As Arthur C. Clarke once said, “Any sufficiently advanced technology is indistinguishable from magic.”1. The field of surgery, defined by miraculous, intricate, and mind-blowingly accurate procedures, already carries an element of “magic” to it, so imagine what the future could look like if highly innovative technologies were coupled with highly advanced surgeries?
Luckily, we don’t need to travel too far into our imagination to see this. Recent advances in technology, coupled with the increase in virtual interaction associated with the COVID-19 pandemic, have introduced concepts like surgical robotics, telesurgery, virtual reality, and augmented reality into many of the traditional, classic surgical procedures that have been around for years, decades, and even centuries.
For starters, surgical robotics is one of the most exciting and up-and-coming fields of technology integration with surgery. At its baseline, this procedure involves the use of robotic devices to perform surgical techniques – in essence, this robotic device is taking the place of a human surgeon that otherwise would have been performing specific aspects of the procedure. Surgical robotics is often involved in surgeries where extreme precision is critical for a positive outcome, such as surgeries related to removing brain tumors, retinal procedures, knee replacements, spinal cord procedures, and heart operations2. Besides the specificity and precision that surgical robots offer, another potential advantage is the ability to perform surgeries from a location other than the operating room3. Remote surgeries have the potential to allow for widespread dissipation of advanced procedures that are exclusively performed by specific surgeons. Rather than patients needing to travel to the very few, select hospitals where the surgery can be performed, patients can instead visit their local hospital and have the procedure be robotically controlled by a surgeon from states, countries, or oceans away.
Another digital health concept that has the potential to enhance surgeries through virtual interaction is the integration of telemedicine into surgery. Although telemedicine techniques would not allow a surgeon to perform a procedure on a patient through a screen, they would allow for the possibility of virtual training and coaching for surgeons in the operating room4. Since the start of the COVID-19 pandemic, there has been extensive development and dispersion of innovative ways for physicians, surgeons, and other medical professionals to interact with their patients and collaborate with each other. The application of these concepts to surgery allows for the possibility of an experienced surgeon familiar with a specific procedure to virtually coach the surgeon operating on a patient. This approach has been used very recently due to the in-person restrictions associated COVID-19, and has significant potential to change the future of surgeon communication and training
Beyond surgical robotics and telesurgery, other innovative technologies that could be integrated into the field of surgery, especially in surgical training, include virtual reality and augmented reality. Virtual reality, which allows individuals to essentially enter any computer-generated environment, could provide medical students and surgical interns with the opportunity to be in the operating room without actually being there, allowing them to gain extensive, in-depth observational experience in the face of locational barriers, in-person restrictions, or other circumstances preventing them from observing the surgery in real time. Augmented reality, which differs from virtual reality in the sense that it incorporates additional features into one’s actual reality, could allow surgeons in the operating room to have more guidance on the patient’s body in front of them. The first AR-integrated spinal fusion surgery occurred in 2020, where an AR Guidance system allowed surgeons to visualize the spinal anatomy of the patient in 3D as they operated5. These innovations have highly positive implications on the field of surgery, and they open many doors for improved training and operational capabilities of future surgeons.
Recent studies have found that over the last decade, the use of robotic surgeries among general surgery procedures has increased from 1.8% to at least 15.1%6. And as the use of surgical robotics increases, it’s reasonable to assume that the use of other technological interventions is also increasing in the surgical field, especially in the age of COVID-19. However, as these figures increase, it becomes increasingly important to not only consider the potential advantages for the growing integration of innovative technologies into the field of surgery, but also to be aware of the possible drawbacks. Technology, despite the high rewards it can offer, can be accompanied by high risks such as cybersecurity breaches, impersonal interactions, and general usage frustration, which can lead to a decreased sense of patient comfort7. These risks can be amplified in a surgical setting, especially when confidential patient data, patient-surgeon interactions, and limited surgeon time and energy are on the line. As a result, it is important to prioritize and consider these risks before large-scale technological interventions are introduced to surgery or any other healthcare field.
1. “The Disadvantages of Technology in Healthcare.” Galen Data, 27 July 2021, https://www.galendata.com/disadvantages-of-technology-in-healthcare/.
2. Kyle H. Sheetz, MD. “Trends in the Adoption of Robotic Surgery for Common Surgical Procedures.” JAMA Network Open, JAMA Network, 10 Jan. 2020, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2758472.
3. Matthews, Kayla, and Kayla Matthews. “6 Types of Surgical Procedures Getting Robotic Assistance.” The Robot Report, 25 Nov. 2019, https://www.therobotreport.com/surgical-procedures-get-robotic-assistance/.
4. McCracken, Harry. “How Telemedicine in the Operating Room Will Transform Surgery.” Fast Company, Fast Company, 1 Nov. 2021, https://www.fastcompany.com/90687625/surgical-training-videoconference.
5. Sandberg, Josh. “First Augmented Reality Spine Surgery Using FDA-Cleared Augmedics Xvision™ Spine System Completed in U.S.” Ortho Spine News, 11 June 2020, https://orthospinenews.com/2020/06/11/first-augmented-reality-spine-surgery-using-fda-cle ared-augmedics-xvision-spine-system-completed-in-u-s/.
6. “The Technological Future of Surgery.” The Medical Futurist, 27 May 2021, https://medicalfuturist.com/the-technological-future-of-surgery/.
7. Zemmar, Ajmal, et al. “The Rise of Robots in Surgical Environments during COVID-19.” Nature News, Nature Publishing Group, 13 Oct. 2020, https://www.nature.com/articles/s42256-020-00238-2.