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SCIENCE & SPACE
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Trust me, I'm a robot

Medical robots set to transform our hospitals

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Robots already allow doctors to make ward visits by remote control.
start quoteMost of us would rather be attended to in a hospital by a robot than be ignored.end quote
-- Joanne Pransky

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Future Summit

(CNN) -- "Ultimately technology could allow even a monkey to do an operation -- the learning curve is getting shorter, the possibility of mishaps is getting smaller," says Dr. Ara Darzi of St. Mary's Hospital in London. "These [robotic] systems won't allow you to do the wrong thing."

Surgery in the future will look very different. Where now there may be up to a dozen medical professionals present in the operating theater, soon there may be only two or three, with robots having taken over many of the jobs done by nurses and support staff. Even the surgeon may be elsewhere.

"It's easy to imagine a future where, if I need a medical specialist from afar [a robot] could remotely become his or her 'eyes, hands, and ears,'" says Joanne Pransky, an expert on robot psychiatry.

The first medical robots are already being used in hospitals now -- the da Vinci Surgical System was approved for use by the U.S. government in 2000, and more will follow.

Man and machine

As yet these systems are not autonomous, and they still require human input. When surgery is performed, small instruments and viewing equipment are inserted through tiny holes in the body minimizing the trauma and damage associated with open surgery. Conventional surgical tools are replaced with robotic instruments under direct control of the surgeon through "teleoperation."

"These robots work on on the 'master slave' concept, with the surgeon as the master," says Dr. Ara Darzi. "[the da Vinci system] has three arms, and you can add a fourth, with 3D stereo imagery available during surgery. It also has a motion scaling concept, which can be scaled down to five-to-one, so you can be much more precise than a human hand could. The surgeon feels very similar sensations to if he or she was working with their hands."

The robots act as an extension of a practitioner's skills, which allows them to perform better by helping improve control and precision. Already robots are being used to position endoscopes, and even perform gall bladder surgery. The hope is that soon they will be able to perform major operations such as heart surgery, perhaps using nanotech tools -- microscopic robots -- that would make the need to crack open a patient's chest a thing of the past.

"Professor Yane is working on a system that can track the eyes of surgeons using an infra red laser to capture the reflection back from the eye," says Dr. Ara Darzi. "If you track both eyes, you can see the fixation point, and that gives you depth perception and means, for example, you can use the instrument to allow 'conceptual docking' and get a larascope to move at the same rhythm as the beating heart, which will give you a static image of the heart to work on."

Robots will also help surgeons cope with the exhaustion of long procedures, and the da Vinci system's mechanics have been programmed to compensate for the hand tremors tired surgeons sometimes suffer from.

Nurse robot

But robots will not just be confined to the operating theatre. Not only are the training potentials huge -- and virtual reality will revolutionize the way students learn by removing the need to practice on animals or humans -- there will also be major applications in the wards.

"Due to the nursing labor shortage today combined with the ever-increasing aging population, robots could easily fill the lack of human assistance and facilities currently available," says Pransky.

"Most of us would rather be attended to in a hospital by a robot than be ignored, and given the choice to stay in our own homes with a nursebot or go to a nursing home, a robot would allow us to continue to live independently as well as offer a more cost-effective alternative."

"We are working on robots that can be used within the ward environment, the RP6 and RP7 mobile robots," says Dr. Ara Darzi. "These allow a doctor to use a robot to do a walk around the wards by remote control. If I was in the U.S., for example, I could use my hotel's high-bandwidth connection to be beside the beds of the patients I'd been with the day before in London.

"The patients love it -- it really enhances communication. You can talk to them and see their details, all remotely.

"One very important side benefit could be in preventing cross-infection. At the moment if a nurse is measuring a patient's pulse or heart every fifteen minutes, not only does it disturb them, but this is when most of the problems of cross-infection happen with diseases like MRSA. But these robot systems allows a no-touch situation."

The human touch

But despite their potential it is unlikely that robots will ever replace the need for a caring human presence.

"What we'll have is a robotic assistant for the nurse, which cleans out the bed pan, and maybe gives you the injection, and helps the nurse lift you out of bed on to the operating trolley," says Ian Pearson, BT's Futurist-in-Residence and CNN Future Summit Nominating Committee member.

"But the core job a nurse does is to provide you with care, it's a caring job, it's an interpersonal job that has to be done by a human being, and there's always going to be some premium on having that human contact.

"If R2D2 trundles over and talks to me when I'm dying of cancer in a hospital bed in 2020, and says 'It's alright Mr. Pearson, don't worry, your mortgage is taken care of,' it won't have any impact on me at all. If a nice cuddly nurse comes over and hugs me, makes me feel happy again, that's something that only a human being can do. It's a species thing. It's nothing to do with intelligence or mechanical skill, or exactly what pressure the hug was, it's nothing like that. It's the fact that it's a human being giving you human contact. And that's something that only humans can do."

Hospitals advocating robot surgery will also have to overcome some barriers with patients. "Robotic-assisted surgery does make people apprehensive," says Dr. Ara Darzi. "But it's only a sophisticated tool and you have to explain that the procedures are less-invasive and more accurate than current systems."

"I don't think we're getting to a stage with fully automated surgery, but who knows? A few years ago pilots were kings of the sky but now computers do many aspects of flying planes. We'll just have to wait and see."

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