White Paper
Nikhil Thomas
Table of Contents
Executive Summary ............................................................................................................... 2
Introduction .......................................................................................................................... 3
Previous Approaches ............................................................................................................. 4
New Findings ......................................................................................................................... 8
Conclusion ........................................................................................................................... 10
References........................................................................................................................... 11
1
Executive Summary
It is believed that around 310 million surgeries are performed each year globally and around 40
to 50 million in the US alone. Of these numbers it is suspected that 1-4% of patients will die,
15% will have post-operative complications and 5-15% will be readmitted with 30 days. As
medicine continues to make advancements with new medications, techniques, tools and
instructions, patients that undergo surgery will continue to face the risk of various complications.
But what if a machine could come in and assist surgeons with various procedures? What if this
machine was completely operated by the surgeon granting them a wider range of motion,
enhanced visualization including areas not visible to the naked eye, and improved outcomes?
What if this machine was able to give the patients less blood loss, reduced risk of infection and
faster recovery?
Thankfully, in 2000 the FDA granted access for the Da Vinci Surgical System to be used. The
surgeon can sit down at the control console and view the surgery from the integrated camera
system. The camera provides a 3D high-definition view inside the patient’s body. The jointed
wrist design of each of the robot arms provides greater flexibility and reaches allowing for
smaller incisions and movement that is more precise.
2
Introduction
When you think of Star Wars, what is the first thing that pops in your head? Darth Vader?
Lightsabers? Space? What about robots? Throughout the entire movie franchise you see a variety
of robots from assistance droids, repair droids but the one that sticks out the most are the medical
droids. Robotic beings so to speak that can diagnose, operate, treat any sort of medical concern.
While we might be hundred or so years away from the medical droids in Star Wars, we have
made amazing progress in the field of medical robotics.
“According to research conducted by Tractica, the market for healthcare robots, which includes
surgical robots, hospital robots, and rehabilitation robots, will increase in revenue from $1.7
billion in 2016 to $2.8 billion by 2021, at a compound annual growth rate (CAGR) of 9.7%.
Tractica predicts that healthcare robot shipments will increase from approximately 3,400 units
per year in 2016 to more than 10,500 units per year by 2021” (Gonzalez, 2017).
In this paper, we will shift our attention to the concept of surgery and the risks that come when
going under the knife. Of course throughout the years surgeries have become safer and reliable
due to the advancements of technology, techniques, and medications. However, that does not
diminish the huge risks that come while undergoing surgery and even recovering from it. With
the implementation of robotics, surgery complications and post-surgery complications could be a
thing of the past. Medical robots such as The Da Vinci Surgical System have been in play since
2000. These robots have transformed the way doctors operate and how quickly patients recover.
The system allows surgeons to be extremely accurate and only require incisions the size of a
dime even for major surgeries.
3
Previous Approaches
In a research article from the NIH, researchers hypothesized that: “Complications are common in
hospitalized surgical patients. Provider error contributes to a significant proportion of these
complications” (Healey, Shackford, Osler, Rogers, Burns, 2002). They conducted this research
by looking at patients from 4 different surgical services:




General surgery
Combined general and trauma
Vascular
Cardiothoracic
And this was their results:
Figure 1
Graph of Complication Rate per Surgery
Complication Rate Per Surgery
70
Complication Rate %
60
50
40
30
20
10
0
GeneralSurgery
Vascul ar Surgery
General and Trauma
Cardiothoracic Surgery
Types of Surgery
AvoidableMinorComplicat ions
AvoidableMajorComplications
While there are numerous complications that can arise from surgery, the most common ones are:
4
1. Infection
“When bacteria enter the site of surgery, an infection can result which can delay
healing. Wound infections can spread to adjacent organs or tissue, or to distant areas
through the blood stream” (Stanford Medical Center, 2017). One common type is
known as septicemia it results from the spread of infection from a localized area which
spread through the blood. “Now these infections can be created with antibiotics, oxygen
therapy, fluids, and other medications however it causes the patient to stay longer in
the hospital which increases cost and recovery time” (Lowth, 2017).
