. Michael’s girlfriend screams.]
The average surgeon does about 40,000 hours of training in residency before they can actually be signed off to independently do surgery and operate on people — although the robot does shorten the learning curve! So as the surgeon, you can transition from open or laparoscopic surgery and offer your patients these minimal invasive options (little, tiny incisions with a faster recovery). Your progress as a surgeon is going to take you less time to get through that learning curve than if you did just with what’s called straight stick laparoscopy — or just doing the keyhole incision holding the instruments yourself (as opposed to using the computer-assisted surgery, which is what robotics is).
So the moral of the story is you can be a complete genius in one area (computer programming/robotics) and have zero knowledge in another area (like surgery).
So for all of our viewers who are planning on making their own surgical robot and doing surgery at home, please don’t do that. Can’t trust you with that! We CAN trust you with going down and hitting the subscribe button and turning on your notifications. We’ll see you next time!