Dr. Vipul Patel on the future of robotic surgery

May 16, 2013
by Nancy Ryerson, Staff Writer
“The future of” column provides a quick look at predictions for the sector from some of the top minds in the field. This month, we feature Dr. Vipul Patel.

Dr. Vipul Patel has performed more than 6,000 robotic prostatectomies — that’s more than anyone else in the world. As someone who has seen the development of surgical robotics from the start, he’s in the perfect position to look forward to what the future holds for surgical robots, the surgeons who control them and the tough diseases they treat.

Surgical robots will take on new tasks
Over the last 10 years, robotics has transformed minimally invasive surgery, especially for urology and gynecology, Patel says. He predicts that trend will continue for the next decade, and that general surgery and orthopedics are up next for a surge in robotic treatment. “There’s already a robot for spine surgery, called Mazor, so orthopedic surgeons are using minimally invasive procedures,” he says. Surgical robots have also helped orchestrate hip replacements. As robotics spreads its reach into more surgeries, the procedures themselves will continue to become more precise. Patel hopes to see improved image guidance during robotic surgery. The next step is intraoperative imaging during surgery, Patel says. He says more intraoperative imaging will help surgeons better treat prostate cancer, for example, by allowing them a better view of where tumors are and more easily avoid damaging vital nerves and vessels.

Tiny robots and telesurgery
As the use of robotic surgery grows, Patel predicts the robots themselves will shrink. “There will be miniaturized robots that you can actually place in the abdominal cavity, then they drive themselves around inside the patient,” Patel explains. Nanorobots are already in prototype form, and should be making their way into the medical world within the next 10 years.

Robots will also help surgeons get up close and personal to a surgery even if it’s being done in another country. He predicts that telesurgery will become more common thanks to the capabilities of future robots. Less experienced surgeons will be able to get real-time advice from robotic surgery pros located anywhere in the world. The first step towards that future isn’t complicated, but it is at the core of many facilities’ health IT woes: wireless connectivity. “The biggest problem we have now is the time delay between motion and action,” Patel says.

Improved training and less trauma
Robotic surgery is physically less taxing than traditional surgery techniques, as it’s more ergonomically friendly, but there is a steep learning curve. Patel predicts that there will soon be a greater emphasis on training using simulations that show what it’s like to be behind the robot console to cut down that curve. The Florida Hospital Global Robotics Institute, where Patel works, already has a training center and a list of fundamental procedures for surgeons to pass before ever operating on a patient.

Better training and more precise technology will naturally lead to better surgical results, Patel says. Minimally invasive surgery and robotic surgery has already provided patients with shorter recovery times due in part to less blood loss and trauma. In the future, Patel predicts surgeries will be even less invasive, bringing the number of incisions all the way down to zero. “It’s called natural orifice surgery,” he says. “Everything is done inside. That’s something we’re all working towards.”