Figure 2
Image of an Infection of a Surgical Site
From ICCS, 2019
2. Pulmonary Embolism
“A pulmonary embolism (embolus) is a serious, potentially life-threatening condition. It
is due to a blockage in a blood vessel in the lungs. A pulmonary embolism (PE) can cause
symptoms such as chest pain or breathlessness” (Tidy & Willacy, 2020). To treat PE
patients would undergo either anticoagulant treatment or through oxygen treatments.
If the PE is severe then patients would have to resort to surgery to remove the embolus.
5
Figure 3
Image of a Pulmonary Embolism
From Wikipedia, 2022
3. Deep Vein Thrombosis
“A deep vein thrombosis (DVT) is a blood clot in a vein. Blood clots in veins most often
occur in the legs but can occur elsewhere in the body, including the arms” (Knott &*
Tidy, 2020). To treat DVT doctors will give anticoagulation medications, thrombolytic
medications which help to dissolve clots, and, in some cases, surgery might be required.
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Figure 4
Image of Deep Vein Thrombosis
From Trombo
While there is a long list of other complications that could arise, modern medicine has created a
wide variety of solutions to treat and manage these complications. From ones that are avoidable
such as foreign objects left in patients, central line bloodstream infections, air embolisms etc. For
a lot it’s a sigh of relief knowing that there is a solution to these complications, but these
solutions result in high cost, a longer healing process and an increased risk of other medical
issues. This is where The Da Vinci system comes in.
7
New Findings
The Da Vinci Surgical System has been aiding surgeons since 2000. “The console controls the
four robotic arms, allowing the surgeon to sit down at the control console and view the surgery
from the integrated camera system. The camera provides a 3D high-definition view inside the
patient’s body. The jointed wrist design of each of the robot arms provides greater flexibility and
reaches allowing for smaller incisions and movement that is more precise” (Gonzalez, 2018).
The implementation of the camera and the flexible wrist design gives doctors better visibility and
flexibility when operating on a patient without the need of a large incision which could cause
longer healing time and increase the risk of infection.
Figure 5
Da Vinci Surgical System
From MachineDesign By Carlos Gonzalez, 2018
Some of the benefits of using the Da Vinci system are:

“Because surgeons don't need to use their hands to directly access the body, incisions
are smaller. The robotic arms also filter out tremors in the surgeon's hands to reduce
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the chance of nicks or punctures that can cause bleeding” (Dunki-Jacobs, 2017).
Specially in risky surgeries or operations in hard to access places, a robotic system can
maneuver around the body much more easily than human hands and make smaller
incisions, allowing for a less invasive surgery.

Since the Da Vinci system is usually less invasive, there is less recovery needed. Most
likely, a patient will experience less blood loss than from an open surgery. In other
surgeries, blood loss can cause complications, and result in even longer recovery times.
Since the process is less invasive the patient won’t be in as much pain and thus will be
less dependent on painkillers for recovery, reducing the risk of addiction.

With the Da Vinci system there is a smaller chance of infection. With conventional
surgery procedures, there is always a chance of infection after surgery. The risk of
developing an infection is reduced, so you avoid the potential complications that come
with infection.
But the system is not only beneficial to the patients but also to the surgeons as well. It enhances
precision, flexibility, and control during the operation, and allows them to better see the surgical
site, compared with traditional techniques. “The robotic arms have a greater range of motion than
the human wrist, so surgeons can successfully navigate hard-to-reach areas with less disturbance
to surrounding tissues. This speeds recovery and lessens the pain of surgery for the patient.
Finally, robotic surgery makes delicate and complex procedures possible that may have been
difficult or impossible with other methods” (Slater,2022).
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Conclusion
The study of medicine has been around since the dawn of mankind. Over the years our
understanding of medicine started to take shape. But is in the 21st century where we took huge
steps to the advancements of medicine to the point of curing various disease. Now this
advancement is only happening due to the integration of technology into the field of medicine.
