The Ro­bot is In: The Fu­ture of Med­i­cal Robotics in Thai­land

Thai-American Business (T-AB) Magazine - - Content - Writ­ten by: Sudi Narasimhan

The idea of med­i­cal robotics might have once been more closely as­so­ci­ated with sci­ence fic­tion than reg­u­lar health­care, but these days the use of ro­bots to as­sist in health­care is be­com­ing a stan­dard prac­tice. In a word, med­i­cal robotics is the fu­ture of medicine. What started out in the 1980s with the use of a ro­botic arm to as­sist in a few select surg­eries has now grown into an im­por­tant com­po­nent of any ad­vanced health­care set­ting. Thai­land’s role in this im­por­tant in­dus­try is more than just an ob­server or even oc­ca­sional participant.

Robotics in health­care are in­creas­ingly nec­es­sary

Robotics are typ­i­cally used where there is a need for pre­ci­sion and rep­e­ti­tion and these are ar­eas where ro­bots have typ­i­cally out­per­formed a hu­man op­er­a­tor. Tra­di­tion­ally, this pat­tern has taken place in the ar­eas of automotive and elec­tron­ics assem­bly and man­u­fac­tur­ing. In­creas­ingly, there are tasks in the med­i­cal field that will also ben­e­fit from the use of robotics, such as high pre­ci­sion pro­ce­dures where smaller move­ments and ad­di­tional de­grees of free­dom are re­quired that would be dif­fi­cult to achieve by only us­ing the hu­man hand. Another ex­am­ple would be in the use of au­to­mated sys­tems that im­prove the ac­cu­racy and safety of the de­liv­ery of health­care to pa­tients. In an ini­tia­tive iden­ti­fied as Thai­land 4.0, the coun­try has taken an ac­tive role in the field of tech­no­log­i­cal ad­vance­ment, in which med­i­cal robotics play an im­por­tant role. Through the ded­i­cated re­search cen­ter at Mahi­dol Univer­sity and the reg­u­lar use of ad­vanced med­i­cal robotics at lead­ing hospi­tals such as Mahi­dol Univer­sity’s Fac­ulty of Medicine at Siri­raj Hos­pi­tal, Bum­run­grad International, and Bangkok Hos­pi­tal, med­i­cal robotics con­tinue to grow in Thai­land. So what ex­actly do these med­i­cal robotics en­tail for the fu­ture of health­care in Thai­land? In or­der to an­swer this, we need to first iden­tify some of the most pop­u­lar ro­bots that are in use at our lead­ing hospi­tals.

THE DA VINCI RO­BOT

Ar­guably one of the most sig­nif­i­cant devel­op­ments in the field of med­i­cal robotics, this con­ver­sa­tion would not be com­plete with­out a men­tion of this ro­bot. The da Vinci Ro­bot in­cor­po­rates sur­gi­cal in­stru­ments with vis­ual aids, help­ing doc­tors per­form im­por­tant surg­eries with even more pre­ci­sion. This ro­bot is con­trolled by the sur­geon, who makes all the nec­es­sary move­ments in real time through an imag­ing and con­trol sys­tem, while the ro­bot car­ries out these move­ments within the pro­ce­dure. The da Vinci Ro­bot con­tinue to play an ex­tremely im­por­tant role in the ad­vance­ment of sur­gi­cal pro­cesses, and is now used by lead­ing hospi­tals around the world, usu­ally for min­i­mally in­va­sive pro­ce­dures.

Here in Thai­land, the use of the da Vinci Ro­bot has been em­braced by many of the coun­try’s top hospi­tals, in­clud­ing Bum­run­grad International and Bangkok Hos­pi­tal Phuket, which in­cor­po­rate the ro­bot to as­sist in com­plex surg­eries such as the treat­ment of prostate can­cer, as well as in cav­ity ar­eas that re­quire very fine pre­ci­sion such as in the kid­ney, uterus, pan­creas or in­testines. Less dam­age to healthy tis­sue, a smaller in­ci­sion, and faster heal­ing time lead to a much bet­ter qual­ity of life for the pa­tient, mak­ing the da Vinci Ro­bot a very im­por­tant part of today’s ad­vanced med­i­cal treat­ment.

SWISSLOG: THE PHAR­MACY RO­BOT

The Swisslog ro­bot is a drug- man­age­ment sys­tem that con­trols the pack­ag­ing, stor­age, and dis­pen­sa­tion of pre­scrip­tion med­i­ca­tion. The use of this phar­macy ro­bot has been stan­dard

prac­tice at Bum­run­grad Hos­pi­tal since 2008, mak­ing it the first hos­pi­tal in Asia to uti­lize the tech­nol­ogy. Med­i­ca­tion er­rors are a very real and a too- com­mon oc­cur­rence in many hospi­tals around the world, sim­ply be­cause be­fore the ad­vance­ment of au­to­mated man­age­ment sys­tems, the safe dis­pen­sa­tion of drugs re­lied on hu­man mem­ory and man­ual safe­guards alone.

