Release date: 2015-08-03
Today, in 2015, if you have to undergo surgery, you must go to the hospital. But in the vision of Open Surgery Machine, in the future we can do the small surgery such as appendectomy. The patient first needs to have a MakerBot device. This is an open source surgical robot that safely performs simple, low-cost surgery for patients without the intervention of a doctor. The patient then downloads the surgical template for MakerBot on the Thingsverse website. As a result, a DIY operation is ready.
OpenSurgery focuses on DIY surgical robots outside the scope of health care supervision to see if they have the potential to replace professional medical services. In essence, Frank Kolkman simply wanted to use surgical robots as a focus of thought experiments. However, if amateurs, engineers and alternative healthcare product designers have developed enough power on the web, can surgical robots develop like 3D printers and CNC milling machines? “The current health care system uses money and labor to measure health care. By challenging the socioeconomic structure of the industry, I hope that my project will evoke attention. This project demonstrates an alternative,†said Kirkman. Sexual medical service model, I hope this will allow people to rethink the social value of health care."
1. Is Da Vinci cool? Maybe she is just a paradox of medical innovation.
In the past decade or so, robots have changed surgery. The robot can peel off the grape skin and expertly stitch it back, and anyone who has seen the technology can intuitively feel the benefits of using robots in surgery. For example, Da Vinci robots can even perform longer, more complex and complicated operations, and the accuracy and sensitivity of robots far exceed those of human surgeons. In addition, surgical robots can reduce the surgical trauma area of ​​a patient, providing a more comfortable surgical experience.
In such simple surgery, traditional surgeons typically cut three or more small minimally invasive incisions into the patient and then infuse the patient with an appropriate amount of carbon dioxide to reduce the chance of infection. The doctor then uses a minimally invasive incision and related equipment to perform surgery on a part of the patient's body.
However, the price of each surgical robot is more than two million dollars. This kind of expensive equipment means large-scale capital investment, and only intensive use can ensure reasonable cost performance. In addition, only surgical robots can really reduce the recovery time of patients, it is worth their own worth. The new market brought about by medical innovation, and the surgical robot is the product that adapts to this market. However, medical innovation drives the market indirectly to increase medical costs and “contribute†to the ever-increasing medical costs.
Even if new technologies like surgical robots can expand the range of medical services available to patients, the approach it takes is to replace traditional low-cost medical options with expensive medical services. This in itself is a paradoxical pattern. Medical resources are generally scarce and it is impossible to provide medical services for all. In order to be able to enjoy medical resources, millions of people who cannot afford private health care must rely on the public health system. However, public health systems are difficult to meet such large-scale needs. As a result, many people have completely lost access to medical services.
Kirkman is an interaction designer born in the Netherlands and recently graduated from the Royal College of Art in London. He said that the source of inspiration for Open Surgery Machine was not science fiction, but YouTube. YouTube has played the role of an indicator in the predicament mentioned above. Because the professional medical system lacks an affordable alternative, many Americans without health care began to use YouTube to share tips and tricks that they can complete their own medical treatment. Some of the techniques come from proven experiments, while others come in the form of step-by-step tutorials. These videos cover a wide range of medical services, from filling up to completing small amateur surgery. Of course, all of this is outside the supervision of the health sector.
Although controversial, we can't help but wonder if this DIY-style medical pragmatism can become a model and gradually promote the development of more accessible medical services that can replace expensive professional medical systems. In the DIY-style medical pragmatism concept, people can enjoy most medical services at home close to professional medical level without being bound by traditional rules.
What would happen if I could build my own DIY surgical robot outside of the regulated health care system?
2. Gray technology: assembling a cheap surgical robot based on open source
The robotics field has repeatedly tried to make cheaper and portable surgical robots. From a technical point of view, some products are comparable to the Da Vinci robots currently used in medical systems. However, stringent medical regulations have made these products accessible to the surgical room.
Especially worth mentioning is the RAVEN II Surgical robot. Originally developed by the US military, the device was designed to create a portable remote surgical device for field surgery. The two wings of this robot look like an arm and look impressive. RAVEN II Surgical is worth $200,000, almost one-tenth of the Da Vinci robot. RAVEN II Surgical also adopts a completely different concept. All software used to manipulate RAVEN II Surgical is an open source product, which means that others can leverage, improve or rewrite the software to suit their needs. At present, there is not much demand for this professional surgical robot control software, but the open source is of great significance to university researchers. Researchers can use this system to test new robotic surgical concepts and develop new software. In fact, the decision to open source has its rationality: RAVEN II will take some time to fully accept the regulatory and commercial worlds. Regrettably, however, the robot did not meet the safety and quality control requirements required by the regulatory authorities to perform surgery on humans.
