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Dr. Vipul Patel on the future of robotic surgery

by Nancy Ryerson, Staff Writer | May 16, 2013
From the May 2013 issue of HealthCare Business News magazine

“The future of” column provides a quick look at predictions for the sector from some of the top minds in the field. This month, we feature Dr. Vipul Patel.

Dr. Vipul Patel has performed more than 6,000 robotic prostatectomies — that’s more than anyone else in the world. As someone who has seen the development of surgical robotics from the start, he’s in the perfect position to look forward to what the future holds for surgical robots, the surgeons who control them and the tough diseases they treat.

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Over the last 10 years, robotics has transformed minimally invasive surgery, especially for urology and gynecology, Patel says. He predicts that trend will continue for the next decade, and that general surgery and orthopedics are up next for a surge in robotic treatment. “There’s already a robot for spine surgery, called Mazor, so orthopedic surgeons are using minimally invasive procedures,” he says. Surgical robots have also helped orchestrate hip replacements. As robotics spreads its reach into more surgeries, the procedures themselves will continue to become more precise. Patel hopes to see improved image guidance during robotic surgery. The next step is intraoperative imaging during surgery, Patel says. He says more intraoperative imaging will help surgeons better treat prostate cancer, for example, by allowing them a better view of where tumors are and more easily avoid damaging vital nerves and vessels.


Tiny robots and telesurgery
As the use of robotic surgery grows, Patel predicts the robots themselves will shrink. “There will be miniaturized robots that you can actually place in the abdominal cavity, then they drive themselves around inside the patient,” Patel explains. Nanorobots are already in prototype form, and should be making their way into the medical world within the next 10 years.

Robots will also help surgeons get up close and personal to a surgery even if it’s being done in another country. He predicts that telesurgery will become more common thanks to the capabilities of future robots. Less experienced surgeons will be able to get real-time advice from robotic surgery pros located anywhere in the world. The first step towards that future isn’t complicated, but it is at the core of many facilities’ health IT woes: wireless connectivity. “The biggest problem we have now is the time delay between motion and action,” Patel says.
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Michel Audette

converging surgical robotics, simulation, and intraop tracking

May 16, 2013 12:01

Michel Audette • I agree with this impending convergence of surgical robotics, simulation and intraop surgical guidance. My research group is dedicated to exactly that.

I agree that you will see continued development of MRI-compatible robots as well as time-efficient MRI pulse sequences that concentrate on a specific, relatively small subvolume of the anatomy (smaller than the preoperative scan), possibly in a way that provides multiple modalities, so that the combination of image gradients can anchor the intraop update of anatomical models developed from preop images and used in navigation. The tricky part will be to account for the resected part of tissues, in relation to preoperative tissues.

As for interactive simulation & robotics, we plan to develop this combination based on open-source toolkits for each. Potentially, this combination could also scale down to nanorobots operating at the cellular level, again leveraging open-source software toolkits, including the former two discussed here, and two more for atomistic molecular simulation and for the simulation of cellular processes.

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