This tech­nol­ogy re­moves the hu­man fac­tor, by al­low­ing for the au­to­ma­tion of prepa­ra­tion, pack­ag­ing, and dis­pen­sa­tion of pre­scrip­tion med­i­ca­tion; these are all tagged us­ing a se­ries of bar­codes that match with the bar­code worn by the pa­tient. Once med­i­ca­tion has been pre­scribed, the sys­tem checks for ev­ery­thing start­ing with the pa­tient’s iden­tity, dosage, time, and any pos­si­ble con­traindi­ca­tions with other drugs, thus elim­i­nat­ing as many neg­a­tive out­comes as pos­si­ble be­fore dis­pens­ing to the pa­tient. The ro­bot is an in­te­gral part of the sys­tem de­sign, which is cre­ated to pre­vent med­i­cal er­rors re­lated to med­i­ca­tion from oc­cur­ring. The use of this ro­bot also fa­cil­i­tates big­ger ef­fi­ciency, as phar­macy staff are able to have a re­li­able backup sys­tem that goes a long way to en­sure pa­tient safety.

RO­BOTIC ARM IN­TER­AC­TIVE SYS­TEM ( RIO): AD­VANC­ING JOINT CARE THROUGH MAKOPLASTY

For pa­tients suf­fer­ing from joint- re­lated in­juries, surgery might be the last hope for get­ting back to bet­ter qual­ity of life. How­ever, in many cases these surg­eries re­quire the kind of del­i­cacy and pre­ci­sion that is best achieved through a ro­bot. This is where Makoplasty comes in. Con­trolled by the doc­tor and pow­ered by the Ro­botic Arm In­ter­ac­tive Sys­tem, a Makoplasty al­lows the sur­geon to treat very spe­cific joint con­di­tions with ex­cel­lent pre­ci­sion and ac­cu­racy. Through the use of real time imag­ing of the joint com­bined with the pre­cise move­ments that a ro­bot can pro­vide, the pro­ce­dure en­sures an ac­cu­rate place­ment of im­plants, more con­sis­tency in mea­sure­ment, bet­ter align­ment, and a sig­nif­i­cant de­crease in im­plant and bone fric­tion. MAKO im­proves the out­come of these surg­eries, thus en­sur­ing a bet­ter qual­ity of life for the pa­tient.

RO­BOT AS­SISTED GAIT TRAIN­ING

The re­ha­bil­i­ta­tion process af­ter a stroke is a cru­cial com­po­nent of get­ting the pa­tient back to a bet­ter qual­ity of life. In or­der for stroke re­cov­ery pa­tients to achieve max­i­mum re­ha­bil­i­ta­tion, the ac­tiv­i­ties that re­quire repet­i­tive body move­ments, such as walk­ing, must be per­formed reg­u­larly. This is where the pro­fes­sional help of phys­io­ther­a­pists and the Ro­botic Gait Trainer be­come es­pe­cially im­por­tant. The amount of ef­fort in­volved in re­gain­ing am­bu­la­tion can be very chal­leng­ing for pa­tients, es­pe­cially when repet­i­tive move­ment is nec­es­sary. The ad­van­tages of­fered by this ma­chine in­clude re­duc­tion in fa­tigue, use­ful feed­back on train­ing pro­grams, suc­cess­ful repli­ca­tion of pa­tient’s nor­mal walk­ing pat­tern, and restora­tion of mus­cle func­tions dur­ing train­ing. These are ex­tremely use­ful ad­van­tages for help­ing pa­tients gain mus­cle strength and en­durance, which will re­sult in tan­gi­ble im­prove­ments in their abil­ity to get back to more in­de­pen­dent am­bu­la­tion and there­fore a bet­ter qual­ity of life.

THAI­LAND AS MED­I­CAL TECH­NOL­OGY HUB

Even in gen­eral terms, the more pre­ci­sion and con­trol a sur­geon can of­fer in any treat­ment, the bet­ter the pa­tient out­come is ex­pected to be. This is one ma­jor rea­son why Thai­land’s lead­ing hospi­tals con­tinue to be early adap­tors of med­i­cal robotics. In sit­u­a­tions where del­i­cate ac­tion is not only nec­es­sary but manda­tory for the best out­come, the com­bi­na­tion of a ro­bot with a highly trained sur­geon is the right choice for en­sur­ing that these del­i­cate pro­ce­dures can be per­formed to the best advantage of the pa­tient.

From com­puter- as­sisted di­ag­no­sis to ro­bot- as­sisted surgery and full au­to­mated pharmacies and all the way through re­ha­bil­i­ta­tion, the fu­ture of med­i­cal in­no­va­tion con­tin­ues to ad­vance at an im­pres­sive rate. Thai­land’s com­mit­ment to be­com­ing a med­i­cal robotics hub in this re­gion is clearly shown by the num­ber of the King­dom’s hospi­tals that of­fer these lat­est tech­nolo­gies. Part of the strat­egy for thriv­ing in the fu­ture is strength­en­ing the en­ter­prises in which the coun­try has al­ready shown great strides. Health­care hap­pens to be one of those clus­ters, which is why the con­tin­ued ad­vance­ment of med­i­cal tech­nol­ogy is one of the most im­por­tant com­mit­ments made in the Thai­land 4.0 plan. Bol­ster­ing the ar­eas where there is al­ready strength, while in­cu­bat­ing the star­tups in new ar­eas is a smart strat­egy for achiev­ing the fu­ture of Thai­land as en­vi­sioned by the ini­tia­tive.

Sudi Narasimhan is Cor­po­rate Di­rec­tor of Mar­ket­ing at Bum­run­grad International Hos­pi­tal. He can be con­tacted at Sudi@ bum­run­grad. com.

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