Surgery is just one of the major fields of medicine where we are seeing these advancements take
place. When surgery first started out mortality rate was incredibly high but as we developed new
skills, techniques, and medicines we saw a decrease in mortality. But surgery still holds its risk
despite the various advancements made in modern medicine. Patients can experience infection,
deep vein thrombosis, huge amounts of blood loss, pulmonary complications, doctor error, etc.
But with the implementation and use of the Da Vinci system all these issues can be less
concerning.
The primary benefit of the Da Vinci is for faster patient recovery. This allows patients to return
to daily activities sooner than with standard open or laparoscopic surgery. In addition, robotic
surgeries have fewer surgical complications and result in smaller, less noticeable scars. Finally,
patients lose less blood during the procedure and report less pain after. All of this equates to less
time spent in hospitals for recovery, less risk of complications which also means no additional
costs.
10
References
Chung, K. C., & Kotsis, S. V. (2012). Complications in surgery: root cause analysis and
preventive measures. Plastic and reconstructive surgery, 129(6), 1421–1427.
https://doi.org/10.1097/PRS.0b013e31824ecda0
Healey, M. A., Shackford, S. R., Osler, T. M., Rogers, F. B., & Burns, E. (2002). Complications
in surgical patients. Archives of surgery (Chicago, Ill. : 1960), 137(5), 611–618.
https://doi.org/10.1001/archsurg.137.5.611
Bontrager, S. (2018, February 7). Does technology actually improve quality of life? ST112
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in%20developed%20countries.
Complications. Stanford Health Care (SHC) - Stanford Medical Center. (2017, September 12).
Retrieved February 27, 2022, from https://stanfordhealthcare.org/medical-treatments/g/generalsurgery/complications.html
Dunki-Jacobs, D. E. (2017, November 20). 4 Advantages of Robotic Surgery. DailyHealthWire.
Retrieved February 27, 2022, from https://www.trihealth.com/dailyhealthwire/healthtopics/robotics/4-advantages-of-robotic-surgery
Gonzalez, C. (2017, September 6). 6 ways robots will be the medical assistants of Tomorrow ... 6
Ways Robots Will Be the Medical Assistants of Tomorrow. Retrieved February 27, 2022, from
https://www.machinedesign.com/mechanical-motion-systems/article/21835916/6-ways-robotswill-be-the-medical-assistants-of-tomorrow
Marshall, B. (2021, March 17). Top 5 benefits of robotic surgery. Crisp Regional. Retrieved
February 27, 2022, from https://crispregional.org/top-5-benefits-of-robotic-surgery/
Slater, J. (2022, January 5). Robotic Surgery Precision, recovery. Mayo Clinic Health System.
Retrieved February 27, 2022, from https://www.mayoclinichealthsystem.org/hometownhealth/speaking-of-health/robotic-surgery-precision-and-recovery
Tidy, D. C. (2020, May 21). Deep vein thrombosis (DVT): Symptoms and treatment.
Patient.info. Retrieved February 27, 2022, from https://patient.info/allergies-bloodimmune/deep-vein-thrombosis-leaflet
Whitlock, J. (2020, April 12). The history of surgery: A timeline of medicine. Verywell Health.
Retrieved February 27, 2022, from https://www.verywellhealth.com/the-history-of-surgerytimeline-3157332
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Willacy, D. H. (2020, May 27). Pulmonary embolism: Symptoms and treatment. Patient.info.
Retrieved February 27, 2022, from https://patient.info/signs-symptoms/breathlessness-andbreathing-difficulties-dyspnoea/pulmonary-embolism
Riek, L. D. (2017). Healthcare robotics. Communications of the ACM, 60(11), 68–78.
https://doi-org.ezproxy.umgc.edu/10.1145/3127874
Lowth, D. M. (2017, July 30). Common postoperative complications. Patient.info. Retrieved
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