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Medical Devices

DIY surgical robots: A step too far?

If you don’t have health insurance in the US, the huge medical costs associated with surgeries, can drive people to do pretty crazy things. Like performing surgeries DIY style. Some even upload videos on YouTube as a tutorial for others to follow. Granted, the cost of medical procedures is much higher in the US compared to other countries. Heart valve surgery, for instance, can cost a whopping $53,400. So being unable to afford it naturally leads to some desperate measures.

Product designer Frank Kolkman noticed the YouTube phenomenon of self-surgeries and thought that there must be an alternative option.

“I was researching surgical robots and found this amazing machine called Da Vinci surgical system and when you look at it, you intuitively understand the benefits of incorporating robots into surgery. But if you look at the healthcare system as a whole, there is this large group of people that are excluded from these types of surgeries because they don’t have healthcare insurance,” Kolkman explains to me over the phone from the Netherlands.

So Kolkman came up with a DIY surgical robot, an open-source robot that can perform simple procedures alongside a surgeon, potentially in the comfort of your own home. Kolkman likes to think of it as a machine for the “maker-scene right now which is focusing on 3D printers” except that the surgical robot is aimed to be more socially critical of the healthcare system.

Kolkman emphasises that at the moment this is just a concept project and the machine is not actually being used. He wants to stir debate about providing viable alternatives to the costly healthcare system that currently exists in America.

“Basically the surgeon always performs surgery with six or seven assistants, whereas if you go outside of the regular healthcare system, you wouldn’t have the luxury of having that many assistants available to you,” says Kolkman. “So from that constraint I figured out if you could use a robot that could hold tools in place and move them around, you could perform the same type of operation with less additional help.”

To create the robot, Kolkman used all sorts of DIY tools like the ones used in 3D printing and laser-cutting. He says he “pushed the limits a bit too” by ordering surgical tools that are certified and professionally made from Alibaba in China: “It’s basically a mix of pre-existing parts and assembled with the help of accessible making technology”.

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The machine right now costs $5000 US dollars. That’s quite a bit of money - especially for Americans that can’t afford surgeries in the first place. What makes Kolkman think Americans will be able to afford this machine when they can’t afford surgeries?

“In the US, if you look at a simple appendectomy it comes down to $10,000 US dollars. So that will be a single procedure. But if you don’t have health insurance, this basically means that you will have to get a small loan just to be able to get that operation done. Whereas in this case, you would have an alternative where you have a group of hackers or a group of surgeons that are willing to go outside of the system. It might mean that the actual procedure could be free but the risk involved is a lot higher.”

Even if the costs add up, it is hard to imagine anyone being comfortable with the idea of having surgery not just performed by a robot (assisted by a surgeon), but outside the comforts of a traditional hospital setting. But this is just the tip of the iceberg. What about all the legal and other liability issues?

Kolkman reassures me that he is under no illusions about the complexities of not only bringing this to market, but also having the concept itself being accepted.

“There is definitely a liability issue. The thing with open source technology is, say I designed this robot and released the files online. [One person] assembles this machine, then someone else uses that machine to perform surgery and something goes wrong. It’s really hard to pin point where that liability is. Is it the person that designed the machine? Or the one that operates the machine?”

For Kolkman he thinks the only solution is for the patient to accept full responsibility. But he thinks the patient will have greater autonomy over the procedure – something that the patient can’t get in the current system.

How does Kolkman envision this project working out?

“You would have small communities of people locally who will be invested in making a machine like this. So it would be a combination between the local hacker space and the local surgeon or doctor that actually has the knowledge of performing surgery with a deep understanding of human anatomy.

“But on a global scale it would mean that you have a large community of people that are actually developing the machine as a whole and sharing the files online to actually make it accessible and improve upon it,” Kolkman adds.

Kolkman sees possibilities for using these surgical DIY tools in third world countries where there is a lack of investment in this area and no intellectual property rights issues.

What do hospitals and surgeons make of Kolkman’s idea?

“A lot of the surgeons were quite interested in the idea because they don’t normally have a big say in what types of equipment they get to use as this is decided by the hospitals and the healthcare insurance companies. This also in a large part determines which operations they can and can’t do. They definitely see a benefit for cheaper tools and some do see this as a viable alternative.”

Positive responses aside, Kolkman had had his fair share of criticism too. A couple of roboticists say he is “committing suicide with this machine” as they believe it will injure people more than help them. But Kolkman is not phased as he’s aware there is a lot more work to be done. For now, he believes the idea is plausible enough.

“What I’m trying to investigate next is – let’s say this robot would work and do the job – how would I open-source it? How would I start this community within legal frameworks that are there?”

 

Read about how Microsoft put robot surgeons in the limelight here.

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Ayesha Salim

Ayesha Salim is Staff Writer at IDG Connect

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