
Autonomous Robot Surgeon Bests Humans - nima3rad
http://spectrum.ieee.org/the-human-os/robotics/medical-robots/autonomous-robot-surgeon-bests-human-surgeons-in-world-first#.Vy_WyXgg3Vo.hackernews
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daveguy
FTA:

Inventor: "We programmed the best surgeon’s techniques, based on consensus and
physics, into the machine"

Third Party: “While in a technical sense, semi-autonomous suturing is a ‘grand
challenge’ problem of surgical robotics, clinically much suturing and bowel
anastomosis is done by staplers which can do the whole thing in seconds,” he
wrote in an email. “Clearly the task they chose does not justify the elaborate
equipment they used.”

So, they used machine learning to perform a limited part of a surgical
procedure, but with freedom of motion and adapting to tissue changes.

At the end of the article they talk about self-driving cars and how we have
lane-assist and the next level is taking over. The inventor likens this
technology to current lane-assist technology, but it seems more involved than
that.

Personally I do not want any machine learning consensus algorithm with control
over a surgical procedure in my body. I think the DaVinci type systems (tele-
operation, but without autonomy) are awesome -- they allow superhuman
precision in delicate surgical tasks.

However, until AGI is a solved problem I do not want an automated algorithm
making decisions with a knife to my organs.

Let the automation algorithm highlight portions of the screen or anticipate
the next viewpoint, but keep it away from the controls.

~~~
JamesBarney
I feel completely differently. As soon as someone shows me a table that says

Human Surgeons Mortality Rate : 1% Computer Surgeon Mortality Rate : 0.5%

I'll be sold on the automated surgeon. And I think this will happen WAY before
AGI is solved.

~~~
mdorazio
I'm with you. The sheer amount of human error in the medical field that causes
death and injury is astounding [1], and I would gladly put my life in the
hands of a capable machine instead of a fallible human if given the choice.

[1] [http://www.futurity.org/medical-errors-
deaths-1157152/](http://www.futurity.org/medical-errors-deaths-1157152/)

~~~
Matthias247
But then again the software in those machines will be written by humans and
will most likely have bugs - which might influence the outcome of the
operation. So the questions is whether you trust more the surgeon or the
engineers of that machine.

~~~
xerophyte12932
As a software developer, I am inclined to trust the surgeon more.

~~~
x0054
How about a surgeon that's been up for 36 hours, hungry, with a splitting
headachy, and some family problems on the mind. A human surgeon might be
awesome and can still make a ton of mistakes for reasons unrelated to their
medical abilities. Meanwhile, while a programmer could easily make a mistake,
other people and tests of the code could spot a lot of mistakes that could be
corrected before the system reaches its first patient.

~~~
coredog64
I'm going to take a different tack: How about we stop hazing medical
professionals at the beginning of their career and only ask them to work 8
hour shifts with an appropriate amount of time off until their next shift?

~~~
mdorazio
Along with lmm's comment, where would all the extra doctors come from? You
can't cut hours worked in half (or close to it) without doubling your staff to
meet the demand. US hospitals (especially ERs) are already running over
patient capacity in many US cities

~~~
x0054
Simple, make the hell of residency go away, and allow more foreign doctors to
come in to US and practice after going through a reasonable residency program.
I have known very smart and competent Russian and Ukrainian doctors who work
as lab employees because they are not allowed to practice medicine here.

------
Daniel_Marcos
The book Complications, by Atul Gawande is a fantastic account of medicine as
an imperfect science that I would recommend to anyone interested in the field.

Things like this make me hopeful about perfecting medicine and surgery to
avoid common human mistakes--even if that is still decades away.

~~~
signa11
in an almost the same vein, i would heartily recommend 'the medical
detectives' for bizarre accounts of medical mysteries and once 'debugged'
almost 'obviously that's how it would have happened' explanations of those
incidents...very cool :)

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argonaut
> In about 40 percent of its trials, the researchers intervened to offer
> guidance of some sort—as in the GIF above, where a human hand is seen
> holding the thread. In the other 60 percent of trials, STAR did the job
> completely on its own.

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sandworm101
Did the robot open the patient? Did the robot locate and section the organ?
This is a surgeon as a sewing machine is a tailor. It's a tool. To call it a
surgeon is very misleading.

Look at this:
[https://en.wikipedia.org/wiki/Da_Vinci_Surgical_System](https://en.wikipedia.org/wiki/Da_Vinci_Surgical_System)

~~~
jonknee
The robot did something that previously took a very highly trained person to
do. It's a huge accomplishment and not misleading at all.

