Robotic Medicine: Over the past few years we have... - Thyroid UK

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Robotic Medicine

helvella profile image
helvellaAdministrator

Over the past few years we have seen many reports on the use of robotic devices in medicine. Some are vastly complicated devices that can make a big difference to complex surgery - improving outcomes and, sometimes, increasing the number of operations possible.

There have also been huge advances in prostheses - some of which have considerable "intelligence" in order to work well.

I'd like to suggest something that might make a considerable difference to day-to-day medicine yet would be at the low end of complexity and, I'd hope, cost.

That is a phlebotomy robot. More or less, you sit on a chair and put your arm in the right place. It then does the blood collection, marks the tube(s), and passes them up the chain to the lab.

If done well, I suspect it would reduce the occurrence of severe bruising, missed veins, etc. And avoid the dependence on trained phlebotomists being available. Thus potentially opening up blood collection to 24-hour working. Allowing collection to be done at a biologically appropriate time (so long as the patients can get there). Avoiding the impact of staff sickness on blood testing. Improving the quality of samples taken.

Many, possibly all, existing phlebotomists will still be needed. For doing the rounds of in-patients. For dealing with non-standard situations (such as the need to take blood from elsewhere than the arm). For meeting, greeting, explaining, and generally helping things to run well.

Those of us who find getting an early blood test difficult, or impossible, might find it makes a big difference so long as its use increases rate of blood draws.

And, eventually, we might even see such robotic devices being installed in many more locations than currently do phlebotomy.

47 Replies
RedApple profile image
RedAppleAdministrator

Oooh, sounds an excellent idea! But have a feeling it's not going to happen any time soon 🤔 so I'll not get too excited!

helvella profile image
helvellaAdministrator in reply to RedApple

:-)

I can't help but think it is so much simpler than the mega-surgical robots, it might be a really good target for developers and manufacturers to prove much technology in the real world.

And, with far more blood tests than operations, the cost-benefits of producing considerable numbers would help with the per-machine prices.

A much simpler idea would be to create a monitor, much like a Glucose Monitor, that measures a FT3 level. That, I imagine, would save quite a bit of time and money while trying to raise levels.

helvella profile image
helvellaAdministrator in reply to nightingale-56

Such a device might be desirable. But you'd need one for each patient covered. Thus making it expensive.

One phlebotomy robot could deal with thousands of people.

Cost per person would likely be quite low if used intensively.

You can imagine a muti-bay machine where one central unit can handle several people at once.

I rather thought that we could buy a machine, much like some buy a blood glucose machine, with strips that read your current FT3 level.

helvella profile image
helvellaAdministrator in reply to nightingale-56

Well, there is a TSH test that has a strip.

But it has a severe limitation which makes it almost entirely useless. It can only check whether you are under or over a specific level. In real strips for sale, that is set at 5.

I suspect quite a lot of members would find that worse than useless by actually misleading. And clearly unusable for checks in pregnancy where the usual mantra is that TSH should be under 2.5 (or 2, or somewhere near - varying by guideline).

You could dream up using ten strips - each one set up for a different level of TSH, thus narrowing down the range - something like less than 1, 1.01 to 2, 2.01 to 3, etc. But the cost would also multiply!

I think a Free T3 test which we could do at home and would give a meaningful and consistent numeric result is quite a long way off.

Yes, the TSH test strip does sound pretty useless. Unfortunately, I also think a FT3 test for home use is a long way off. It has been mentioned once before but did not get off the ground.

I like that idea. Like the continuous blood sugar monitors you attach to your arm that give readings to an app on your phone.

I was thinking much simpler than that, just like a simple glucose monitor, where a finger prick is needed. Not everyone has a smart phone, and a glucose monitor is cheaper.

Very interesting with many merits but I’m not sure if I like this idea or if it terrifies me….on a human level. Metropolis and all that. I am creeped out by those Japanese robots but at least they are trying to address care for an aging population in innovatory ways not just sitting on a time bomb. I even hate diy tills in shops I’d much rather be served by a human being even if it takes longer and depends on someone else. Having my blood taken robotically would terrify me I am sure… what if the darn thing went wrong and started stabbing randomly and furiously 😱 I’d always think of the most absurd things that could go wrong with it. No doubt one would soon get used to it with practice!

helvella profile image
helvellaAdministrator in reply to TSH110

I think we'd need humans as well - partly for anyone who is understandably not enthralled by the machine/robot idea.

I'd hope even those who don't use them would benefit from shorter queues.

nellie237 profile image
nellie237 in reply to TSH110

I'm with you TSH110........I'm sure they could make them with super precision, but also a bit horrified.

