AUTOMATION, ROBOTICS AND THE FUTURE OF PREVENTATIVE SURGERY

Future surgeries will be minimally invasive, shift from treatment to prevention and rely more heavily on automation and robotics. This is according to Dr Paul Stoffles, Chief Scientific Officer, Johnson and Johnson. Arab Health Magazine sat down with Dr Stoffels at the 40th edition of the Arab Health Exhibition.Stoffles is in good shape to determine that future given his position atop one of the largest surgery companies in the world which he takes pride in describing as being focused on “extreme innovation”. Outlining his vision of the future, he focused on the goals of reducing the cost burden on society, better patient outcomes and improving efficiency and reducing complexity for surgeons – something that has a significant impact on the cost and quality of care.

Stoffles is in good shape to determine that future given his position atop one of the largest surgery companies in the world which he takes pride in describing as being focused on “extreme innovation”. Outlining his vision of the future, he focused on the goals of reducing the cost burden on society, better patient outcomes and improving efficiency and reducing complexity for surgeons – something that has a significant impact on the cost and quality of care.

Minimally invasive surgery, Stoffels explains, reduces the cost burden of surgery for both patients and healthcare providers. The procedures lead to a dramatic reduction in recuperation time for patients, reducing the strain on healthcare infrastructure such as bed spaces in hospital. Indeed, Stoffels explains that minimally invasive surgery is an “intervention with higher value for society by doing it more simply and having more impact”.According to Stoffels, a lot of research is being done on automation in the operating theatre. With the technological advances that are now on hand, more parts of a surgical intervention can be automated or aided by robotics – a development that he sees as increasing the

According to Stoffels, a lot of research is being done on automation in the operating theatre. With the technological advances that are now on hand, more parts of a surgical intervention can be automated or aided by robotics – a development that he sees as increasing the precision of surgery. The biggest impact he identifies in the move towards greater automation is in cancer treatment. More precise surgery means that surgeons will be able to intervene earlier in the progression of the disease and have better results when removing cancerous tissue while, crucially, leaving as much healthy tissue in place as possible. Indeed, the move towards robotics will allow doctors to reach areas that were previously much less accessible thanks to the improved accuracy and reliability of robotised surgery. The key push in development, he explains, is the need to make robotic surgery “more flexible and useable in all sorts of situations”.

The combination of minimally invasive surgery and the move towards automation will have a hugely positive impact on surgeons, says Dr Stoffels, making the work they do easier and, crucially for controlling healthcare costs, more efficient. Citing the example of a new knee-replacement technique, he described the procedure as being simpler and quicker to perform while still providing a better outcome for patients than other, older methods.

The generally accepted narrative about the challenges the developed world faces in terms of health, specifically the Middle East, often lead us to imagine that the future of healthcare will be focused more on treating the symptoms associated with chronic disease. Where communicable disease and malnutrition were once the major hurdles to be overcome, the GCC must now contend with lifestyle conditions such as obesity, heart disease and diabetes. Indeed, the diabetes epidemic and the prospect of an ageing population are associated with pharmaceutical interventions and long term care solutions. However, Dr Stoffles’ vision of the future of surgery demonstrates how the field can not only be used as a reactive tool but as a key measure in preventing further symptoms and even the development of diseases.In talking about the future development of surgery and the tools used to perform it, Dr Stoffels calls for a shift from mere treatment of conditions to prevention. He explains that the shift to a more sedentary lifestyle as well as dietary habits in the Middle East region, as well as the developed world as a whole, has led to an explosion of cases of diabetes. Through prevention, he says, doctors could intervene earlier, allowing them to avoid or mitigate the onset of the disease. Surgical intervention, he explains, “will play a big role in morbidly obese patients in

In talking about the future development of surgery and the tools used to perform it, Dr Stoffels calls for a shift from mere treatment of conditions to prevention. He explains that the shift to a more sedentary lifestyle as well as dietary habits in the Middle East region, as well as the developed world as a whole, has led to an explosion of cases of diabetes. Through prevention, he says, doctors could intervene earlier, allowing them to avoid or mitigate the onset of the disease. Surgical intervention, he explains, “will play a big role in morbidly obese patients in brining them back into control” for example, helping to reduce the burden chronic conditions like diabetes and cardiovascular disease place on the region’s healthcare providers and society.

Diabetes will require an “extraordinary intervention” and leads to myriad complications such as renal insufficiency, blindness and limb amputations. All of these complications place an enormous burden on society in terms of treatment costs, lost manpower and the requirement for on-going and long-term care.In terms of the cost of diabetes, Stoffles cited kidney failure as an example of how the disease produces extremely expensive and sometimes burdensome care requirements. It can only be treated with a kidney transplant, one of the most expensive and extreme operations available, or regular dialysis, which significantly impacts a patient’s life and ability to function in society. As such, preventing patients from ever reaching such a stage presents an enormous benefit both to those who pay for healthcare and society as a whole.

In terms of the cost of diabetes, Stoffles cited kidney failure as an example of how the disease produces extremely expensive and sometimes burdensome care requirements. It can only be treated with a kidney transplant, one of the most expensive and extreme operations available, or regular dialysis, which significantly impacts a patient’s life and ability to function in society. As such, preventing patients from ever reaching such a stage presents an enormous benefit both to those who pay for healthcare and society as a whole.

These advances in surgery go hand-in-hand with advances in medical imaging and diagnostics. On display at Arab Health were a variety of new imaging technologies that will play a crucial role in the future of surgery that Stoffels envisions. Earlier intervention through advanced surgical tools is largely possible thanks to better methods of disease detection and accurate imaging. More detailed, accurate scanning and advances such as 3D printing are key technologies that will allow surgeons to intervene in a more preventative manner.For every great leap forward in surgery, there are a myriad of smaller, more iterative changes. While Dr Stoffels sees smartphones as the example for medical device development, he is also focused on products that will change surgery and its outcomes without ever being seen. He cites advances in surgical sutures that span 40 years, new interlocking nails for hip-replacement procedures developed over a period of 15 years and new methods of sealing after

For every great leap forward in surgery, there are a myriad of smaller, more iterative changes. While Dr Stoffels sees smartphones as the example for medical device development, he is also focused on products that will change surgery and its outcomes without ever being seen. He cites advances in surgical sutures that span 40 years, new interlocking nails for hip-replacement procedures developed over a period of 15 years and new methods of sealing after gastro-intestinal surgery that help patients recover and minimize the risks of complications post procedure due to leakage. These new developments are well placed to improve how surgeons deal with trauma and orthopaedic surgery that, Stoffels was quick to assert, are not going to reduce in number.

Indeed, the surprisingly high number of road accidents on the region’s roads as well as the issue of construction related injuries were highlighted during a session on public health attended by Dr Stoffels. Surgery, he says, will play a growing role in preventative care as well as in the treatment and management of non-communicable diseases but many of the advances discussed by Stoffels can be applied to all surgical situations. Indeed, the exhibition floor at Arab Health was replete with new and improved surgical devices for orthopaedic and trauma surgery.

While a patient’s idea of surgery has perhaps remained unchanged for a great many years, Stoffels is clearly excited at where the field is headed. The advances he talks about have the opportunity to increase quality of life for patients; treat diseases earlier and perhaps even prevent them through minimally invasive, more automated surgery. Crucially, he says, they can achieve these goals while improving speed and efficiency for surgeons, controlling the cost of care and reducing the burden many conditions place on healthcare infrastructure. Treating conditions earlier, more quickly and with less time in hospital is a win for both patients, through better outcomes and healthcare providers through faster turnaround, and increased efficiency.

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