Although the story of RAVEN II is instructive, its $200,000 price still exceeds what most medical technicians can afford. In order to test the preferences and rationality of DIY surgical robots, Kerkman has been trying to build such a device for the past five months. He uses prototyping techniques such as laser cutting and 3D printing, and uses components designed by others as much as possible.
Medical professionals and robotics experts say that there are three main problems in designing a surgical robot that can perform laparoscopic surgery: first, the problem of tools. During surgery, the robot needs to replace different types of tools. Therefore, the robot needs to be configured with multiple types of tools or with a structural design of the replaceable tool. In addition, the medical instruments used in laparoscopic surgery are very small, so self-made tools are a very big challenge; the second problem is to ensure that any parts that come into contact with the human body remain sterile to reduce the chance of infection. The medical devices used in hospitals are made of stainless steel, so they can be sterilized using autoclave equipment. However, the huge autoclave equipment uses high pressure and hot steam, which is difficult for people to own. The third problem is the shaft movement of the surgical robot. The robot performs the operation in the human body through the trocar, and the trocar must remain stationary during the operation to avoid tissue damage.
In fact, researchers can easily buy the equipment and tools needed for laparoscopic surgery online. At the beginning, Kirkman ordered from Ebay, but several attempts were unsuccessful. Later he turned to Alibaba, where he could buy the products he needed directly from Chinese manufacturers. The shipping cost to the US is approximately $40, and the manufacturer will also use aseptic packaging if needed. Ordering directly from the manufacturer ensures that the supply is stable and can order different types of medical devices and tools. This not only gets rid of the design troubles, but also discards the instrument after using it, and instead orders a new batch of products directly. In addition to selling laparoscopic surgical instruments, many companies on the Alibaba website also sell surgical equipment that is reasonably affordable, such as surveillance equipment, camera modules and carbon dioxide air pumps.
During the project study, Kerkman also discovered a new DIY approach. For those who can't use hospital equipment, they can simply retrofit their home equipment to meet their needs. For example, a household oven can last up to 160 degrees for four hours, making it a simple replacement for autoclaving equipment. If you want to sterilize plastic parts, you can even use a microwave oven.
In this way, designing a mechanical system is the most complex part of the overall DIY process, as it requires a lot of iterative testing and improvement. Kohlman chose four 3D printing components, and the control unit used two DC servo motors that could move around the center point.
The electronic information system used by Kirkman mainly draws directly on the existing designs in the online 3D community. This not only increases design accessibility, but also provides technical support to others in the 3D community when needed. The system software is built on the open source scripting language Processing, in order to increase accessibility and get the necessary support.
Although Kohlman's DIY surgical robot has made some progress in five months of debugging and improvement, it is not recommended to use it to complete the operation. These DIY surgical robots still need to be operated by a professionally trained surgeon or other person who is familiar with human anatomy and surgical knowledge. I believe that doctors will share similar knowledge and skills in the website community in the future.
However, it should be noted that the legality of DIY surgical robots remains questionable, and its preferences are also controversial.
3. DIY surgical robots that are free of patents and regulations
In the startup phase of the DIY project, Kirkman intends to make it an open source project. So he spent a lot of effort ensuring that he didn't use any parts used by commercial medical robots and tried to develop his own mechanical system. However, practice has shown that it is impossible to design components and systems related to surgical robots that do not infringe on the intellectual property rights of others. Most of the basic concepts of surgical robots have been patented, so there are not many similar alternatives on the market. At least during the patent protection period, few alternatives are seen.
Of course, there is nothing wrong with applying for intellectual property rights. However, large companies have monopolized a large number of patent portfolios in the field of design concepts and mechanical systems. This practice has caused great troubles in the medical field, resulting in many people not being able to enjoy the medical services and products that could save lives. In addition, most of the research related to health care is funded by public resources, and the monopoly of patents of large companies has caused startup companies to suffer. Because this means that the government and taxpayers bear a lot of risks, but in the end they only get a small amount of income. Moreover, the cost of patents also makes it difficult for startups with insufficient funds but subversive ideas to enter the medical market. So this surgical robot may not be commercialized, because in the early days it was smashed in the cradle because of patent issues. The government's innovation policy has created a system in which people will only pay for the worthwhile innovations, while ignoring the potential of new ideas with long-term efficiency. This reality poses a huge challenge for entrepreneurs.
However, DIY medical equipment has great potential. As long as you can privately manufacture parts protected by intellectual property and use them for non-commercial purposes, you can theoretically circumvent patent infringement. Of course, the difficulty of sharing similar system files online will also increase. A viable solution is to share using a peer-to-peer network, ensuring that files are only passed between communities with strong privacy. In this way, innovation can be guaranteed to develop freely. In addition, entrepreneurs can also develop R&D in areas where regulatory and intellectual property regulations are less stringent, but where demand for DIY medical devices is high. In these areas, they are able to develop and test technology more freely, pushing existing medical systems forward in different forms.
Source: Singularity
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