Black Pean - Darwin information #6

[tronella]

Spoilers for episode 9.

Tokai’s progress

Tokai used the Caesar by remote operation. This time, I’d like to talk about that Dr Tokai’s progress.

Do you think that using the robotic surgery assistant means Dr Tokai has progressed?

“It’s 100 times easier by hand” is a good line, isn’t it? I think this line means “although controlling the robot is difficult, skilled surgeons can use it”. I think that Dr Tokai realising that fact was truly a moment where he progressed as a surgeon, and I feel like he’ll progress even further in future by using robots.

It is difficult to perform surgery using a robot, so if you can learn to do it, not only do you improve your robotic surgery skills, but also your thoracic surgery skills, etc. You sharpen your skills more and steadily refine your intuition, eyesight and hands, so perhaps ordinary surgery would feel very easy. I think that’s something only people who have reached that level would understand, though. It’s a world full of unanswerable questions. Since we know how difficult it is, there comes a point where the robot makes the scales fall from our eyes and we realise how simple normal surgery is, so perhaps he has progressed that far.

Does performing robot-assisted surgery mean that he has reached the next step as a surgeon?

For example, endoscopic surgery is another step, and it is more difficult compared to abdominal surgery.

The field of view is small, and your sense of touch is replaced by watching a screen as you practice. When a surgeon first starts to perform endoscopic surgery, they should think “so it’s a bit different from suturing by hand”. Since you are really operating at a distance from the affected part with this technique, if endoscopic surgeons perform abdominal surgery by cutting the stomach wide open, it must feel very easy to them. You think “the surgeries I did up to now was so easy!” But I don’t think you understand that feeling until you’ve done a difficult endoscopic surgery, and it’s the same thing with robots.

For example, even if you learn something difficult at school and think “this is difficult, I can’t do it well,” in later years you learn even more difficult things, and when you look back at the problems from that time, you can solve them easily. Maybe it’s like that kind of feeling. When learning a language, to start with you have no idea at all what is being said, then at some point you can suddenly understand what you’re hearing. Maybe it’s like that moment. Like that, whether it’s an endoscope or a robot, when you start doing something that’s on a completely different level, the things you were doing before become easier. I think that’s “progress”.

I thought Dr Tokai had never touched a robot before, so could he really do that?

That’s the key point, isn’t it? If you aren’t a skilled surgeon, you can’t perform robot-assisted surgery like that. I think that in episode 9, Dr Tokai really embodied that statement. To make another comparison to F1, good drivers can drive F1 cars really fast, but if a bad driver gets in the car, they can’t even get it to move.

Although your field of vision has better resolution, it is limited in scope, making it hard to see what you’re doing. You have to form a 3D image from what you can see on the screen, and use the intuition you developed by actually touching the affected part to create the same kind of information inside your head as you work. In some ways, you need completely different training. That’s why I think his line, “it’s 100 times easier by hand”, was an amazing one. Because it’s true!

It’s not true that just anyone can perform robot-assisted surgery, is it?

There are two kinds of cutting-edge medical devices. One is “automated” devices like cleaning robots that even a child could use just by pressing a button. Anyone can get results using these. The other kind of device fundamentally depends on the person’s abilities. Some people might be thinking of a Gundam. They can’t be used without a person to control them properly. These devices can be said to “amplify a person’s skill”, so if you don’t have any skill to start with, you can’t use them.

Some people may not know that there are two kinds or what the differences are between them. I think both kinds will keep improving from now on. In this drama, maybe Dr Nishizaki doesn’t understand the difference between them. Professor Saeki understands it well, since he knew that there were people who could use the robot and so ordered the use of the Caesar. The people around him were surprised that Dr Saeki, who is so fixated on operating by hand, would choose the opposite route. I felt he was able to say that line because he knew that Dr Tokai, with his high-level thoracic surgery skills, would be there.

Even with remote operation being possible and with the progression of robotics and devices, this field continues to progress every day even now, so I think episode 9’s story was very interesting.