Is a robot a better surgeon?

Robotics has also long since found its way into medicine. The University of Bern, for example, recently created the first professorship for robotics, and robot-assisted interventions have become indispensable in surgery. But can robots completely replace people, doctors or surgeons? Is it perhaps even better, faster, more precise and more efficient? And is this just a bold utopia or perhaps reality in the very near future? So what will our operating theater of the future look like?

Although the future development of medical robotics cannot, of course, be predicted with certainty, Andreas Raabe dares to make a prognosis at the end of his lecture. To do this, he addresses four specific questions:

Neurosurgeons generally operate in delicate places in very narrow structures and usually with a very large magnification under the surgical microscope. Almost always, it is about structures that lie hidden and must be made visible. With the naked eye, a functional center in the brain cannot be recognized, a tumor cannot be distinguished from healthy tissue. That is why today's operations are carried out with the help of images taken before the operation and superimposed on the screen (augmented reality), structures made visible with contrast agents or fluorescence, functional centers of the brain monitored neurophysiologically with microcurrents (monitoring) or detected with a kind of search radar (mapping). Thus, neurosurgical operations are highly technologically supported.

This form of Robotics 2.0 has been brought to market by, for example, the Bern-based medical technology company Cascination AG. Its robot- and image-based solutions enable efficient and safe interventions. For example, robot-assisted cochlear implantation, one of the most complex microsurgical procedures, guarantees minimally invasive and highly precise access to the inner ear. The robot-assisted drilling accuracy is in the range of tenths of a millimeter, so that the drilling can be done safely through the middle ear, past the facial nerve. With its image-guided robot-assisted surgery, Cascination AG is making Swiss medical history, according to Andreas Raabe. But there is still a long way to go.

According to Andreas Raabe, the next step in medical robotics, i.e. Robotics 3.0, is sensor-based, intelligent robotics. These future robots will probably also have tactile intelligence, which would enable them to sense and measure currents, blood flow, density and resistance much more precisely than humans.

But where are the limits of robotics? Where is man superior to the machine? Andreas Raabe has an answer: the robot is excellent at performing repetitive tasks and reaches its limit precisely where non-repetitive, dynamic processes are involved. If, for example, an unforeseen situation arises at the operating table, such as sudden bleeding, a shifting structure or a blood pressure crisis, a robot is simply overwhelmed. It cannot make complex decisions or take dynamically changing factors into account. Its limits lie in programmed rationality and logic. A quick decision appropriate to the situation is what a surgeon needs.

And it is precisely for this reason that Andreas Raabe comes to his prognosis at the end of his lecture. And that is: No, robots will not replace the neurosurgeon. At least not anytime soon.