Hey, dad, why is Grandma not answering her phone today?
Oh, I forgot to tell you.
She has a surgery at the hospital today for her lung cancer treatment.
She left early this morning to take out the tumor from her chest.
Oh, no.
She must have traveled so far to reach the hospital from our house.
What kind of surgery would it be?
They'll use a cool new robot called the Da Vinci System.
Robot? You can use robots in surgeries now?? Can you tell me more about them?
Yeah, sure. Take a seat.
Let's begin with a brief history of surgery.
Modern surgery is thought to have been
started by a surgeon in India named Sushruta, who invented many flap surgery
techniques like rhinoplasty, surgery on your nose.
From there in ancient Asia and South America, archaeologists have found that
many tribes that actually used heat and compounds like sulfur to stop bleeding and
infections, which is kind of like surgery using fire.
Using fire? That must have been very painful.
I remember burning my finger, lighting my birthday candles.
Yeah, surgery and medical procedures were really painful back then.
A lot of cultures experimented with different substances to numb the pain.
And the most commonly accepted one for a long time was actually alcohol.
It wasn't until 1846, when Dr.
Norton was the first to use ether gas as
an anesthetic and was successful in pioneering modern anesthesiology.
Anesthesiology?
Is that something that makes people go to sleep when you do surgery?
Yeah! You remember when my appendix burst last year, right.
It was really risky because my appendix reached a point where it burst and the
surgeons could not just make a small cut and do surgery.
They actually had to open up my belly to treat me.
And that's why you see a big cut here on my stomach.
Oh, no, that's so unfortunate, dad, but
I'm glad you are well know! But will Grandma have a big cut as well?
No, son.
I told you she'll be using a cool surgical robot.
I can tell you more about robots now.
Ask me anything.
Well, then, what's the story behind these surgical robots?
So the application of robotic surgery
began in the 1970s as a military project, which was done by NASA.
Essentially, the idea was to replace the
physical presence of surgeons in space or on the battlefield.
That's so cool. What did the first robot do?
So the first robot was used for image guided precision tasks, something like
taking a biopsy of the brain with the use of imaging techniques.
This was done in 1985, where a machine
named PUMA was used to get a brain biopsy using a CT scan.
How do robotic surgeries differ when compared to regular surgeries?
So there are lots of pros and cons of
using robotics in surgery, and I'll go over a few of them for you.
So some of the pros are that it reduces the size of the incision, meaning that
less damages caused to surrounding healthy tissues.
The surgical accuracy goes up by a lot,
which makes it better for certain surgeries like brain surgeries.
And the recovery time goes down, meaning Grandma can come home quicker.
But still, there are some disadvantages of using this technology.
These include things like higher costs
related to installing and maintaining the machine.
There could be a possibility of a delay between the command of the surgeon and the
action of the robot and the hand eye coordination of the surgeon has decreased.
So there are others that I haven't gone
over here, but it's good to really do your own research before making a decision
involving surgery with robots, you should look into it more.
What type of robot will they be using on grandma?
Oh, it's great that you ask that question right now.
Look, there's a show that's talking about the Da Vinci surgical system, the one
that's going to be working on Grandma today.
Good afternoon, everyone.
And welcome back to Demystifying Medicine News.
Today, we will explore a revolutionary surgical robot called Da Vinci surgical
system that has significantly facilitated the field of minimally invasive surgery.
For those who don't know the Da Vinci surgical system, it consists of four
robotic arms that move in a greater range of angles and motions than a human hand, a
3D vision system that gives surgeons a crystal view with ten times bigger than a
normal vision and a console to manipulate those four arms to perform various kinds
of surgery on patients more precisely and accurately.
More than 1700 Da Vinci systems are
already installed at different parts of the world, and more than 775,000 patients
have had a procedure where Da Vinci was used.
Today, we have one of the pioneers to use
the Da Vinci system in Canada to treat early stage lung cancer.
Hello, Dr. Yasufuku.
How are you? Pretty good. How are you, Nadia?
I'm good. Thank you for your time today.
It's a pleasure to introduce Dr.
Kazuhiro Yasufuku, who is professor of surgery at the University of Toronto.
Staff thoracic surgeon at the Division of
Thoracic Surgery at Toronto General Hospital.
So, Dr.
Yasufuku, we know that you have been a leader in the field of minimally invasive
diagnostics and therapeutics for thoracic malignancy.
And you have been conducting research on development of new technologies in early
diagnosis and ultra minimally invasive thoracic surgery.
Thank you, Nadia. Maybe I'll just start out with a little
history of robotics, especially for lung cancer in Canada.
So in 2011.
So this is ten years ago, in October, I was the first thoracic surgeon to
actually apply robotics for lung cancer surgery in Canada.
It had started several years ago in the US and around the world.
So I've been using the technology for about ten years.
And in simple words, the robotic enhances
the surgeon's ability to do surgery in a minimally invasive way.
So what is your motivation behind practicing robotic surgery?
Well, I think, as I mentioned, it does
enhance the ability of the surgeon to do a very precise surgery.
I think you mentioned that robotic is used for early stage, but actually, with the
robotic, you can actually do more advanced disease surgery, where traditionally you
may have to open with the robotics, you can do it pretty well very safely.
