Operating equipment at the cutting edge

There are few higher-pressure working environments than the operating theatre, and few where any help that technology can offer to relieve the strain on medical staff is more welcome.

Sometimes this involves applying clever engineering to fulfil a fairly straightforward need. The development by Philips of a voice-command system for operating theatres is a good example. The need, quite logically, is to enable surgeons (who tend to have their hands occupied with other matters) to exercise control over some of the equipment surrounding them.

According to Philips, the surgeons who have tested the system are delighted by their ability to exercise control while unencumbered by headsets or other accoutrements.

Quite right too, and a job well done. But when it comes to the adoption of robotic surgical technology, the stakes are higher and the issues less straightforward.

The consistent precision and control associated with advanced robotics obviously present huge opportunities for medics. Indeed, top figures in the profession have been leading its development, well aware that the tireless, nerve-less qualities of robot assistants have the potential to greatly enhance the chances of a successful surgical outcome.

There is plenty of innovative (dare we say cutting-edge) work under way. But dig a little deeper and it is clear that the technology is not the only issue. The difficult, sometimes impossible, economics of the healthcare system, also come into play. Robotic surgery, like all technology, comes at a price. A commercial enterprise, when considering whether to adopt a new system, would apply a cost/benefit equation relating to capital outlay, increased productivity, lower costs and eventual return on investment.

A similar equation applies in the healthcare sector, but the rules are subtly yet significantly different. If outlay on an expensive piece of robotic technology could reduce the already very small error rate in a particularly complex operation to almost zero, does that make it worth investing in?

For those few per cent of patients in our hypothetical example who are currently subject to error, the answer is certainly yes. But what if the investment in our imaginary robot meant that another item of equipment, perhaps benefiting far more people in a less dramatic fashion, missed the boat in a tight NHS budgetary round?

Such are the economics of healthcare, where balancing the needs of the many and the few is an everyday task.

Then of course there are the human surgeons, who have studied long and hard to reach the level of skill they apply on the operating table. Surgeons are trained to be literally ‘hands-on’ practitioners of their science, and any sense that they are being turned into arms-length overseers of a far more precise robot is likely to be viewed with some suspicion.

Persuading medical professionals to view this technology as their slave, not their master, will be crucial in helping it to achieve its full potential.

Andrew Lee, editor