[idiot900]

Robotic head and neck surgery is routine at major medical centers all over. Da Vinci has been around for many years and it is human controlled.

I’m glad this patient was helped but there is absolutely nothing interesting otherwise about this.

[richk449]

What an amazing world we live in. There is nothing interesting about a robotic assisted surgery able to perform more delicate and sophisticated operations than the best human surgeon in the world.

[iancmceachern]

This kind of headline drives me nuts.

Da Vinci is telecontrolled. The robot does nothing but imitate the exact motion its commanded to by the surgeon.

The headline should read " Surgeon saves patients life using surgical tool that has been widely available an on the market for decades"

The medical professionals deserve the credit. If this was 20 years ago, yeah, we should celebrate the technical achievement and advancement, but there isn't one here. It's old news.

Source- I've designed several (surgical robots)

[arghwhat]

Yes, but let's also avoid oversimplifying how complicated that robot is, how much tuning the controls took and how much special training the surgeon needed.

Not a new concept by any means, but still worthy of continued praise and admiration.

[iancmceachern]

Agreed, well said

[ww520]

Yes, the medical advancement is quite amazing. Couple years ago a friend went on a funding tour visiting startups and he mentioned he saw a demo of 3D oral scanning device to build a 3D model of the teeth. This year I saw the device in my dentist office and did an oral scan to build the 3D mold for bite guard. He said it's cheaper than the old method.

[PrimeMcFly]

Correct. In the same way there is nothing interesting about being able to buy a 60" flat screen TV for $300 brand new.

Times change, technology advances, and when those advances become 'old' they cease to be interesting for the most part.

[dehrmann]

Cars are just as impressive, just a century older.

[coldtea]

>What an amazing world we live in.

The kind of amazing where untold millions of people can't afford basic healthcare in the same country that we have a robot surgeon?

[richk449]

Yea, amazing, not perfect.

If DaVinci hadn’t developed the robot, would more people be able to afford health care?

[iancmceachern]

Yes.

Da Vinci is famously not better. There isn't a single study showing its better. It's also not less expensive, and doesn't reduce staffing needs in the OR.

What is it? A marketing tool. Surgery centers and hospitals can drive increases in patients and patient throughput, improving their bottom line. It's marketing and throughout.

They have a classic razor razor blade model. The surgical instrument are proprietary and locked in with eeprom chips in the disposables. They only last a handful if cases and then must be replaces. Intuitive made something like 80 billion last year and has had no real competition in their market for decades. As a result they've been able to pretty much write their own checks, choosing how much stuff costs and achieving huge margins on lots of very expensive equipment and supplies.

Source- I've worked on and lead the design teams for surgical robots for several companies in the field.

[robotresearcher]

> There isn't a single study showing its better.

The link you provide below says

"When it comes to prostatectomies, urologists have found the outcomes for da Vinci robotic surgery to be much better than for laparoscopic surgery and use this method in more than 90% of these procedures [...] Robotic surgery also appears to provide clinical benefits for some, but not all, types of head and neck surgery."

It also reports negative value overall for gynecological surgeries.

The evidence you provided suggests it's better for some things and not others, which seems like the expected case.

[robotresearcher]

> Da Vinci is famously not better.

Not better than surgeons with competing devices, or not better than surgeons without these tools?

[iancmceachern]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4941968/

https://www.nytimes.com/2021/08/16/well/live/robotic-surgery...

[richk449]

Thanks for the informative reply. Your comment rings true to me, since I am aware of other medical systems that are marketing tools.

I have questions though.

Is the davinci amazing? I have heard that it is.

Why doesn’t someone else make a similar product? Is there technology that is hard to replicate?

[iancmceachern]

It's totally amazing. It's like a space shuttle. It's the culmination of decades if investment and decades of some of the smartest people in robotics working tirelessly. It's a modern marvel.

Others have been trying for years. The latest big player is J&J who faces an existential threat due to robotic surgery overtaking conventional surgery, and therefore one of J&J/Ethicons core business. They bought Verb and Auris and a few other smaller companies in the space and smashed them together. There are others in the space trying to do the same.

Ultimately Intuitive has a pretty big moat. They have a lot on the technical/IP side, but also just business wise. These hospitals and surgery centers pay millions for a robot, then need to keep it busy doing cases for several years to pay it off. There is a lot of risk and not really any clear advantages to changing to a new challenger. That new challenger would need to demonstrate some key advantage, which they have yet to do.

It's hard, its akin to trying to compete with space x or similar, starting now.

[coldtea]

If we were spending more on spreading the basics and less on 'nice to have' robots, yes.

[monero-xmr]

Do you hate yourself for living under a roof when so many can’t? For eating dinner when so many are starving? For drinking clean water when so much pollution exists?

Good stuff happening shouldn’t make you miserable.

[coldtea]

>Do you hate yourself for living under a roof when so many can’t? For eating dinner when so many are starving? For drinking clean water when so much pollution exists?

Of course.

[hollerith]

I've seen authors describe their ideological opponents as being self-hating, but till now have never seen anyone own it.

There are many things in a person's emotional life that a person does not have any control over (at least not in the short term and without spending lots of time and money on, e.g., psychotherapy). I think it is commendable that you understand your own emotions well enough to perceive this self-hatred, and I do not think any less of you because of it.

If there are many people who share your emotional reaction to inequality, that would have explain a lot of things that so far have been puzzling to me.

What is your opinion of those who have things that others lack, but do not hate themselves for it? Is there something wrong with such non-self-hating lucky one in your eyes?

[nscalf]

This robot didn’t pull money that would otherwise be used for giving people healthcare. You’re complaining about unrelated things, the problem is around bought and sold politicians allowing for regulatory capture in healthcare, not around great science and engineering building an impressive product. This what-aboutism is just pathetic.

[wait_a_minute]

It's interesting to me. This is the first I read about Da Vinci and its capabilities in surgery.