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terroroftoma t1_iz15c9l wrote

Reply to comment by Dr_Esquire in New type of surgical robot used to remove throat tumour by diacewrb

The robot has massively changed the game in oropharynx cancers. Before the robot we would have to split the mandible or do a lingual release to access these tumors. Especially with the healthier, younger HPV-related population, we have been able to cure their disease with limited impact on quality of life.

I’m not sure what is special about the robot in the article. I suspect it’s mostly for marketing.

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persimmonsfordinner t1_iz1ilcj wrote

There isn’t anything particularly special about this system, it is mostly marketing. There are other systems that surgeons can use to complete the same minimally invasive procedure that have been around for a couple decades.

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ohaikthxbai t1_iz33b7x wrote

This is not necessarily true. This new robot is modular while the older models have all instruments and camera coming from one giant unit.

It also has an open console as in the surgeon controlling the robot arms can still directly look at the patient without having to completely give up control or visualization of the machine's camera view.

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persimmonsfordinner t1_iz3nslc wrote

These aren’t the huge benefits that CMR sells them as. The footprint of a modular robot is massive and the single-unit isn’t as restrictive as it would seem. From the care team perspective, OR footprint is a huge deal, if your hospital isn’t new with huge ORs.

I’m also not sure what the benefit of an open console is- all the MDs I’ve spoken with don’t feel disconnected in a console that they can pop their head out of quickly. It’s not like they’re in a different room than the patient?

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ohaikthxbai t1_iz3pdof wrote

Not sure what CMR is selling to end users, I'm just speaking from seeing that modular robot in an OR and how much less space it takes up compared to the booms of the newest da vinci models. Wheeling the Versius arms around a room is faster and less burdensome than driving the massive da vinci patient cart doing 18 point turns in an OR that already has tons of other equipment. Remember with a modular robot you can choose to bring in a camera and 2 arms if that's all you need, save the space of a 3rd arm.

MDs aren't aware of what they're missing when they're buried in the da vinci console because they've been conditioned to value its "immersion". It depends on your specialty but for procedures that have the instrument arms potentially colliding, the console surgeon can't see that. They can't look at a patient scan without taking their head out. They can't see patient vitals or other activity in the room without disengaging the robot. To "pop their head out quickly" versus not pop your head out at all and use the same room awareness you'd have in an open/laparoscopic surgery has value. It's like looking through 4K binoculars instead of a 1080p panoramic view when you're captaining a ship, but the binocular manufacturer keeps selling you the fancy 4K visuals.

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ohaikthxbai t1_iz32zu8 wrote

This is true more for tongue base tumors than predominantly tonsil tumors. You really don't need a robot to do a proper radical tonsillectomy, though a robotic platform may enable more surgeons to do a proper radical tonsillectomy.

I think what's novel about this robot is its modularity and much lower profile. It also has an open console, as in you're not tunnelling your head into a console when operating the robot - you're wearing glasses but have an open view of the OR including the patient's bedside.

I think this might confer an advantage for those who do transoral robotic surgery because with da Vinci you are still dependent on the quality of your bedside assistant to know when and how tools and the camera are colliding with the patient's teeth and with each other. With an open console you can see the patient without taking the camera view out of your field of vision.

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