The Economist reports that adverse events occur relatively frequently when physicians insert catheters:
placing needles inside veins deep in the body is notoriously difficult. Some 15-30% of attempts suffer complications, mainly punctured arteries that can lead to infection (around 250,000 cases in America annually), but also bleeding, collapsed lungs and even cardiac arrest. Failure rates in children can be higher still.
However, there may be a solution.
A team led by Hugo Guterman, a robotics expert, has built a prototype device that uses ultrasound, machine vision and a robotic needle-dispenser to make placing a central venous catheter a push-button affair.
The operator lays the wireless device on a patient’s arm, leg or neck and views an ultrasound image on a nearby computer screen. The system then identifies the centre and edges of each blood vessel, as deep as 15cm inside the body and as narrow as 0.5mm in width, making it particularly useful for treating children. Using a joystick, the operator aligns a target icon over a vein. The system uses a tracking algorithm to keep the blood vessel aligned. When ready, the operator simply presses a button to insert the needle.
Will robotic insertion of catheters become the new norm? The technology promises to greatly reduce the number of adverse events and improve patient health. However, there may be backlash from physicians. The device does not require the robot operator to be a physician. Physicians may feel that the robotic procedure is unsafe if it is no supervised by a physician. This may be true in the early stages of implementing the robotic procedure, but as people become more familiar with the technology (assuming it does in fact work), then the physicians may not be needed. Having physician oversight, in fact, could simply increase the cost of the robotic procedure so that the technology increases cost rather than decreases it.
It is not clear how the use of robots will change the practice of medicine, but innovators must worry about backlash from entrenched interest groups (e.g., physicians) if the new technology could jeopardize part of their financial stability.