Hi! Are you tired of getting #$%**@ advice from random people on social media about health issues? Well, the doctors of YouTube are here to help! I’m Doctor Rich — and our channel is here to provide evidence-based information about women’s health and many other issues. Has Hollywood gotten surgical robotics right or wrong? Let’s see if House knows anything about a surgical robot!
Don’t have time to read this post? Watch the video here instead!
[Video of Dr. House at the controls of a surgery robot for a demonstration. Dr. Cameron lies down on the operating table.]
House:
Relax, Cameron. I’m not gonna cut you…
Doctor Rich:
That ain’t no robot I’ve ever seen! So I think this is a made-for-Hollywood robot. Everybody thinks of da Vinci as synonymous with surgical robotics — but there’s actually eighty different surgical robots currently available (or in development). And a handful of those are direct competitors for Intuitive’s surgical robot.
House:
I just want to show you what this puppy can do. I can make a one millimeter incision. Do you know how small that is? It’s small even in metric!
Doctor Rich:
So House got that one on the nose! The main advantage of surgical robotics is the precision of the dissection. Essentially, the robot (through a computer algorithm) translates your broad movements in space into tiny little millimeter movements inside the patient, making everything you do more precise.
[In the video, Dr. House strokes Dr. Cameron’s face with the surgical instrument, then moves the mechanical arm down her abdomen.]
Doctor Rich [laughing uncomfortably]:
I don’t know what freaky-deaky stuff Dr. House is doing with the robot… Robots are not designed to tickle people’s cheeks or do anything weird. I guess he’s taking it for a test drive. Typically though, you would do that on a box trainer with little silicon pieces that you can suture and do stuff. Usually you’re not going to take a test drive on your med student’s face… unless of course you want to go see HR after the case!
[Dr. House uses a suction tube on the robot on Dr. Cameron’s belly button, then uses a scalpel to cut off the top button of her blouse.]
Doctor Rich [cringing]:
So you don’t have a handheld irrigator that you just plug onto a robot. You don’t have a scalpel that you just plug onto a robot. The robot is actually not designed to have anything to do with making incisions (as we talked about in our last video that you can check out here). There’s none of this suctioning someone’s navel and cutting off their dress! Assuredly, the robot has much more glorious implications than hitting on your med students!
Dr. House [to another med student who’s observing]:
Either you do this or you die…
Doctor Rich:
Well THAT’S ominous!
So Dr. House? I’m going to give him a five out of ten. The actual utilization of the robot wasn’t demonstrated here. The reason they get five points out of ten is because he does allude and actually specifically talk about the precision of the surgical robot, which is its main advantage. And in this show, they’re discussing a condition that requires ultra precision. So they’re bringing a robot for that.
Now, fan favorite: Grey’s Anatomy!
[In the video, a robot moves its arms and says, “All systems ready!” when an excited Dr. Bailey walks into the room.]
Doctor Rich:
Okay, well this is clearly made for Hollywood! The robot doesn’t jitter with excitement and say “all systems ready” as soon as you walk in the room. But it actually does have a voice, and it says mundane things like the patient height and clearance. This is actually an older version of the robot. This SI came out the same year as the iPhone 1 (if you can imagine!), so we’re two generations ahead. We have the XI and the SP now — that’s the current version.
[In the video, Dr. Bailey is operating on a patient. Dr. Webber is assisting and says he’s going to move the small bowel over for better visualization. Dr. Bailey tells him that, thanks to “Leo”(nardo da Vinci Robot), she doesn’t need his help.]
Doctor Rich:
For a minute there, I thought this was an advertisement from Intuitive Surgical for the da Vinci Robot!
So yeah, you get 3D vision and articulation with the wristed instruments that you could never have laparoscopically — and frankly more precision than you would have even if you did an open surgery that allows for a minimally invasive approach.
And we also all have nicknames for our robots. I’ve seen “WALL-Es,” I’ve seen “Terminators,” I’ve seen “Winter Soldiers” — everybody’s got their own name for the robot. We named ours “The Med Student Terminator” because (as she’s pointed out here) she doesn’t need help.
The fantastic thing about the robot is that you have total control of both of your instrument arms AND the camera! In comparison, in laparoscopic surgery, we have to give control of the camera to somebody else, and they’re moving all around — and you’re dizzy by the end of the case. But with the robot, you have control of all of that, PLUS an additional arm! So it’s like you’re a four-armed surgeon. We see Dr. Bailey kick Dr. Webber to the curb because she doesn’t need his help — because she has a fourth arm! Maybe they’ll genetically engineer surgeons so they have four arms in the future…
[Video resumes]
Dr. Bailey:
You can’t do that with a laparoscopy…
Dr. Webber:
…or an open surgery! You know, Dr. Chalikonda at Cleveland Clinic is doing single-incision gallbladder removal through the belly button. We can try that on the next one…
Doctor Rich:
Yeah, so having trained at the Cleveland Clinic — we have early access to virtually all technology. We actually got our da Vinci Robot two generations before this one in 2002, three years before it was FDA-approved for gynecology.
So all in all, actually pretty accurate! I would give Grey’s Anatomy a nine out of ten. Basically, the features, advantages, the technology (and how it’s used) was all pretty accurate. They mentioned some obscure references (the single site) which are all correct. The only difference is it doesn’t jump for joy when you walk into the OR — other than that, pretty accurate!
Looks like we have to send House back to medical school to figure out this surgical robot thing! But YOU don’t have to go to medical school. All you have to do is drop down, hit that subscribe button, and learn everything you ever wanted to know about the surgery robot.
