Robot-assisted surgeries may be popular, but research suggests augmenting surgeons with robots isn’t worth the time or money

Surgeons removing patients’ kidneys in keyhole surgeries are better off working without robot assistance because using tech can result in longer operating times and increased costs.

That’s the conclusion put forward by researchers at the Stanford University School of Medicine who found that whether the operation was performed by human-only teams or with robot assistance had little effect on patient outcomes and lengths of hospital stay, but robot assistants contributed to longer operating times and increased costs, compared to traditional keyhole (laparoscopic) surgery.

“Although the laparoscopic procedure has been standard of care for a radical nephrectomy for many years, we saw an increase in the use of robotic-assisted approaches, and by 2015 these had surpassed the number of conventional laparoscopic procedures,” said Benjamin Chung, MD, associate professor of urology.

“We found that, although there was no statistical difference in outcome or length of hospital stay, the robotic-assisted surgeries cost more and had a higher probability of prolonged operative time.”

Although, surgeries that are less technically challenging, such as the removal of a whole kidney, may not benefit as significantly from a robot’s help, the researchers note that robots can help when tackling procedures that require increased dexterity.

Procedures such as the removal of the prostate or the removal of just a portion of the kidney, require a high degree of delicate manoeuvring and extensive internal suturing that render the robot’s assistance invaluable.

In cases where robot assistance was used unnecessarily, the researchers concluded there may be an expectation on the part of the hospital or the surgeons themselves to justify the large initial investment in purchasing the robot by using it for many types of procedures.

Patients themselves may also view robot-assisted surgery as more technologically advanced.

“There is a certain incentive to use very expensive equipment,” said Chung. “But it is also important to be cognisant as to how our health care dollars are being spent. Although robotic surgery has some advantages, are those advantages relevant enough in this type of case to justify an increase in cost?”

To gather their data the researchers analysed the approach of 416 hospitals across the US from 2003 to 2015.

They found that while in 2003 only 1.5% of patients needing laparoscopic surgery had it done via robot-assisted surgery, this had increased to 27% by 2015.

On average, the total hospital cost (including the cost of supplies, room and board, pharmaceuticals and operating room time) for the robot-assisted procedure exceeded that of the traditional laparoscopic procedures by about $2,700 per patient.

The researchers speculated that the increased cost may be due to longer times spent in the operating room as well as the increased cost of disposable instruments upon which surgical robots rely.

Soviet report detailing lunar rover Lunokhod-2 released for first time

Russian space agency Roskosmos has released an unprecedented scientific report into the lunar rover Lunokhod-2 for the first time, revealing previously unknown details about the rover and how it was controlled back on Earth.

The report, written entirely in Russian, was originally penned in 1973 following the Lunokhod-2 mission, which was embarked upon in January of the same year. It had remained accessible to only a handful of experts at the space agency prior to its release today, to mark the 45th anniversary of the mission.

Bearing the names of some 55 engineers and scientists, the report details the systems that were used to both remotely control the lunar rover from a base on Earth, and capture images and data about the Moon’s surface and Lunokhod-2’s place on it. This information, and in particularly the carefully documented issues and solutions that the report carries, went on to be used in many later unmanned missions to other parts of the solar system.

As a result, it provides a unique insight into this era of space exploration and the technical challenges that scientists faced, such as the low-frame television system that functioned as the ‘eyes’ of the Earth-based rover operators.

A NASA depiction of the Lunokhod mission. Above: an image of the rover, courtesy of NASA, overlaid onto a panorama of the Moon taken by Lunokhod-2, courtesy of Ruslan Kasmin.

One detail that main be of particular interest to space enthusiasts and experts is the operation of a unique system called Seismas, which was tested for the first time in the world during the mission.

Designed to determine the precise location of the rover at any given time, the system involved transmitting information over lasers from ground-based telescopes, which was received by a photodetector onboard the lunar rover. When the laser was detected, this triggered the emission of a radio signal back to the Earth, which provided the rover’s coordinates.

Other details, while technical, also give some insight into the culture of the mission, such as the careful work to eliminate issues in the long-range radio communication system. One issue, for example, was worked on with such thoroughness that it resulted in one of the devices using more resources than it was allocated, a problem that was outlined in the report.

The document also provides insight into on-Earth technological capabilities of the time. While it is mostly typed, certain mathematical symbols have had to be written in by hand, and the report also features a number of diagrams and graphs that have been painstakingly hand-drawn.

A hand-drawn graph from the report, showing temperature changes during one of the monitoring sessions during the mission

Lunokhod-2 was the second of two unmanned lunar rovers to be landed on the Moon by the Soviet Union within the Lunokhod programme, having been delivered via a soft landing by the unmanned Luna 21 spacecraft in January 1973.

In operation between January and June of that year, the robot covered a distance of 39km, meaning it still holds the lunar distance record to this day.

One of only four rovers to be deployed on the lunar surface, Lunokhod-2 was the last rover to visit the Moon until December 2013, when Chinese lunar rover Yutu made its maiden visit.

Robot takes first steps towards building artificial lifeforms

A robot equipped with sophisticated AI has successfully simulated the creation of artificial lifeforms, in a key first step towards the eventual goal of creating true artificial life.

The robot, which was developed by scientists at the University of Glasgow, was able to model the creation of artificial lifeforms using unstable oil-in-water droplets. These droplets effectively played the role of living cells, demonstrating the potential of future research to develop living cells based on building blocks that cannot be found in nature.

Significantly, the robot also successfully predicted their properties before they were created, even though this could not be achieved using conventional physical models.

The robot, which was designed by Glasgow University’s Regius Chair of Chemistry, Professor Lee Cronin, is driven by machine learning and the principles of evolution.

It has been developed to autonomously create oil-in-water droplets with a host of different chemical makeups and then use image recognition to assess their behaviour.

Using this information, the robot was able to engineer droplets to have different properties­. Those which were found to be desirable could then be recreated at any time, using a specific digital code.

“This work is exciting as it shows that we are able to use machine learning and a novel robotic platform to understand the system in ways that cannot be done using conventional laboratory methods, including the discovery of ‘swarm’ like group behaviour of the droplets, akin to flocking birds,” said Cronin.

“Achieving lifelike behaviours such as this are important in our mission to make new lifeforms, and these droplets may be considered ‘protocells’ – simplified models of living cells.”

One of the oil droplets created by the robot

The research, which is published today in the journal PNAS, is one of several research projects being undertaken by Cronin and his team within the field of artificial lifeforms.

While the overarching goal is moving towards the creation of lifeforms using new and unprecedented building blocks, the research may also have more immediate potential applications.

The team believes that their work could also have applications in several practical areas, including the development of new methods for drug delivery or even innovative materials with functional properties.