Against the backdrop of digitization, 1992 brought the introduction of the ROBODOC surgical system, followed by the "Computer Assisted Surgical Planning and Robotics" system (CASPAR) in 1998. At the time, both were considered quintessential surgical procedures. Back then, the robot milled cavities for hip implants in the femur, which used to be the surgeon’s job. A 3D model of the endoprosthesis was created based on CT scans of the patient’s hip. Based on this model, the robot then calculated the respective toolpath, providing a custom fit of the endoprosthesis into the hollow of the natural bone. Nevertheless, ROBODOC and CASPAR ended up not standing the test of time. One reason for this: the units were too large and bulky. Another reason: Although the systems provided precision milling of the bone, they had no feel for the bone density, which normally allows the surgeon to determine whether the prosthesis fits tightly into the bone. What’s more, the robot exclusively focused on the bone and ignored the muscle tissue. If muscle tissue was injured in the process, patients would end up having severe walking difficulties and pain.
Still, robotic surgeries are on the rise in the age of digitization. Unlike the first-generation technology, which included ROBODOC and CASPAR, medicine is now in the third generation of robots. Not only are these medical robots smaller, but they are also able to tell the difference between bone cement and bone, which is crucial when it comes to the implantation of an endoprosthesis. A doctor does not have this ability. The benefit here is that the robot can remove the cement from the femoral canal, causing only minimal or no damage to the bone in the process. When combined with a navigation system, the robot can even remove residual cement from hard to reach areas – areas the surgeon has difficulties to get to as they are not visible to the naked eye. What’s more, robots are able to respond faster than their human counterparts.
It’s a question of time and evolution of technology before "Doctor Robot" gains the trust of patients versus garnering doubt and rejection. That’s where a detailed explanation by the physician can be helpful.