We discuss the role of robotics and artificial intelligence in various stages of the surgical process, emphasizing their potential to reduce infectious contamination. Beyond pandemics, we explore the cost-effectiveness and benefits of surgical robotic systems, which promise to revolutionize surgical performance and management, making them invaluable assets in healthcare.

Introduction

The COVID-19 pandemic has presented unprecedented challenges, particularly in healthcare settings. Medical professionals, including surgeons, have been exposed to significant risks due to the nature of their work, leading to the need for innovative solutions to mitigate pathogen spread. One such solution is the integration of robotics in surgical environments, which can reduce the risk of infectious contamination while enhancing surgical efficiency and patient care. In this perspective, we discuss the role of robotics in various stages of the surgical process, and their potential to revolutionize surgical management not only during pandemics but in the long term as well.

Historical Evolution of Robotic Surgery

Robotic surgery has come a long way since its inception, with the original goal of enabling surgery to be performed remotely. The first robotic systems, such as Arthrobot and Unimation Puma 200, assisted in surgical tasks and needle orientation. Over time, systems like AESOP and ZEUS brought advancements in surgical robotics, allowing for more complex and precise procedures. The Da Vinci robotic system, developed by Intuitive Surgery, marked a significant breakthrough and is now used in various surgical specialties. Several other robotic systems have since been developed for different surgical procedures.

Role of Robotics in the Age of Pandemics

Robotic technology has been instrumental in safeguarding human health in various hazardous environments. In the context of the COVID-19 pandemic, robots can play a crucial role in protecting healthcare workers and patients, ensuring uninterrupted surgical services. Healthcare workers are particularly vulnerable during pandemics, as evidenced by past outbreaks such as SARS, where healthcare workers accounted for a significant portion of cases. The shortage of personal protective equipment (PPE) and healthcare workers further exacerbates the problem. Robots can help address these challenges by reducing patient-provider contact, thus lowering the demand for PPE. They can operate at maximum capacity, providing valuable support during high-demand periods.

Robotic Technology in the Surgical Environment

Surgical environments pose significant risks of pathogen transmission due to the urgency, involvement of multiple teams, and high-risk activities. To effectively reduce the spread of pathogens, robots can be integrated into various stages of patient care, including pre-operative and post-operative care, anesthesia, and the surgical procedure itself. The overarching goal is to minimize contact between the patient and healthcare providers at each step, reducing the risk of contamination.

Pre- and Postoperative Care

Robotic technology can streamline pre-operative processes by coordinating logistical and medical information, disinfecting patients, and distributing PPE. Sterilization is essential to avoid pathogen contamination, and continuous robotic ultraviolet surface disinfection can effectively reduce contamination risks. These systems can provide real-time feedback on contamination levels, ensuring a safe environment. Robotic devices can also assist in tasks like blood sampling and drug delivery, minimizing the risk of contamination and reducing economic burdens.

Anesthesia

The anesthetic team is particularly vulnerable during surgery due to direct exposure to the patient’s airway. Robotic technology can help manage airway procedures, protecting healthcare workers from potential airborne transmission of infectious agents. Automated anesthesia systems can ensure precise control of anesthesia levels, blood pressure, and muscle relaxation during surgery.

Surgical Procedure

Robots can play a crucial role in reducing the risk of pathogen transmission during surgery. The smaller the surgical team, the lower the risk of contamination. Robot-assisted surgery can help minimize this risk, and the ultimate scenario is contactless robotic surgery, where only the patient is present in the operating room, reducing the risk of contamination to a minimum. Magnetic navigation systems (MNS) represent an emerging technology that enables contactless surgery by guiding surgical probes with magnets. This approach minimizes contamination risk and reduces exposure to infectious aerosols. In addition, fewer surgical instruments are required, further reducing contamination risks.

Economical and Psychological Aspects of Elective Surgery Cancellations

The COVID-19 pandemic has led to the cancellation of elective surgeries, resulting in a substantial economic impact on hospitals and psychological consequences for patients. Elective surgeries are a significant source of revenue for hospitals, and their cancellation can lead to reduced salaries, halted appointments, and even hospital bankruptcies. Patients waiting for elective surgeries experience a decrease in their quality of life, living with pain or anxiety-triggering conditions. Robotic technology can help in addressing both these issues. Robots can clear surgical backlogs, reduce operative time, and improve surgical efficiency, which can lead to cost savings. Moreover, robotic systems can provide care to isolated patients through social robots, minimizing the psychological impact of elective surgery cancellations.

Economic Considerations and Benefits of Surgical Robots Beyond Pandemics:

The adoption of surgical robots is driven not only by pandemic-related challenges but also by their potential to improve clinical outcomes and surgical efficiency. Machine learning and data analysis can assist surgeons in improving their skills, while centralizing vital information for surgeons can streamline the surgical workflow. Enhancing the surgeon’s senses, such as using voice commands and eye tracking, can make procedures more efficient. Telesurgery, aided by 5G connectivity, offers solutions to remote surgery and can reduce the need for patient travel. Robotics can result in reduced operative time, shorter hospital stays, and faster recovery, contributing to cost reduction and better clinical outcomes. The continuous development of user-friendly robotic systems and increased competition will lead to shorter procedure times and lower purchase costs for hospitals.

Conclusion

The COVID-19 pandemic has highlighted the importance of minimizing physical contact in healthcare settings to reduce the risk of pathogen transmission. Robotic technology and artificial intelligence offer innovative solutions to address these challenges. By integrating robots into various aspects of the surgical process, we can reduce contamination risks and ensure the continuity of surgical services during pandemics. Beyond the pandemic, the adoption of robotic systems promises to enhance surgical safety, improve clinical outcomes, and streamline surgical workflows. Robotics may well be the next quantum leap in the field of surgery, with the potential to revolutionize healthcare for the better. Modeling studies are needed to estimate the true benefit of robots in containing pathogen spread in surgical environments.