I love scanner's that you take round the supermarket ..........self scan at the tills isn't great if you've got lots though 'cos I'm not so good at multi-tasking anymore.

helvella profile image
helvellaAdministrator in reply to nellie237

I detest those scan-while-you shop devices. Never used one and don't want to.

Funny how different we all are.

nellie237 profile image
nellie237 in reply to helvella

"Never used one " Don't knock it until you've tried it helvella. I first used them at a time when I was on quite a tight budget.......so that I could see what I was spending without trying to keep adding it up in my head, while also trying not to forget anything vital.

Now I see people with bulging trolleys going through the normal tills and think to myself.....why? You've got to unload it all, and then pack it??????????

I don't really like that I have to have various supermarket cards to be able to do this, and that an opinion about me is made based on my shopping habits, but holding onto principles here would bar me from grocery deliveries too, and they are sometimes necessary, so I had to give up on that.

TSH110 profile image
TSH110 in reply to nellie237

I didn’t know they totted it up for you I quite like that, my mental arithmetic is not great

nellie237 profile image
nellie237 in reply to TSH110

The only thing I didn't like about the scanners at 1st is that they do random manual scans (the screen will tell you at the check-out), and I felt a bit conspicuous standing there while my shopping was re-scanned by a shop assistant. These used to happen a lot more frequently than they do now, and mostly they only check about 5 items, rather than the whole trolley.

Years ago on the day I started a new job somebody's purse went missing. The person concerned was adamant that she'd had her purse with her (loudly implying that it must have been stolen in the office) because she'd used it to buy lunch. I felt bloody awful........nobody knew me........I'm going to be the prime suspect. 🙈 Having your shopping re-scanned feels a bit like that at first.

Later that day she got called by security to say that a gentleman had found her purse outside the office, seen her work pass, and handed it in.

TSH110 profile image
TSH110 in reply to helvella

What’s at the bottom of that dislike I wonder? It seems rather extreme! I feel the same way but I can’t say I detest them, I just don’t feel inclined towards them. I put it down to being so ill it was too much to cope with when I was first shown one. The way things are going we won’t need any of it - they know what you’ve taken and automatically deduct it from your card as you leave the shop in some places in London I read.

nellie237 profile image
nellie237 in reply to TSH110

Yes, I don't think I'd trust that.

TSH110 profile image
TSH110 in reply to nellie237

I never was any good at multitasking I’m a bit of a man in that department one task at a time in a pedestrian linear manner is all my brain could ever handle. I was really ill with hypo when I was shown those scanners but I was too ill to actually use one. I remember the shop assistants being really kind to me and helping me they must have realised I was struggling. I think it must have put me off those scanners - as if I see one I think oh no those aren’t for me…..but I’ve never actually tried to use one! It must be a negative association harking back to that time and boy was I poorly…..but that’s another story….I freak out in those MRI scanners I dont think I could go into one again once the magnets went off I felt absolutely fine. I found the sensations really disturbing like hurricanes were blowing through the bits they scanned very weird plus all those radom noises and being strapped down the claustrophobia which idiot thought I was a good idea ti shunt you towards the centre why not the other way round? Far less alarming… and it being seemingly interminable. That’s a machine I hope I avoid before I cocking up up my toes!

nellie237 profile image
nellie237 in reply to TSH110

Yes, I've heard MRI's are really horrid. "which idiot thought I was a good idea ti shunt you towards the centre why not the other way round?" Is it just because the poor doc has to learn how to rotate the image on screen?

I wouldn't recommend endoscopy without sedation either.......I vowed I'd never do that again.

TSH110 profile image
TSH110 in reply to nellie237

Not sure - I’ll ask a pal who operates one.

I had a barium enema once before it was all digital they gave me something to relax me - it really worked you got moved all over the place during the exam it was pretty horrible but I didnt greatly care on whatever it was they gave me - knock out drops! I hear endoscopy is even worse 😱 NDT would have sorted it too 🙄

nellie237 profile image
nellie237 in reply to TSH110

The answer might be interesting............just in case.

nellie237 profile image
nellie237 in reply to TSH110

Needless barium enema.......the things we have to endure. I had a barium meal years ago, which was not at all uncomfortable....hiatus hernia.

I had angioplasty for a blockage. I was quite relaxed waiting outside the cath lab........until the Cardiologist came out to see me to tell me that they intended to fit a stent (Yes, OK know that) but if they found they were unable to do so, that I'd be sent straight away for bypass..........My thoughts were "What, you're telling me this NOW......you couldn't have mentioned this earlier..........OK so now I'm really going to need that sedation I declined earlier" Angioplasty was a breeze.

helvella profile image
helvellaAdministrator in reply to nellie237

I've had both MRI and endoscopy without sedation!

