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original alaska baomeis medicine

a large tertiary hospital used a robot surgery that resulted in the death of a patient

what should we do if traditional surgery is lost due to long-term reliance on robots?

on september 9, a yellow card certified deputy chief inspection technician in guangdong revealed an accident to his colleagues in the industry, which is enough to arouse our attention and vigilance.

he said: "there was a gynecological medical accident in a top three hospital in shenzhen. a 40-year-old patient died when a robot was used to remove a tumor in her uterus! now that robots have been introduced in a large number of surgical operating rooms, surgeons have been greatly relieved of all kinds of pressure. judging from the results after the operation, they seem to be quite satisfied. however,we have been relying on robots for a long time. is traditional surgery going to be lost? we used to think that minor surgeries were all handed over to robots. does this increase the risk?”

it is reported that the patient's tumor was large, estimated to be a common benign fibroid, which could be completely removed with traditional surgery, and the operation was not difficult. however, the doctor still chose to use a robot. perhaps there were complications in the operation, which eventually led to tragedy.

as for the specific details, the deputy chief technician did not reveal much, and we were not in a position to ask further.

as the topic becomes more heated, many doctors have expressed different opinions on the accident and the long-term reliance on robots for major and minor surgeries.

a urologist in shanghai said: "robotic surgery is tailor-made for doctors who specialize in urinary and reproductive systems. doctors in our hospital cannot do without robots. in theory, the probability of accidents is very low, but because the preparation time before use is very long and it needs to be set up, there are also uncontrollable factors. robotic surgery is more suitable for cleaning malignant tumors because it is more refined. for example, benign uterine fibroids can be solved with traditional operations. in fact, there is no need to use robots. this is a waste of talent."

a cardiologist in guangdong expressed his opinion. he said: "now hospitals in guangzhou and shenzhen have fully popularized robots, and doctors really rely on them. on the one hand, they save effort and are accurate.on the other hand, it is extremely expensive. once the operation is started, a fee of tens of thousands of yuan will be charged regardless of the difficulty of the operation or how long it takes.since hospitals now implement drg cost control and medical insurance limits, they like to do these self-funded projects. "

“although it is a robot, it is also operated by doctors. if you are not skilled, there will be very serious consequences, because robot surgerylack of tactile feedback, some operations rely on visual judgment, not suitable for all types of surgery, and has certain surgical limitations. but if the doctor is really skilled in the operation, he can overcome the above difficulties. i can only say that this patient is too unlucky..."

robotic surgery has many benefits

however, many medical accidents have occurred in recent years.

the so-called robotic surgery does not mean that a robot replaces the doctor to perform surgery on the patient alone. that is too exaggerated. it is actually arobotic armin addition to the robotic arm, the entire system also includes a console and an advanced imaging system. this robotic arm can assist doctors in performing surgery.

during the operation, the surgeon sits in front of a control panel not far from the robotic arm. like operating a game controller, he puts the thumbs and index fingers of both hands into the sensing finger sleeves on both sides of the operating system, looks into the 3d eyepiece on the control screen, and then performs forward, backward, cutting, picking and other movements.

doctors operating robots for surgery

so why do surgeons rely so much on this robotic arm? because it is really powerful.

take the da vinci surgical robot as an example. its robotic arm has 7 degrees of freedom and can rotate 540 degrees, breaking the limit of human hands. it is more flexible to operate and can automatically filter out human tremors. it has stability and precision that human hands cannot match. in terms of imaging, the system provides high-definition three-dimensional images magnified 10 times, enhancing the realism and depth perception of the surgical field. moreover, you only need to sit during the operation, without bending over and hunching over. in the face of these advantages, as long as the patient is willing, no surgeon would not want to use a robot to perform surgery.

for example, the director of the urology department of a hospital in shenzhen said: "in the past, doctors had to stand in front of the operating table to perform surgery on patients, which was a great test of the doctor's physical strength. but the surgeon who performs the surgery with the da vinci surgical robot can sit in front of the control console to complete the surgery, which is more comfortable. now i particularly like to do robot surgery. i don't feel tired even after doing it for a whole day. except for being a little nervous, i feel very satisfied."

robotic surgery has many benefits, but as doctors we often overlook its risks. due to its lack of tactile sensation, accidents can easily occur if the surgeon or surgical team operating the da vinci robotic surgery system does not have enough knowledge of the robot itself, lacks training, or the surgeon's own hand and foot movements are not coordinated enough.

at present, many medical accidents caused by robotic surgery have been reported in china.

