Ultimately, the future of technology in medicine must be assessed through a patient’s level of comfort with new changes, which was most recently seen in a study where patients expressed extreme discomfort after being treated by robotic nurses. In a study conducted at the Georgia Institute of Technology, a robotic nurse, known as Cody, was used to provide primary research on the complete eradication of nurses in the performance of rudimentary tasks. The robot was to touch and wipe a patient’s forearm during the experiment. Additionally, the experiment consisted of having the robot either warn the patient that they were about to be touched, or say nothing at all. The results of the study showed a strong discord in public opinion, which stemmed from the robot’s intent of action. If the robot was just completing the task of touching and wiping the patient’s arm, most people were accepting and comfortable. However, when the robotic nurse attempted to comfort the patent by informing them before they were to be touched, most of the patients felt a strong discomfort. Charlie Kemp, the professor involved in the study, attempted to explain the reasoning behind the uneasiness that patients experienced, “In general, if people interpreted the touch of the nurse as being instrumental, as being important to the task, then people were OK with it. But if people interpreted the touch as being to provide comfort … people were not so comfortable with that.” (Georgia Institute of Technology, 2011)
This study suggests that patients themselves remain the strongest obstacles to modern medical technologies. Perhaps the fear of artificial intelligence stems from the unfamiliarity with machinery replacing human touch or even fear of the unknown potential that a medical robot may evolve to do more than just replace a nurse’s fundamental role. However, it is still very difficult to gauge true and accurate feelings to pinpoint how society really feels about technological advances.
Even with leading innovations arising in the healthcare field, the public perceptions on the use of technology in healthcare is still largely unknown. Research on the matter is fairly new, and a recent web-based survey conducted over the course of three months tried to answer some of the underlying questions on approval ratings for new technologies. Over 53% of those surveyed had a background in healthcare and 13% were physicians. Perhaps the most surprisingly conclusion of this study was that even though 72% of the respondents agreed that robotic-assisted surgery was safer, faster, and less painful, or offered better results, 55% still preferred conventional minimally invasive surgery instead. (Boys et. Al, 2016) These results align with a discussion on artificial intelligence from Business Insider, which stated that “the reality check for the most ardent advocates of applying technology to healthcare [are] to get technology such as predictive AIs into clinical settings where they can save lives means tackling… negative connotations and fears.” (Johnson, 2016) This brings a new light to the irony of the aforementioned conversation on technology in healthcare, for those who would receive the greatest benefit from its incorporation are also the greatest obstacles to its progression.
Clearly, people seem to mistrust robotic integration in the medical world, but do they even have the knowledge to assess the differences and benefits between the old and new systems of surgeries? A study conducted by the Weill Cornell Medical Institution attempts to answer just that. The study’s objective was to “investigate knowledge and attitudes [of patients] toward surgical approaches in gynecology.” (Irani et. Al, 2016) A total of 219 female patients seeking obstetrical and gynecological care completed the survey.
Three types of surgical systems were the focus of the questions: open abdominal surgery, laparoscopic surgery, and robotic surgery.
A few sample questions of the survey include:
What is your Education level?—Please check one of the following:
- Less than high school
- Some high school/high school degree
- Some college/college degree
- Graduate/professional degree
In Robotic surgery: (please choose the best answer)
- The surgeon moves the robot’s arms to perform the surgery
- The surgeon tells the robot which surgery to perform, and the robot performs it while the surgeon supervises
- I do not know
In your opinion, which surgery costs more to the health care system/insurance? Check only one answer.
- Open abdominal surgery
- Laparoscopic surgery
- Robotic surgery
If you were having surgery, which approach would YOU prefer? Circle only one answer choice.
- Open abdominal surgery
- Laparoscopic surgery
- Robotic surgery
- Does not really matter
The differences between the three involve the way they are performed. Open abdominal surgery involves making an 8 to 10 inch incision in the abdominal area to almost completely expose the internal chest area to a team of surgeons in preparation for surgery. Laparoscopic surgery requires a minimally invasive procedure, where multiple tiny incisions are made in the abdominal area. A small fiberoptic tube, called the laparoscope, is connected to a video camera and then carefully inserted into the incisions. The video provides a less open, but still detailed look into a patient’s abdomen for this style of surgery, which is conducted solely through the incision points. Robotic abdominal surgery technically is laparoscopic surgery with an additional layer of technology added. It involves making a dime-sized incision into a patient’s abdomen, and then expanding the chest area with carbon dioxide gas. Three additional incisions are made to allow for the insertion of tubes with miniature surgical instruments attached to them. These include tiny tweezers and scissors that are literally the size of a human fingernail. These tubes with their instrument ends are attached to the arms of a robot, which allows a surgeon to then begin operating it behind the scenes.
The subjects of the survey had no such detailed knowledge of each type of surgery as aforementioned, but 89% of them had education levels of high school and beyond. However, the results were surprising in that “67.5% of the participants did not know that the surgeon moves the robot’s arms to perform the surgery, 46% of the participants did not understand the difference between laparoscopic and robotic procedures, and 37% thought that laparoscopy requires the surgeon to have a higher technical skill.” The survey exemplifies a generally decent result from a pool of varied, but mostly educated individuals. Likewise, another survey also conducted by the same team surveyed 747 adults and revealed that most respondents acknowledged the benefits of robotic-assisted laparoscopic surgeries but still preferred conventional laparoscopy. These outcomes showcase the importance for educating the public as robotic surgery and further advancements in technology become more common in the healthcare field. The benefits of new technology may soon exceed past systems of surgeries, and so it is especially important to dispel misconceptions and even fears that give rise to mistrust and incorrect knowledge on robotic surgery.
Even doctors have debated whether or not there are truly differences between surgical systems of operations. The results of a high profile study, conducted by surgical oncologists at Memorial Sloan-Kettering Caner Center in New York, show almost no difference in rates of complications between traditional open surgery and robotic surgery for bladder cancer. The researchers initially planned to conduct a longer study, however they stopped early since their findings were so well evident.
Studies like this have helped to quantify the benefits of robotic surgery and dismiss myths of its flaws. Memorial Sloan Kettering Center recruited patients with bladder cancer and scheduled them for definitive treatment with the use of radical cystectomy from March 2010 through March 2013. Four surgeons with experience in open surgery performed all open procedures, and three surgeons with extensive experience in robot-assisted pelvic surgery performed the robotic procedures. The outcome of the experiment showed that using robotic assisted surgery versus unassisted traditional surgery hardly yielded a difference in the rate complications as well as no correlation in the lengths of patients’ hospital stays.