The reason why I started robotic surgery was because of this.
But also, I see a future of robotic
surgery because technology continues to get better and better.
And if you do not use the technology, you're going to be left behind.
So I think we constantly have to look at what is
available and the new technology and how we can apply to our patients.
That's really inspiring.
Thank you for sharing your thoughts. So when you perform robotic surgery, is there
anyone in the operation room to specifically take care of the machine?
So when you get training to do robotic surgery, obviously, you need to know if
there are emergencies where the robot malfunctions.
You need to know all of that and all of the members of the wire they need to know.
So there is a robotic coordinator or robotic nurse.
It's a real nurse, not a robot.
But she oversees all of the robotic surgeries.
And she is the kind of dedicated nurse
that can kind of troubleshoot and everything.
And there's always a medical engineer from the company that provides the DA Vinci.
So there's always someone that's assigned
to our Toronto General Hospital so that if there is any issues, they're available,
That's good to know.
Have you ever encountered any difficulties using the Da Vinci system?
I'm very meticulous, and I'm very careful with what I do.
I try to prepare well in advance.
So in the ten years I've been doing
robotic surgeries, I have had zero zero issues.
That's wonderful.
Just like surgical robots develop and
improve with advancement technologies, over time, people are slowly getting to
know that there are robots that help surgeons to perform better in surgeries.
But I'm sure there are some people who are
still hesitant to go through robotic surgery or simply cannot trust the robots.
What is the one thing you always tell your
patients when guiding them through different types of procedures?
How do you present information to your patients?
That's a great question.
And when we talk to our patients, definitely, we have to explain to them
what surgery is about, what we're going to do.
Then we start discussing about the different approaches in detail.
So you're not going to say, "okay, we're going to do robotic surgery for you".
And as a patient, if you hear robotic
surgery, you might imagine, "oh, so you're not going to do the surgery.
The robot's going to do the surgery itself." But that's not true!!
The robot will not even move unless we move the robot.
The surgeon is responsible in moving the actual robot.
So if they get a wrong perception of what
robotic surgery is about, they may not feel comfortable.
But as long as you explain to them what
it's about, I've had no patients (who had issues) so far, and in fact, a
lot of the patients come to see me because they prefer having the robotic surgery.
Even if they do come wanting robotic surgery.
I also always explain about the different approaches.
Well, thank you, Dr.
Yasufuku, for taking the time for us today.
We really appreciate your help.
You're welcome. Thanks
for watching Demystifying Medicine News, see you next time.
That was interesting. But what will happen when Grandma goes back to the farmhouse?
Are there any doctors that could take care of her in that tiny town?
That's a really good question.
Actually, robots will still be helping out
with taking care of Grandma even when she goes back home after the surgery.
How?
Well, one way that robots help with
healthcare in small towns is by improving what's called telemedicine.
By having robots in small town hospitals and clinics, doctors can use them to
provide care from somewhere else, like the city they live in.
They can call in over the robot and help out their patients.
But how would that help?
Couldn't they just call over the phone without a robot?
That’s how it used to work! But these robots can help make it faster, allow the physician to move around to change their viewing angle,
do small procedures, and even help collect patient data and vitals.
So cool! But what about if grandma’s not at the town hospital?
Well, another use for robots is as stay-at-home medical companions. 185 00:10:56,440 --> 00:10:25,920 If she wants, your grandma could have a robot that lives with her and monitors her to make sure nothing bad happens.
These robots can help her with her vitals, remind her to take her meds,
connect her with help if she needs it, play games with her, and even help her call you!
That sort of robot has been proven to actually increase the quality of life of patients and decrease healthcare incidents.
Wow, that’s awesome. Robots seem like the future!
Yeah! It’s true that robots can have a lot of advantages. They’ve been proven to lower long-term healthcare costs,
deliver services to people who otherwise might not have access to them, reduce the load on overworked, and tired healthcare workers, 192 00:10:56,440 --> 00:09:58,920 take over simple hospital tasks, things like that.
But, they also have a lot of downsides. Can you guess what some of them are?
I bet they’re expensive. And they probably have glitches.
Yeah, you’re right. They can definitely cost a lot of money up front!
And technical issues are definitely a big problem too.
they can take a lot of time and money to fix. And they're not exactly uncommon in the types of robots that are used in the sort of rural settings.
If healthcare systems depend too much on these robots, those systems could become vulnerable if robot breaks down or malfunctions.
And some people just aren’t comfortable receiving care from robots and don’t really feel safe around them.
This could decrease the quality of care people receive and
would stop them from seeking care entirely.
Robots also raise some really important issues around data security, privacy, and healthcare ethics
- like how do we make sure that the data they collect is kept safe?
Finally, some people are worried that relying on robots could lead to the disappearance of human doctors
and nurses from certain areas because they might become completely neglected by funders and policymakers.
Wow. It seems like robots are really cool, but there are definitely some things we need to figure out before we go all-in on them.
You're right. Just know that your grandma is in good hands with her combination of skilled doctors,
nurses, physicians, surgeons and robots that can help those human practitioners do their job as effectively as possible.