You may not have read the article because it explicitly mentions the system
you linked to:

> The current state-of-the-art robot for soft tissue surgery is the da Vinci
> system from Intuitive Surgical, but it’s not automated at all. The da Vinci
> is a teleoperated system, in which the surgeon sits at a console and
> manipulates controls in dexterous maneuvers that are mimicked by tiny tools
> inside the patient’s body.

~~~
tremon
I agree with the GP, calling this a surgeon is misleading and looking for
hype. Yes, it's a great accomplishment. No, this is not a surgeon.

You can start calling it a surgeon when it can autonomously perform an
appendectomy, including handling common complications (excessive bleeding,
situs inversus, etc) during surgery.

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Agentlien
As a programmer who used to work with the development of training simulations
for surgeons, I find this tremendously exciting.

The company I used to work for focused on using computers to improve the state
of surgery, primarily laparoscopy, by using virtual reality to train surgeons.
This is an alternative approach, teaching the computer to perform the
procedure itself, rather than to evaluate its performance.

As a side note: I actually spent a fair bit of time exercising with modules
for suturing, including specifically for the small intestines, and it's
definitely quite fiddly work.

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YeGoblynQueenne
Oho! Stop the press:

 _> > Its vision system relied on near-infrared fluorescent (NIRF) tags placed
in the intestinal tissue; a specialized NIRF camera tracked those markers
while a 3D camera recorded images of the entire surgical field. Combining all
this data allowed STAR to keep its focus on its target. The robot made its own
plan for the suturing job, and it adjusted that plan as tissues moved during
the operation._

 _> > The researchers trained STAR only on how to perform this particular
intestinal suturing procedure. “We programmed the best surgeon’s techniques,
based on consensus and physics, into the machine,” Kim said._

So it's a combination machine learning - expert system robot. Machine learning
(I assume Convolutional Neural Networks) for vision, some planning algorithm
for the suturing job and expert knowledge for the surgical techniques.

That's the shit I'm talking about! Let's see more of that! Don't just end-to-
end train some deep net and try to have it learn to do _everything_ from
scratch. Use background knowledge! Combine techniques! Be smart, dammit!

Edt: btw, this sort of thing, systems with hard-coded expert knowledge besting
human experts, that's age-old stuff. It's how it used to be done before the
last winter ( _AI_ winter). Nice to see it back.

Edt 2: Apologies for the ex!cla!mation! marks! but I'm so! excited!

~~~
YeGoblynQueenne
Ho-hum. After reading the paper, they didn't use anything like machine
learning or expert knowledge. They just kludged the whole thing step-by-step
into the robot. Its "planning" was to draw a line between the NIRF tags on the
surface of the pig gut.

So it's not even properly autonomous- they're just misusing the term to mean
that nobody was remote-controlling it.

Meh. All those exclamation marks in vain :(

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vermontdevil
CDC recently stated that medical errors are the third leading cause of death.

If this technology would improve the rates, I'm for it

[https://www.washingtonpost.com/news/to-your-
health/wp/2016/0...](https://www.washingtonpost.com/news/to-your-
health/wp/2016/05/03/researchers-medical-errors-now-third-leading-cause-of-
death-in-united-states/)

------
damon_c
When they came for the surgeons, I was not a surgeon so i did not speak out.

~~~
toomuchtodo
Then they came for me - and there was no one left to speak out for me. We
rejoiced: work had been abolished.

EDIT: [http://www.theguardian.com/sustainable-
business/video/2016/f...](http://www.theguardian.com/sustainable-
business/video/2016/feb/17/last-job-on-earth-automation-robots-unemployment-
animation-video)

~~~
knieveltech
Yeah. There have been spontaneous demonstrations of joy and gratitude for our
happy new way of life. Said no-one who's job just got automated. Automating
work out of existence may or may not be a laudable goal. Assuming it is we've
yet to see a roadmap presented that doesn't brick the economy somewhere in the
middle of the gap between now and full automation.

~~~
stephengillie
Do you long to return to the time when more than 50% of the US labor force had
to work in food production? Thanks to automation, less than 2% of our
population is employed to feed us all, freeing the rest of us to develop
software or drive trucks.

