The next frontier in healthcare 

Utilizing robotics in medicine - a promising trend for the future?

Philipp Grätzel von Grätz
Published on 30. März 2021

Robotics in healthcare is not about dehumanizing medicine, but about improving quality, safety, and access. Minimally invasive interventions are a case in point. But the trend is much broader.

When Professor Guang-Zhong Yang of the Institute of Medical Robotics at Shanghai Jiao Tong University was temporarily quarantined at a Chinese hotel for several days early in 2020 while traveling during the COVID-19 pandemic, a little robot on wheels delivered take-away food right to the door of his hotel room. On arrival, the robot gave Yang a call on his mobile phone: “Dinner is served.” No direct contact between humans was necessary and there was no risk of SARS-CoV-2 transmission.
During a global pandemic, quarantine situations show very clearly how robots can be put to good use in healthcare. But the quarantine robot is just a niche example of what could soon be an important trend. In recent years, robotics has transformed manufacturing, especially in the automotive and electronics industries. Robots are also starting to transform the service industries. “We expect sales of both professional and personal service robots will continue to increase strongly,” says Milton Guerry, President of the International Federation of Robotics (IFR).
The COVID-19 pandemic showcased the benefits to healthcare of using robotic assistance. Yang gave an overview of these benefits in the journal “Science Robotics”.[1] Had they been available, surface disinfection robots, for example, could have helped in making public transport safer. Mobile screening robots could have taken the temperature of people in various institutions, thus reducing the risk of unrecognized viral spread. Diagnostic robotic systems that assist in collecting swabs could have increased the safety of professionals in COVID-19 diagnostic units. And sophisticated surgical robots and robotics for minimally invasive vascular interventions could have been used on a large scale to reduce infection risks around surgical and interventional units. While robotics in healthcare might not have been ready for routine clinical management during the management of the COVID-19 pandemic, there has been a clear increase in its use in recent years. Medical robotics takes an impressive share of the overall professional service robotics market, and the segment is poised for growth.
The market for medical robotics will not only grow, it will also move beyond gynecology and urology into other fields.
Medical robotics procedures globally
Globally, countries embrace robotics at a different pace. China is a case in point: The Chinese government has made robotics a priority to compensate for a lack of skilled workers, a fact that is illustrated by the number of annual installations of industrial robots – which is higher than anywhere else in the world.
Annual installations industrial robotics in 2019
China’s labor shortage is especially critical in healthcare, with only two doctors per 1000 inhabitants in 2017, as compared to 3.5 in the OECD countries. This, again, is mirrored in robotics market data: Compared to 2018, the number of installations of the world’s most commonly used surgery robot increased more than eightfold.<p><br></p>

Peter Schardt, Chief Technology Officer Siemens Healthineers

<p>But why should healthcare embrace robotics? It comes down to three reasons: better access, improved outcomes, and standardization. The success of the Intuitive Surgical Da Vinci robot in recent years in areas like prostate surgery, cystectomy, and increasingly colorectal surgery, illustrates that surgeons are very aware of the benefits of robotic approaches. This is true not only for conventional and laparoscopic surgery, but also for endovascular interventions.</p>
We believe a combination of endovascular robotics, image guidance, and dedicated devices will significantly impact how neurovascular procedures will be performed in the future, and we remain focused on bringing value to customers and patients.
Key visual for Endovascular Robotics
<p>But doesn’t the use of robotics come at a cost? Do we not prefer our doctors to be human beings? What if robots cause complications, as happened in the early years of robotic surgery with robots that assisted in hip replacement surgery? How, in other words, should medical and specifically interventional robotics be judged from an ethical point of view? How should robots in any field be judged from an ethical point of view?&nbsp;</p><p>Many of the ethical discussions around robotics in healthcare come down to two aspects: risk-benefit assessment and the degree of “autonomy” of a robot. Regarding autonomy: the robot complements the work of the physician, taking over some tasks and allowing the physician to focus more on clinical decision-making. The robot won’t “replace” the physician. It is autonomous in that it performs small, precise moves that are better done by a machine, but it always remains an extension of the doctor’s capabilities. The physicians remain in the driver’s seat. They oversee what robotics does at any given time.&nbsp;</p><p>When it comes to risk-benefit assessment, it is worth keeping in mind that a robotic system doesn’t simply enter the medical arena. It has to be approved, and it has to thoroughly demonstrate its benefits. This, of course, is not as straightforward as it sounds. Exactly how much responsibility a machine should have is a discussion that will yield different answers in different types of medical disciplines and different kinds of care scenarios. However, there is a fundamental truth: As soon as patient outcomes are better with robotics than without it, it might in fact be unethical not to use it.</p><p><br></p><p><br></p>
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By Philipp Grätzel von Grätz

Philipp Grätzel von Grätz lives and works as a freelance medical journalist in Berlin. His specialties are digitalization, technology, and cardiovascular therapy.