“The future of robotic surgery can be
determined only by probing the possibilities.
To ignore the potential for extending the
boundaries and safety of surgical care with
robotic technology seems unwise.”
– (From "The Future of Robotics,"
Bulletin of the American College of Surgeons (July)
2013; 98: 9-15.)
It is a spring morning in July 2047. Dr. Aiden Smith, a surgeon, enters the clinic room and greets Rebekah, the nurse practitioner, who is
sitting at the room’s control panel. “Good morning,
Rebekah! Looks like our patient tolerated the surgery
just fine. How has she been doing?”
“So far, so good, Doctor. Mrs. Morgan had a thyroidectomy last week.”
“Well, let's take a look at the incision.” He turns to Rebekah and
speaks under his breath. “We performed this robotic surgery through
her belly button.”
Rebekah helps Mrs. Morgan lie back and exposes the incision.
Dr. Smith dons a headset with the words "Clinic Room Operational
Computerized Upload Synthesizer" emblazoned on the side. He speaks
into the headset. “CROCUS, create a microscope.”
A wall panel opens and a 3-D printer appears. Within seconds, a fully
functional operating microscope custom fitted to Dr. Smith’s interpu-
pillary distance and left-handedness emerges from the printer. A robotic
arm grasps the microscope and brings it to eye level. Dr. Smith examines
the umbilical wound carefully.
Dr. Smith begins to dictate his report. “Everything is healing well.
The incision is clean and dry. Both stitches are intact. No evidence of
any postoperative complications.”
Dr. Smith adjusts the controls. “CROCUS, deploy the laryngoscope.”
A nano-camera on a fiber emerges and inserts itself into Mrs. Morgan’s
right nostril, advancing quickly into her throat. The examination table
creates a vacuum between itself and Mrs. Morgan that prevents her from
“CROCUS, remove the microscope.” The nano-camera retracts
and the robotic arm drops the microscope down a chute in the wall. A
whooshing sound is heard. The billing total updates.
Rebekah taps Dr. Smith on the shoulder. “Why did you close her
incision with stitches? I haven't seen you use suture since I started work-
ing with you! You usually use bioengineered and genetically-compatible
adhesive closure devices.”
“Glad you asked, Rebekah! The rep told me about a new suture
removal technique and I wanted to try it out. Watch
this!” He speaks into the headset. “CROCUS, create a
Robotic Suture Removal Device.”
The 3-D printer begins working furiously. A robotic
console emerges. Dr. Smith sits down at the console and
looks through the eyepieces, his back to Mrs. Morgan.
Next, a full-size surgical robot emerges. The arm yanks it
over the exam table. As it does so, a puff of smoke emerg-
es from the side of the robot. Mrs. Morgan frowns as she
watches wisps of smoke continuing to appear.
“See, Rebekah? In the past, I sometimes pulled too
hard when I removed sutures by hand. The company
claims that this approach is more precise, causes less
pain, and improves patient satisfaction.”
Two robotic arms emerge, one with a diamond-tipped
micro-dissecting scissor and the other with a laser-
cut articulated precision-matched jeweler's forceps. The billing total
updates. The robot grasps the first stitch and cuts the suture just below
the knot. The billing total updates again.
Mrs. Morgan, who has been watching smoke pour steadily from the
robot, now notices sparks. She passes out. The robot is quickly engulfed
in flames. The sprinkler system activates. Everyone is drenched.
“Dr. Smith!” Rebekah shouts over the deluge, “Mrs. Morgan has
fainted! Move the robot so I can get to her!”
Dr. Smith turns with surprise. “CROCUS, extinguish and discard the
Alarms sound and strobes flash. The flaming robot, now steaming
from the sprinklers, is dumped down the chute. A whooshing sound is
heard. The billing total updates.
“Wow, Dr. Smith, that was close! But, she still has one stitch left.”
“Good thinking, Dr. Smith. Safety first! By the way, you failed to initi-
ate the Time Out Checklist before the suture removal.”
Dr. Smith looks at her in horror. “Oh, no! I forgot to initiate a Time
Out? Not again! That's the third time this year!!!”
The 3-D printer springs to life and the robotic arm grabs Dr. Smith,
holding him in place as a jail cell emerges and encases him. He sits
helplessly on the hard bench, pulls the rough wool blanket around his
shoulders, and drops his head into his hands. “Now I'll never get my
The power supply for the examination table shorts out, which releases
Mrs. Morgan. As Rebekah contemplates Dr. Smith’s fate, Mrs. Morgan
carefully steps down from the table and quietly sloshes her way out the
Bruce Campbell, MD,