~~~
knieveltech
Or suffer through chronic unemployment. Or work for starvation wages at a
McJob.

~~~
coredog64
Funny that you mention starvation wages. 50 years ago, you would have had to
spend twice as much on food and you wouldn't have gotten anything at the level
that's available today. I'd encourage you to read some of Megan McArdle's
posts on how we look back at historical food preparation with glasses that are
extremely rose colored.

[http://www.bloomberg.com/view/articles/2015-10-30/friday-
foo...](http://www.bloomberg.com/view/articles/2015-10-30/friday-food-post-
the-economics-behind-grandma-s-tuna-casseroles)

~~~
knieveltech
50 years ago is only the 1960's. Food was more expensive then in no small part
due to the fact that production was mostly by family farms. The economies of
scale that have wiped out rural communities around the country had only just
begun to develop in earnest. This meant small family farms were still
competitive in the market and could enjoy a high quality of living. I welcome
an explanation of how driving family farms out of business with vanishing
margins and concentrating what little profits remain in the hands of massively
capitalized corporate farming outfits is a net win for society. Note: cheap
food is ripe for all of the standard criticism normally aimed at trickle-down
economic theory so plan accordingly.

Also, define "food", because we can certainly devote some time to discussing
processed foods.

------
Aelinsaar
Once very very small step closer to the dream of Larry Niven's "Autodoc".

~~~
qaq
As long as virus scan doesn't start during the procedure :)

~~~
Aelinsaar
"Hmmm, the headache is gone, but I seem to have a few more limbs than when I
started..."

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adaml_623
The thing that everyone seems to be missing is that this will lead to
parallelism and miniturisation. One day we will get to the point where
pinpoint sized cameras and auto suturers will be able to stitch up incisions
without scars. And maybe a few decades after that we will get surgery at the
cellular level. Imagine a robotic surgical tool that only cuts tumour and can
avoid non cancerous cells and membranes.

"Intel Inside"

------
domtron_vox
> a bot stitched up a pig’s small intestines using its own vision, tools, and
> intelligence to carry out the procedure. What’s more, the Smart Tissue
> Autonomous Robot (STAR) did a better job on the operation than human
> surgeons...

I'm curious if they took into account how a person will do a better job when
said job is important/risky to themselves. I. E. stitching up a human where a
mistake has dire repercussions vs stiching up a bit of desposable flesh.

Was the pig even alive?

~~~
saulrh
Professional pride, along with "this is unusual and I am being graded on it",
can be a significant motivator. I'd actually be more worried about the
surgeons being tested being under _too much_ stress, not _too little_ stress.

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chillingeffect
Posed human vs computers, like other topics, but I'm starting to see
reputation as more important. A quality company is better than a dumb one,
regardless of internal mechanism. Some ai-based orgs will be ome the fast food
of their industry. And your choice won't be ai vs human but you will shop
reputation/quality vs price. And like our diets accomodated automation, so
will all our choices.

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lunchTime42
This is another thing, where a sort inverse domino effect exists. The more the
machine learns, the less training the human gets, the faster the conversion
spreads. Same as why you trust a machine to fly you more by now then a human.

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Overtonwindow
Don't worry everyone, we won't be seeing robotic surgeon's anytime soon, until
the next time insurance companies look to enact cost cutting measures. Best
guess, in the next few years. If you can still afford insurance then...

~~~
jonknee
The horror of getting stuck with a cheaper and better robot!

~~~
enraged_camel
>>cheaper and better

Those two adjectives don't often belong together.

~~~
hasenj
Really? Today's computers are cheaper and better than computers were in the
eighties.

~~~
enraged_camel
You are missing the context. Advancements in computer technology were a result
of research and development, not someone ruthlessly cutting costs.

~~~
stickfigure
These are symbiotic. The research and development pays off because somebody
else is willing to ruthlessly buy the new, cheaper/better option instead of
the safe traditional choice. Mainframes gave way to minicomputers which gave
way to microcomputers which gave way to laptops and now to mobiles.

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orblivion
Doctors next in line after truck drivers...got to say I didn't see this one
coming.

~~~
toomuchtodo
Doctors and lawyers are the top paid professions in the United States: it
would make sense to automate their jobs sooner rather than later.

~~~
ArkyBeagle
If you eliminate all the good-paying jobs, what are you left with?

