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"The way things hang down and the way cords come up from the
floor make a big difference in the ability to deliver efficiency and
safety. A colleague calls it the 'spaghetti syndrome,' having all of
those wires everywhere."
Ready for robots
When the subject is the future, the discussion inevitably turns to
robots. We're already seeing a glimpse of that technology in the OR,
but what's coming is likely a far cry from what's here.
"Right now, one company (Intuitive Surgical, manufacturer of the da
Vinci robotic surgical system) really owns the market," says Rob Maliff,
director of the Applied Solutions Group for the ECRI Institute, an inde-
pendent, non-profit research organization working to improve the safe-
ty, quality, and cost-effectiveness of patient care. "But we expect there
to be a few competitors in the market very soon. It will be interesting to
see what that does to the price. And obviously there will be a continu-
ous effort to expand the number of procedures robots can be used for."
Dr. Gewertz is circumspect about the current value of robotics, but
excited about the future. "There's very little evidence that robotic
surgery is safer, better or quicker at the current date," he says. "In
fact, there's probably pretty good anecdotal evidence that they're
being misused in a wide range of surgeries."
But when competition and innovation inevitably push the envelope?
"I think in 10 or 15 years every OR will have a robot," says Dr.
Gewertz. "But not the kind we're seeing now. It might be just a light-
weight thing like a microscope, something that swings down from the
ceiling when you need it."
Jeffrey Milsom, MD, chief of colorectal surgery at New York-
Presbyterian/Weill Cornell Medical Center in Manhattan and one of the
drivers behind the facility's recently developed "advanced technology
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