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austinkhale 5 days ago

If Waymo has taught me anything, it’s that people will eventually accept robotic surgeons. It won’t happen overnight but once the data shows overwhelming superiority, it’ll be adopted.

cpard 5 days ago | parent | next [-]

I think Waymo is a little bit different and driving in general. Because you have an activity that most people don’t trust how other people perform it already. It’s easier to accept the robo driver.

For the medical world, I’d look to the Invisalign example as a more realistic path on how automation will become part of it.

The human will still be there the scale of operations per doctor will go up and prices will go down.

qgin 5 days ago | parent | next [-]

LASIK is essentially an automated surgery and 1-2 million people get it done every year. Nobody even seems to care that it’s an almost entirely automated process.

iExploder 5 days ago | parent | next [-]

Not a doctor or an expert on this but as a patient I would say LASIK sounds less invasive than internal organ operations...

matthewdgreen 4 days ago | parent [-]

They're cutting into your eye!

beAbU 4 days ago | parent [-]

With a laser!!!

jacquesm 5 days ago | parent | prev | next [-]

Maybe not the best example:

https://www.theguardian.com/us-news/2023/apr/18/lasik-laser-...

soco 3 days ago | parent [-]

Any intervention, heck even jogging around your house, has a risk. The only important question is: are there less automated errors than human errors? If yes, here's the progress we asked for.

jacquesm 2 days ago | parent [-]

If no, then it isn't. Given that they overstate their success rate by orders of magnitude there seems to be a problem.

cpard 5 days ago | parent | prev | next [-]

Makes total sense, I think robotic surgeries are happening for quite a while now not only for eye surgeries.

And I think it’s another great example of how automation is happening in the medical practice.

hkt 5 days ago | parent | prev [-]

If they can automate training me not to recoil from the eye speculum I'd appreciate it, my pesky body does not like things getting too close.

(Serious remark)

0_____0 5 days ago | parent [-]

I think sedation may be an option (chemical automation, how about it?)

hkt 4 days ago | parent [-]

I was told it wasn't :(

filoleg 4 days ago | parent [-]

Full anesthesia - yeah, not an option, you need to be awake. Something milder - it could be an option (depending on the state, maybe? not sure, mine was done in WA).

Neither me nor my friends (all of us who got lasik) asked for it, but my clinic gave me valium, and my friends’ clinic gave them xanax shortly before the procedure.

Tangential sidenote: that was nearly 8 years ago, and I am absolutely glad I got it done.

hkt 4 days ago | parent [-]

Noted! I'm in the UK and nobody mentioned anything. Maybe I'll ask! I'd love to not have glasses even if it was just some of the time.

herval 5 days ago | parent | prev | next [-]

My perception (and personal experience) is medical malpractice is so common, I’d gladly pick a Waymo-level robot doctor over a human one. Probably skewed since I’m a “techie”, but then again that’s why Waymo started at the techie epicenter, then will slowly become accepted everywhere

chrisandchris 5 days ago | parent [-]

> My perception (and personal experience) is medical malpractice is so common [...]

I think it's interesting that we as human think it's better to create some (somewhat mostly) correct roboter to perform medical stuff instead of - together as human race - start to care about stuff.

herval 5 days ago | parent [-]

I don’t think the problem is “caring”. Waymo has proven the obvious - a machine with higher cognitive function that never gets distracted is better than most humans at an activity that requires constant attention and fast reflexes. I’m sure the same will eventually apply to other activities too.

It’s a much better investment of time to make robots that can do delicate activities (eg Neuralink’s implant robot), consistently and correctly, than training humans and praying that all of them are equally skilled, never get older or drink coffee or come to the operating table stressed out one day…

neom 5 days ago | parent | prev [-]

Uhmmm... I'm sorry but when Waymo started near everyone I talked to about it says "zero % I'm going in one of those things, they won't be allowed anyway, they'll never be better than a human, I wouldn't trust one, nope, no way" and now people can't wait to try them. I understand what you're saying about the trusted side of the house (surgeons are generally high trust) - but I do think OP is right, once the data is in, people will want robot surgery.

cpard 5 days ago | parent [-]

Of course they will. I don’t argue that they won’t.

