[capnahab]

Noted. What has been stable for a long time and remains frustratingly static and unrefined is the field of surgcial instruments. There are a few exceptions but most haven't changed in the 20years I have been a surgeon. The regulatory costs of developing new instruments and intertia of manufacturers doesnt help. Once a manufacturer gains a market share they try and keep by not innovating which keeps their deveopment costs down and the consumer volume is comparatively low. I don't get the feeling there is any sense of patient altruism. I have been using the same 4mm dia endoscope 25cm long since 2007 when the first iphone came out. It is very simple, made of glass fibres with a sony 3chip camera that is 10y old. We get some v slow progression on video output and have just got 4k. Compared to consumer tech the advances are ridiculously slow. We need a camera (the iphone camera is small enough) on a steerable stick. How hard an engineering task can that be?.

[skinkestek]

A couple of weeks ago I noticed we had several active farmers here, today a surgeon with twenty years of experience :-)

I'm happy to see so many different people here in addition to programmers, techies, VC etc.

[temac]

> The regulatory costs of developing new instruments and intertia of manufacturers doesnt help.

I work on (mostly non-critical) medical devices and I would like to remind that regulatory is there for a purpose.

If anything the 737 Max fiasco should remind people what can happen when regulatory is considered a cost that need to be cut in a field where there can be some hazards, and where some people in the chain do not have the best interest of the public in mind.

And yes, in the medical industry too, there can be some people who care more about optimizing profits than about patients.

Maybe there are some undue regulatory rules, but hopefully there are not the majority.

In the case of what I work on, regulatory does not prevent us from using state of the art CPUs and GPUs, so yes R&D may need somehow longer cycles from consumer electronics to get a return of investment, but let's be honest it is not too much scandalous to get some features a few years after you get similar things in consumer electronics, especially in cases where there are diminishing returns of improving X or Y.

And yes it is easier to build things when you don't have to care about e.g. ability to disinfect materials, you can cope with more bugs, etc.

[burnte]

Half of that is the manor manufacturer, and the other half is the FDA. These huge companies that can afford lots of money intentionally get the FDA to set a high bar with lots of expensive testing in the regulations. This creates a HUGE barrier to entry. Right now I'm working with a pathology lab who are buying a pathology slide scanner. This is basically a slide handling robot with a high end camera hooked to a PC with an image viewer. The combined system costs over $300,000 from companies like Leica and Philips. The software is incredibly basic, it's basically Thumbs Plus with Irfanview and that's $100,000 alone, aside from the scanner. But they charge that because it's incredibly expensive for a startup to come in and challenge their pricing.

[a_t48]

I don't suppose you'd count something like the da Vinci robots as a step forward? I got to try out a demo unit once (on a dummy! not on a real human), really cool stuff. I'm really glad I tried it _after_ I had my laparoscopic appendectomy - it was somehow a little terrifying how clumsy it felt holding the "regular" tools used, compared to using the robot.

[capnahab]

Yes, tho they have been around now for about 20y, are big (no good for eg neurosurgery, ent) and cost $2m. You don't need that for lap appendicectomy, - just a better scope, and a good surgeon. Robots have no advantage over human dexterity. They have a few niche roles eg where we can't get our hands in eg the prostate.