WALL-E, the last robot on earth, cleaned up the planet, one piece of trash at a time. But what if his creator programmed him differently? What if WALL-E performed gastroscopy, not garbage collection?
Robots are no longer the domain of Disney flicks and sci-fi novels but doctor's offices and surgery centers. More surgeons are opting for robotic help during minimally invasive operations, with three-quarters of hospitals offering robot-assisted surgery in 2018. Expect this number to have increased post-COVID. Robots support procedures in surgical environments from a remote distance, reducing patient contact.
This "rise of the machines" is a fascinating phenomenon. At first glance, robots are a credit to overworked, overstressed surgeons. But there is ever-spreading skepticism in the medical community about artificial intelligence (AI) — the terrific tech that underpins robot-assisted surgeries. Can AI _replace _surgeons? Or is this fear no more credible than a Disney movie?
A (Very) Brief History of Robot-Assisted Surgery
Robotic surgery dates back to 1985 — long before "WALL-E,""I, Robot" and "The Matrix" — when doctors used the PUMA 500 surgical arm to perform delicate non-laparoscopic neurosurgery. The FDA approved the AESOP system, which performs endoscopic surgical procedures, five years later. Since then, robots have supported minimally invasive surgeries, mostly, performing more of an _assistive _role than a directive one.
There are, of course, limitations to robotic surgery, but doctors are more than aware of the insane capabilities of AI and the potential impact of this tech on the future of medicine. Robotic surgery systems can, or will soon be able to, execute procedures such as hysterectomies, hip replacements, gallbladder removal, tissue removal, and, shockingly, coronary artery bypasses.
You'd think robots couldn't replicate the delicate operations that only human hands can facilitate. But future AI advancements will make robotic systems able to emulate the tactile sensations a surgeon experiences during invasive procedures. The possibilities for robotic surgery, therefore, are almost limitless.
So what does this mean for surgeons?
Will Robots Replace Surgeons?
Fears that robots will make surgeons obsolete are pretty fathomless, so often borne out of the darkest corners of the internet. (Namely, conspiracy theory forums and Reddit.) These so-called predictions follow the same train of thought, one that theorizes surgeons are wholly replaceable, and the robot uprising will happen when artificial intelligence gets even more intelligent.
Proponents of the robot-replacer theory point to manufacturing, where AI is having an even more remarkable impact than in healthcare. Robotic process automation (RPA) in production plants can run 24 hours a day, offering manufacturers enormous cost savings and productivity perks. It's no wonder, then, that robots could replace up to 20 million warehouse jobs by the end of the decade. (The emphasis here is could.)
Manufacturing and healthcare are two completely different beasts. RPA-based processes are nowhere near as complex as invasive surgical ones. Automating car component production, for instance, has nothing on craniectomy, a truly terrifying procedure where surgeons remove a fraction of the skull to reduce pressure on the brain. And the robotic system that rolls another few chip packets down the production line can't perform oesophagectomy, bladder cystectomy, thoracic aortic dissection repair, or any other of the world's most dangerous surgeries.
Plus, there's a collective misunderstanding of _what _robots do during medical procedures. Even in the absolute worst-case scenario for surgeons, where machines perform operations as proficiently as humans, scientists can only program robots to _replicate _human behaviors, not create new processes. If robots replaced all surgeons, AI algorithms would execute the same pre-programmed tasks over and over again. There would be no medical progress. Ever. Medicine would never evolve.
OK, for argument's sake, say robotics could perform craniectomy. Surgeons would still need to command a prescriptive role during all medical procedures, both invasive and non-invasive. Plus, professionals would need to manage the AI that powers these robots — highly complex algorithms that, if tweaked in the wrong way, could cause surgical disaster. Surgeons would still need to make (potentially life and death) decisions. They would have the final say.
"There are responsibilities and duties which technologies cannot perform,"says The Medical Futurist. "While IBM Watson can sift through millions of pages of documents in seconds, it will never be able to do the Heimlich maneuver. There will always be tasks where humans will be faster, more reliable — or cheaper than technology."
So don't believe the scare stories. Surgeons, your jobs are safe. And they always will be.
Even in an alternate universe where robots are conscious and have human-like brains, there will still be the question of ethics. How can machines perform such life-threatening surgeries when real human professionals are just as capable? No healthcare system, no matter how frugal, could justify such radical changes to public health.
The One Thing Robots Will Never Do
Even if — or _when _— robots can perform such operations, there is something they will never master:
Sure, Wall-E had feelings. But that's why Disney made a movie about him. Robots are incapable of care, kindness, calmness, clemency, and the entire gamut of emotions that make humans human. And, as anyone who's had an operation knows, surgeons do more than cut open a patient's body for repair and refurbishments.
Surgeons serve a dual role: Operation-performer and caregiver, helping patients emotionally navigate the physical and psychological aspects of medicine. A surgeon's words, behavior, and actions are just as critical as her scalpel and scissors.
"We don't remember machines, but no one forgets the experience of someone holding a hand, sitting through tears, explaining things, and listening,"says Australian oncologist Ranjana Srivastava. "For all those who scoff that the job of medicine is to diagnose and treat and not to hold a hand or speak nicely, I say wait until you get sick. In the face of astonishing new drugs and discoveries, the art of medicine will calmly hold on to its relevance."
Healthcare needs humans because real robots aren't like Wall-E.
Are AI-powered robots a genuine threat to doctors? The answer goes much deeper than robot-assisted surgery.