I just say that the path to that and the way it’s going to be implemented is going to be different and Invisalign is a better example to how it will happen in the medical industry compared to automotive.

copperx 5 days ago | parent | prev | next [-]

Yeah, if there's overwhelming superiority, why not?

But a lot of surgeries are special corner cases. How do you train for those?

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Tadpole9181 5 days ago | parent | prev | next [-]

By collecting data where you can and further generalizing models so they can perform surgeries that it wasn't specifically trained on.

Until then, the overseeing physician identifies when an edge case is happening and steps in for a manual surgery.

This isn't a mandate that every surgery must be done with an AI-powered robot, but that they are becoming more effective and cheaper than real doctors at the surgeries they can perform. So, naturally, they will become more frequently used.

myhf 5 days ago | parent | prev | next [-]

I don't care whether human surgeons or robotic surgeons are better at what they do. I just want more money to go to whoever owns the equipment, and less to go to people in my community.

It's called capitalism, sweaty

aydyn 5 days ago | parent [-]

based

rahimnathwani 5 days ago | parent | prev [-]

Who do you think has seen more corner cases?

A) All the DaVinci robots that have ever been used for a particular type of surgery.

B) The most experienced surgeon of that specialty.

kingkawn 5 days ago | parent | next [-]

The most experienced surgeon bc the robots are only given cases that fit within their rubric of use cases and the people handle edge cases

rahimnathwani 5 days ago | parent [-]

Incorrect.

DaVinci robots are operated by surgeons themselves, using electronic controls.

kingkawn 5 days ago | parent | next [-]

Correct.

I know that.

Still the robots are not used outside of their designated use cases and People still handle by hand the sort of edge cases that are the topic of concern in this context

yahoozoo 5 days ago | parent | prev [-]

Da Vinci robots don’t know they were used for those edge cases.

hansmayer 5 days ago | parent | prev [-]

...Except that a surgeon can reason in real-time even if he wasn´t "trained" on a specific edge-case. Its called intelligence. And unless they have been taking heavy drugs ahead of the procedure, or were sleep deprived, its very un-likely a surgeon will have a hallucination, of the kind that is practically a feature of the GenAI.

dragonwriter 4 days ago | parent [-]

AI “hallucination” is more like confabulation than hallucination in humans (the chosen name the AI phenomenon was poor because the people choosing it don't understand thr domain it was chosen from, which is somewhat amusing given the nominal goal of their field); the risk factors for that aren't as much heavy drugs and sleep deprivation as immediate pressure to speak/act, absence of the knowledge needed, and absence of the opportunity or social permission to seek third-party input. In principle, though, yes, the preparation of the people in the room should make that less likely and less likely to be uncorrected in a human-conducted surgery.

hansmayer 4 days ago | parent [-]

I guess my point was less about the nuances of how we define 'hallucination' for a GenAI system, and more about the important part - not having my liver accidentally removed because the Surgery-ChatGPT had a hickup, or the rate limit was reached or whatever.

throwup238 5 days ago | parent | prev | next [-]

We’re already most of the way there. There’s the da Vinci Surgical System which has been around since the early 2000s, the Mako robot in orthopedics, ROSA for neurosurgery, and Mazor X in spinal surgery. They’re not yet “AI controlled” and require a lot of input from the surgical staff but they’ve been critical to enabling surgeries that are too precise for human hands.

andsoitis 5 days ago | parent [-]

> We’re already most of the way there. They’re not yet “AI controlled” and require a lot of input from the surgical staff but they’ve been critical to enabling surgeries that are too precise for human hands.

