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2017; Elsevier BV; Volume: 104; Issue: 1 Linguagem: Inglês
10.1016/j.athoracsur.2016.11.037
ISSN1552-6259
Autores Tópico(s)Radiation Dose and Imaging
ResumoI would like to thank Dr Burack [1Burack J. A hand is a terrible thing to waste (letter).Ann Thorac Surg. 2017; 104: 367Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar] for his response to my editorial [2Lazar J.F. Is the future of robotic surgery mirroring aviation and the glass cockpit?.Ann Thorac Surg. 2016; 102: 679-680Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar]. I completely agree with his conclusion that “a skillful hand and a practiced mind are a terrible thing to waste” [1Burack J. A hand is a terrible thing to waste (letter).Ann Thorac Surg. 2017; 104: 367Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar]. It is the parallel he draws between the reliance of pilots (and modern surgeons) on monitors as an underlying cause for aviation disasters that diverges from the premise of the editorial. (“Are pilots and surgeons letting their manual skills grow rusty while they stare at the video screens?”) [1Burack J. A hand is a terrible thing to waste (letter).Ann Thorac Surg. 2017; 104: 367Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar]. The predicament in aviation is directly related to the pilot’s reliance on automation. The loss of ability to handle a crisis when the computer fails is due to the pilot’s failure to quickly identify the root cause of the crisis and initiate the appropriate action. This came from years of skill erosion through an overreliance on automation. The current robotic platform has very little to no automation, but this will eventually change because we are at the infancy of surgical automation. My reservations regarding this future is a central tenet of my editorial: “It goes without question that surgeons must remain a vital part of the robotic movement and not become passive supervisors trapped in their own glass cage…. By following an integrative path, we ensure our very bright future while providing our patients and trainees the best aspects of a synergistic relationship with technology” [2Lazar J.F. Is the future of robotic surgery mirroring aviation and the glass cockpit?.Ann Thorac Surg. 2016; 102: 679-680Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar]. The source of our potential demise will not be from how surgeons attain their visual cues (eg, monitors) or the size of the incisions but from a brand of hubris that allows technology and automation to disengage the surgeon’s mind and hands from actively participating in the patient’s care. A Hand is a Terrible Thing to WasteThe Annals of Thoracic SurgeryVol. 104Issue 1PreviewIt was with great interest that I read the recent editorial regarding the similarities and differences between robotic surgery and automated flight [1]. While one must agree with the author’s statement, “What currently separates the current robotic technology from the A320 (airplane) is that none of the surgical devices are automated,” surgeons do share an essential component of the glass cockpit with our aviator colleagues—the video monitor. Full-Text PDF
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