<p>Hello,</p>
<p>I've always been interested in a career in surgery, but recently I've seen that the future of surgery could be undergoing some dramatic changes soon, with the use of robots, etc. to do the majority of surgeries. I mean, yeah you're still controlling the device and all, but it just doesn't seem the same, holding that knife in your hand and doing it the "real" way. Do you guys think that this is truly the future of surgery- and if so do you think it's worth it?</p>
<p>If anything control of those devices is going to require even more skill...I can tell you first hand that laproscopic surgery is a much different set of skills than just slicing someone open...</p>
<p>That said, there are still going to be plenty of surgeries that won't allow use of robots and such. Things like tumor removal in certain areas of the body (breast lumpectomies for example) or ones that are more superficially located. I don't see carpal tunnel releases or certain types of hernia repairs ever getting to a point where you won't just do it open (unless robots get a lot smaller). Those are examples where just by the nature of the procedure, you'll still have to open people up.</p>
<p>There are certainly procedures that could be done laproscopically, but b/c of the outcomes are poorer than open surgeries, they will not be done laproscopically. For example, bowel/colon resections due to colon cancers are not done laproscopically because they found that doing them laproscopically seeds the cancers to other parts of the abdomen - something that NEVER happens during an open procedure. In fact my surgeon I followed this summer said that he knows of no reported cases in which an open surgery seeded a tumor to other organs, and yet there's something like a 5% risk doing it laproscopically. He said initially most people didn't believe that it was the laproscopes at fault, because no one had ever heard of a seeding tumors during a colon resection. </p>
<p>Finally, in addition to certain types of procedures that must be done the "real" way because of the anatomy, and other procedures that must be done the "real" way b/c of outcomes, there are certainly patients who must be opened up b/c of their body size/shape/condition/co-morbidities/etc. There will always be patients who, regardless of the advances made, won't be able to handle "futuristic" surgeries. The most obvious contraindication is often obesity...</p>
<p>My biggest worry as someone looking into a carrer in surgery isn't the technology. Its the hours and compensation for the hours, and how it will affect life. If it ends up the the per hour pay basis is too low and you work too many hours will it be worth it? Thats my question, and no one can really be sure what it will be like in the future. If surgery is what you want to do no amount of technology will change that, at least for me.</p>
<p>Another thing to worry about is the outsourcing of expensive surgeries to cheaper countries, such as India. India is apparently coming up with state-of-the-art hospitals to cater to this. I had a discussion with an Indian friend who says that with US companies becoming more stingy to pay health benefits, people will start bearing much of their own costs and seek out cheaper hospitals in foreign countries.</p>
<p>"Its the hours and compensation for the hours, and how it will affect life. If it ends up the the per hour pay basis is too low and you work too many hours will it be worth it? Thats my question, and no one can really be sure what it will be like in the future"</p>
<p>"Another thing to worry about is the outsourcing of expensive surgeries to cheaper countries, such as India. India is apparently coming up with state-of-the-art hospitals to cater to this"</p>
<p>Guys, how many doctors do you know that go hungry? Every occupation changes over time. Chances are still pretty good you'll receive enough in compensation to live a good life compared to many other people out there. </p>
<p>The delivery of medical services will for the majority of people require doctors and support staff locally. The very wealthy can of course go anywhere currency is accepted and have anything done. There's nothing new to that.</p>
<p>As far as India moving ahead, I would think China, who finally admitted it harvests it's executed prisoners for organ transplants would do better as they have an unending supply of potential criminals to choose from. </p>
<p>Medicine should allow you to have an interesting life, with reasonable financial success and a certain level of prestige within your community.</p>
<p>Outcomes and benefits of laparoscopic surgery are unpredictable. Laparoscopic cholecystectomy is typically faster than open cholecystectomy and allows a much faster post-op recovery. Endoscopic carpal tunnel relase requires more operative time, greater expense and a similar incision to open release and it results in a greater complication rates. Endoscopic inguinal hernia repair requires greater expense and general anesthesia compared to open IH repair and results in greater recurrence rates. Laparoscopic ventral incisional hernia repair, by contrast, allows a smaller incision and results in fewer recurrences.</p>
<p>Certain laparoscopic procedures are easier than open procedures in obese patients: nephrectomies, cholecystectomies and Nissen fundoplication. The physical feature most commonly limiting laparoscopic surgery is prior surgery or prior infection causing intra-abdominal adhesions.</p>
<p>Most laparoscopic procedures require thorough understanding of the anatomy which can only be gained by understanding the corresponding open procedure.</p>