That does not sound like “most of the way there”. At most maybe 20%?

throwup238 5 days ago | parent [-]

If you consider “robotic surgeon” to mean fully automated, then sure the percentage is lower, but at this point AI control is not the hard part. We’re still no closer to the mechanical dexterity and force feedback sensors necessary to make robotic surgeon than we were when the internet was born. Let alone miniaturizing them enough to make a useful automaton.

constantcrying 4 days ago | parent | prev | next [-]

>If Waymo has taught me anything, it’s that people will eventually accept robotic surgeons.

I do no think that example is applicable at all. What I think people will be very tolerant of is robot assisted surgeries, which are happening right now and which will become better and more autonomous over time. What will have an extremely hard acceptance rate are robots performing unsupervised surgeries.

The future of surgery this research is suggesting is a robot devising a plan, which gets reviewed and modified by a surgeon, then the robot under the supervision of the surgeon starts implementing that plan. If complications arise beyond the robots ability to handle, the surgeon will intervene.

suninject 5 days ago | parent | prev | next [-]

Taking taxi is a 1000-times-per-year with low risk. Having a surgery is 1 per year with very high risk. Very different mental model here.

fnordpiglet 5 days ago | parent [-]

That calculus has a high dependency on skill of the driver. In the situation of an unskilled driver or surgeon you would worry either way.

The frequencies are also highly dependent on the subject. Some people never ride in a taxi but once a year. Some people require many surgeries a year. The frequency of the use is irrelevant.

The frequency of the procedure is the key and it’s based on the entity doing the procedure not the recipient. Waymo in effect has a single entity learning from all the drives it does. Likewise a reinforcement trained AI surgeon would learn from all the surgeries it’s trained with.

I think what you’re after here though is the consequence of any single mistake in the two procedures. Driving is actually fairly resilient. Waymo cars probably make lots of subtle errors. There are catastrophic errors of course but those can be classified and recovered from. If you’ve ridden in a Waymo you’ll notice it sometimes makes slightly jerky movements and hesitates and does things again etc. These are all errors and attempted recoveries.

In surgery small errors also happen (this is why you feel so much pain even from small procedures) but humans aren’t that resilient to the mistakes of errors and it’s hard to recover once one has been made. The consequences are high, margins of error are low, and the domain of actions and events really really high. Driving has a few possible actions all related to velocity in two dimensions. Surgery operates in three dimensions with a variety of actions and a complex space of events and eventualities. Even human anatomy is highly variable.

But I would also expect a robotic AI surgeon to undergo extreme QA beyond an autonomous vehicle. The regulatory barriers are extremely high. If one were made available commercially, I would absolutely trust it because I know it has been proven to out perform a surgeon alone. I would also expect it’s being supervised at all times by a skilled surgeon until the error rates are better than a supervised machine (note that human supervision can add its own errors).

rscho 5 days ago | parent | prev | next [-]

Overwhelming superiority is not for tomorrow, though. But yeah, one day for sure.

ikari_pl 5 days ago | parent | prev | next [-]

waymo only needs to operate in a 2D space and care about what's in front and on the sides of it.

that's much simpler than three dimensional coordination.

an "oops" in a car is not immediately life threatening either

ben_w 5 days ago | parent | next [-]

> an "oops" in a car is not immediately life threatening either

They definitely can be. One of the viral videos of a Tesla "oops" in just the last few months showed it going from "fine" to "upside-down in a field" in about 5 seconds.

And I had trouble finding that because of all the other news stories about Teslas crashing.

While I trust Waymo more than Tesla, the problem space is one with rapid fatalities.

constantcrying 4 days ago | parent | prev [-]

>an "oops" in a car is not immediately life threatening either

There are enough "oops"'s that are life threatening though.

mnky9800n 5 days ago | parent | prev | next [-]

TBH i trust the robot more than some random uber driver who just can't stop talking about their fringe beliefs.

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kingkawn 5 days ago | parent | prev [-]

There’s been superiority with computer vision over radiologists for >10 years and still we wait