The world of technology has made its most prominent mark in the realm of surgery, through the use of the da Vinci Surgical System. It is regularly used to conduct entire surgeries and is the only FDA approved system for soft tissue surgeries. Its only flaw, or rather its only restraint, is that surgeons still operate it behind the scenes. A single robot costs up to two million dollars, and the surgeon who operates it is also paid a handsome amount (Forbes Quora, 2016). The benefits of the system, as stated by the company’s website, is that it utilizes minimally invasive techniques and the robotic arms have “wristed instruments that rotate and bend far greater than the human hand.” (Intuitive Surgical Inc., 2017). The robotic arm also has a laparoscope, which consists of a light source and camera that sends the video feedback to surgeons for observation and control of the system. The key to the system’s advanced technology is its three dimensional production of images to give the head surgeon a hands-on experience just as if it were their own hands.
The new system, however, is not without its critics. In a recent interview with Healthline.com, Dr. John Santa, the medical director at Consumer Reports Health said, “[the da Vinci Surgical System] is a technology that is costing the healthcare system hundreds of millions of dollars and has been marketed as a miracle – and it’s not…it’s a fancier way of doing what we’ve always been able to do.” (Scott. 2016). There have been many successful uses of the da Vinci Surgical System, however a justification for the high costs of robotic surgery is still sought, especially since it costs ten times that of regular laparoscopic surgery.
Perhaps the most important aspect of technological integration in the medical world is its approval rating amongst those who receive it, which is not always positive. Despite its supposed superior quality of technology, the da Vinci Surgical System has received a spike in FDA conducted surveys since several freak accidents were reported. Mistakes include a robotic arm that wouldn’t let go of a tissue grasped; an accidental hit to a blood vessel; and a robotic arm even hitting a patient in the face during her own surgery. This has raised questions of the liability issues associated with the absence of human presence. For example, the family of Juan Fernandez, a man who died after da Vinci spleen surgery, received a $7.5 million dollar jury award in a 2012 lawsuit (Daily News, 2013). The irony of the matter can be especially seen in that robotic surgery aims to reduce the chance of liabilities, but can actually increase them since technological error is just as vulnerable and possible as human error. Although the artificial intelligence behind the da Vinci Surgical Systems does have the capacity to learn, it does not have the ability to take calculated risks that often distinguish top surgeons from rookies.
Beyond the simple world of surgery, the realm of a doctor’s role has also been hit by medical chips that, once implanted in the body, can deliver drugs. In today’s world why have to bother with remembering to take that one pill, when you can just have a chip pump preloaded medication into your bloodstream? According to CNN’s “Healing the Future,” there are scientists working on this innovation at the Massachusetts Institute of Technology. (The CNN 10, 2017) Theoretically, if a device like this were to be produced, it would be able to release drugs at any given time, any set interval, or any dosage amount. However, a doctor would be behind the scenes controlling it from a remote control. In 2012, an experimental device was implanted below the waistlines of eight women in a trial study to study its affects on osteoporosis. Not only did the study prove to be successful, but it has also been significantly improved over the years. Currently, scientists are working to branch this level of microchip technology into the world of birth control. In this type of dosage delivery, for the prototype to be successful, it would ideally be turned on and off by the user. Currently, the on/off trigger function is in development so that it can allow for hormonal dosages in microchips to hit the market in a prototype phase in 2017.
In addition to adding convenience, technology in medicine has been a driving force behind eradicating widespread diseases, most notably cancer. Cancer studies have typically demanded a scientist’s brain more than a doctor’s, but physical labor and treatment has always been the physician’s niche. Past and current models for treatment have always involved intense rounds of chemotherapy. However, there have been new developments in using the body’s own immune cells, nicknamed “smart bombs,” which are drugs that contain man-made antibodies. (CBS News, 2012) These can enter cancer cells and release toxins once inside. A second type of new and revolutionary cancer treatment involves using the patient’s own immune cells, in a similar fashion as if one were to fight off a cold. The exact mechanism of fighting off cancer cells is still being researched, however a trial run conducted on 14-year-old boy with leukemia proved successful. It was a last resort effort in a sense, since the boy’s body resisted treatments done with chemotherapy, radiation, and even a bone marrow transplant. This case is a prime example of how doctors’ roles have withered away to mere administrators and overseers of treatments. They aren’t actually doing anything except for an “installation” of a cure that takes matters into its own hands. Now what would happen if the faulty organs were completely replaced by an organic substitute? What would doctors have to do then, since their role today is trying to treat organ failure?
An astounding spark of technological magic has now made replacing entire organs into a reality through the realm of 3D bioprinting. It involves printing–yes, printing– custom made organs. Most recently, a printed skull replaced a 22-year-old’s diseased skull in the University Medical Center Utrecht in the Netherlands. The printer is about 6 feet tall by 6 feet wide and creates organs out of a thin film of white dust, containing human cells. It truly sounds like something out of a science fiction movie, however it has been extremely successful. It is now being used on a smaller scale than cranking out skulls, for its current target is the creation of human ears made from human cells.
The most radical and hair-raising transformation that can result from bioprinting is the replacement of the entire body’s skin, which is technically an organ. According to scientists at the Carlos III University of Madrid, “[This new skin] replicates the natural structure of the skin, with a first external layer, the epidermis with its stratum corneum, which acts as protection against the external environment, together with another thicker, deeper layer, the dermis. This last layer consists of fibroblasts that produce collagen, the protein that gives elasticity and mechanical strength to the skin.” (Cubo, 2016) There are options in the ways in which it can be created. One is to produce allogeneic skin cells that come from a stock residue of cells. The second way involves making autologous skin cells that use the patient’s own cells. An example of the second pathway is more commonly used for treating burn victims. Since it is made from human cells, the “new skin” is bioactive and can adapt to follow the previous skin’s excretions, such as semi-natural production of human collagen. This bypasses the previous medical use of animal collagen in skin transformation methods. This has become a revolutionary and fairly new way to allow for necessary, therapeutic, and cosmetic purposes. However, in all of its mystical power, it seems to be dethroning the prestige and power of doctors and crowning the world of engineering, which may in fact be the highest contender to replace doctors in the future.