2022november 22a patient went to the gynecology department of zhongnan hospital for irregular menstruation and was then transferred to the hepatobiliary and pancreatic surgery department. ct scan showedterminal bile duct nodules, after ercpsevere dysplasia, then underwent a da vinci pancreaticoduodenectomy.december 11discharged from hospital.

after discharge, the patient had mild backache. on december 16, his condition worsened and he vomited. he also developed complications after pancreaticoduodenectomy. due to lack of timely medical treatment, he died.december 30death, the cause of death was septic shock and multiple organ dysfunction. looking at the entire process of death, it is hard to say that there were no problems with the operation of the robotic surgery.

according todemocracy and legal timesaccording to previous reports, patients in jilinpan hongshe died 12 days after being hospitalized. eight days before her death, a surgical robot performed an operation on her.

according to the introduction,pan hongshe was diagnosed with a "left adrenal tumor" by a well-known hospital in the province. on the fourth day after the diagnosis, the hospital performed a "surgical robot left adrenal tumor removal surgery" on her.

this type of surgery is clinically high-risk, and there may be great fluctuations in blood pressure during and after the operation. complications are difficult to predict, but the hospital did not provide detailed information on the severity of the danger. sure enough, during the operation, pan hong's blood pressure and heart rate fluctuated significantly. after the operation, she fell into acute respiratory failure and was transferred to the icu for emergency treatment. her condition gradually worsened and she died a week later.

the judicial appraisal department reported that the hospital was at fault in the diagnosis and treatment of pan hong, which was causally related to her death from postoperative shock, and that this process was related to the surgical robot.

the democracy and legal times also reported a similar incident in nanjing.zhang zhongbefore his death, he went to a tertiary hospital in nanjing for treatment due to physical discomfort. the hospital diagnosed him with: right retroperitoneal mass, fever to be investigated, right lobe cyst of the liver, postoperative patellar fracture, and postoperative appendectomy.

after discussion, the hospital finally performed a "robot-assisted laparoscopic right retroperitoneal mass resection". after the operation, zhang zhong was transferred to the icu for monitoring and treatment. he then had a fever, with the highest temperature reaching over 39 degrees. more than 20 days later, he died of hemorrhagic shock caused by abdominal bleeding.

after judicial appraisal, the conclusion was that the nanjing hospital had medical malpractice during the da vinci robot surgery treatment performed on zhang zhong.

looking at these accidents caused by robotic surgeries, we shudder. we originally thought that robotic surgery was an easy, mature and simple operation, but now it seems that the risks it brings cannot be ignored.

robotic surgery is the future

it can help both doctors and patients

do you want to deny it? you can't just endure it without suffering.

robotic surgery does have risks if performed improperly, and has indeed caused many medical disputes in recent years.

may 20, 2024the chinese hospital journal published a paper titled "case analysis of medical damage disputes involving surgical robots", which specifically discussed the medical disputes caused by robotic surgery in recent years.

data shows that between 2015 and 2022,the number of cases included in the criteria is 63among them, 2019 and 2021 had the most cases, with 13 cases, accounting for 20.6%, followed by 2020, with 11 cases, accounting for 17.4%. the number of cases showed an overall upward trend. beijing had the most cases, reaching 16.

among the 63 valid documents, the departments where the disputes occurred wereurologythe largest number of cases was in the department of gastroenterology, with 25 cases in total, accounting for 39.6%; followed by the department of gynecology and obstetrics, with 15 cases in total, accounting for 23.8%; the department of gynecology and obstetrics was third, with 7 cases in total, accounting for 11.1%; others were in the department of neurology, department of thoracic surgery, department of orthopedics, department of general surgery, department of pediatrics, department of orthopedics, department of emergency, and department of endocrinology.

in terms of the amount of compensation,the largest number of cases involved compensation ranging from 100,000 to 500,000 yuan, totaling 38 cases, accounting for 60.3%, followed by compensation of 10,000 to 50,000 yuan.

medical accidents in robotic surgeries are frequent and hospitals have to pay compensation, so some netizens commented in the comment section:some people say that robotic surgery should no longer be strongly supported and that doctors should return to traditional surgery. some even say that surgery performed by robots lacks emotion.

i really want to laugh when i see this statement. how can surgery be related to love? although robotic surgery has risks, we must not give up because of fear. we should still strongly support robotic surgery.

because robotic surgery, as a representative of advanced technology, is the trend of the future, it can help doctors reduce physical exertion. at the same time, because robotic surgery causes smaller wounds and higher precision, patients bleed less and recover faster after surgery, which can also reduce patients' pain.

in addition, robotic surgery can achieve surgical simulation, remote guidance, and remote actual operation. imagine,the patient is in xinjiang and the doctor is in beijing, thousands of miles apart. however, through the robotic system, those experienced doctors are no longer restricted by geographical location. they can perform remote-controlled surgery in real time and with precision. isn’t this shocking?

this will, to some extent, alleviate the problem of uneven distribution of medical resources and allow high-quality medical services to reach more remote areas.

in fact, since the introduction of robotic surgery systems in my country in 2006, the annual number of robotic surgeries has exceeded 100,000. the top five departments in terms of surgery volume are urology, thoracic surgery, gastrointestinal surgery, gynecology, and hepatobiliary surgery. with so many surgeries, it is understandable that some medical accidents occur.after all, the probability is there.

therefore, any idea that denies robotic surgery is inappropriate.some traditional surgeries have become outdated and have been lost, so let them be lost. don't force yourself to eat something without any effort. when you can obviously eat white flour buns, would you still want to eat steamed corn bread?

of course, under normal circumstances, the price of white flour steamed buns is much more expensive than steamed corn bread, and sometimes we have to eat steamed corn bread.

written by | alaska treasure

editor | alaska treasure