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By Newsweek Editors
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One autumn day in 2000 a 61-year-old freelance journalist living near Yokohama felt an unbearable pain in his chest. He managed to call an ambulance just before falling unconscious. What happened next was all too typical. Surgeons stopped his heart, attached him to a heart-lung machine to circulate his blood artificially and replaced arteries with a vessel taken from his right leg. The operation took 11 hours and left the patient too weak even to climb a couple of stairs. He had to quit his job and stay at home. Three years later, he still hasn't recovered.
As this case shows, surgery can be brutal. "The 18th-century surgeon John Hunter was fond of saying, 'A surgeon is like a barbarian who gets by force what someone much more clever would get by artifice'," says Sherwin Nuland, professor of surgery at Yale Medical School and a fellow of the World Economic Forum. Doctors have made great strides in recent years in taking the barbarism out of surgery. Tiny surgical robots, for instance, allow doctors to avoid making large chest incisions when doing coronary-bypass surgery. Now researchers are experimenting with ways of operating on a heart that's still beating. Engineer Yoshihiko Nakamura of the University of Tokyo has developed a "heartbeat-synchronization" robot that allows a surgeon to operate on a beating heart as though the organ had been stopped. A robot that matches the heart's rhythm holds the scalpel and does all the cutting, while a surgeon directs the operation from a monitor. A high-speed camera and a computer modify the image so that it appears to the surgeon that the heart is virtually still. There's no need to stop the heart and put the patient on a heart-lung machine, which can cause infection and other complications that lengthen recovery time.
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Doctors have successfully tested Nakamura's system on a pig's beating heart, but before it's ready for people he needs to improve the robot's accuracy. "Clinical trials won't come for at least three years," says Nakamura.
If you don't like the idea of robot surgeons, you'd better get used to it. Robots are expected to handle more and more surgical tasks in the next decade. "Using robotics, surgeons in the future will essentially sit at consoles and direct probes--probes that are able to cut and suture within the body," says Nuland. "They'll use a computerized mockup of the operation superimposed over a virtual reality of the patient and his disease. A surgeon will be able to do six operations at a time." That will go a long way toward removing the trauma from surgery--that is, until doctors reach their ultimate goal of relying on alternative treatments, and do away with surgery altogether.
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