Both bearable but the noise of the MRI does really get to you. And the endoscopy - well, not too bad except for my severe gag reflex!

The MRI scan viewers really are trivial to use.

I think they put you that way round so that if they have to pull you out they have your legs accessible already. A lot of MRIs are of the head and neck.

nellie237 profile image
nellie237 in reply to helvella

Yes, the gag reflex......and when they pump air in. Urgh! I had one last year with sedation, it's a totally different experience.

helvella profile image
helvellaAdministrator in reply to nellie237

At the end, they did write on ,my records "Very Severe Gag Reflex" :-)

But at least I could drive afterwards.

TSH110 profile image
TSH110 in reply to helvella

OMG how how does anyone bear to get their head scanned in one of those 😱 they’d have to knock me out! 🥊

helvella profile image
helvellaAdministrator in reply to TSH110

I thought it was going to be horrible due to the enclosed environment but that was quite easy to manage. There was a mirror above my head so I could see out. The noise was more difficult.

I also had something that is quite unusual - the visual effect known as magnetic phosphenes. Small spots of light dancing around.

TSH110 profile image
TSH110 in reply to helvella

Yes the noise is very disconcerting, then there’s the claustrophobia of it and being immobilised I suffer a lot from cramp and was thinking god please don’t get cramp the leg they trussed up started shaking towards the end I simply could not kept it still! My heart was pounding so much I thought I was going to have a heart attack! It just got worse and worse the longer I was in there no amount of telling myself millions of people have had an MRI scanner it’s just routine would calm my increasingly agitated state. But I think the magnetism itself affected me weirdly and most of all. The sensation of wind blowing through my knee was really disconcerting. It must be all the tissues reverting back to they’re correct polarity or initially being forced into something abnormal. It’s so clever how they get an image with it all those differential rates being turned into a scan it’s fantastically clever. Once it was shut off I felt absolutely fine. I had expected to feel awful for a short while after as I recovered from the experience but the horrible feelings and panic stuff stopped instantly. I believe horses are very sensitive to magnetism and other animals - plus this one 🤣🤣🤣 and only my legs were inside it!

helvella profile image
helvellaAdministrator in reply to TSH110

Do bear in mind that they blow air through to make sure the "tube" remains cool.

TSH110 profile image
TSH110 in reply to helvella

Oh that’s interesting perhaps that was why I thought there was a hurricane blowing through my knee! It was a pretty weird feeling. Do they blow it all the time or in bursts with the magnets powering?

helvella profile image
helvellaAdministrator in reply to TSH110

That I don't know. I suspect all the time - though the rate of air movement might change.

TSH110 profile image
TSH110 in reply to helvella

Apparently it varies to cool the chamber the magnets hot it up a lot, and the part being scanned is always moved towards the middle of the magnet.

TSH110 profile image
TSH110 in reply to helvella

I missed your visual effect, I don’t remember being told that might happen at least I escaped that one! Why does that happen is it something within the eye it affects?

Just looked it up - very interesting . I get phosphines if I stand up too quickly along with orthostatic blood pressure I’ve never actually keeled over but have felt pretty giddy.

I do wonder if it’s as safe as is claimed it’s a strange thing to do to a body, but only time will tell. Look at X-rays, röntgens hand and all that.

helvella profile image
helvellaAdministrator in reply to TSH110

I did look it up at the time and it seemed no-one was quite sure.

TSH110 profile image
TSH110 in reply to helvella

The magnetism is supposed to generate electricity in the retina that induces the lights according to what I read about it.

helvella profile image
helvellaAdministrator in reply to TSH110

I saw both that it was the retina and that it could be direct stimulation of parts of the brain.

TSH110 profile image
TSH110 in reply to helvella

Wow it’s pretty amazing isn’t it! Were they enjoyable? A relative had migraines but only got the visuals no headache. Said they were quite fascinating colourful pulsating triangles was one

helvella profile image
helvellaAdministrator in reply to TSH110

They were just like tiny orbs of light floating in space!

I also get visual migraines - sometimes they are pretty boring. But the odd time they are spectacular and almost exciting. :-)

There are many impressions of visual migraines posted around the internet and mine are pretty much "standard".

Just adding:

The phosphenes were actually not a million miles away from some of the scenes in Grave of the Fireflies:

en.wikipedia.org/wiki/Grave...

youtu.be/4vPeTSRd580

TSH110 profile image
TSH110 in reply to helvella

Rather pretty!

helvella profile image
helvellaAdministrator in reply to TSH110

And a very sad film - though I think it worth watching.

You can have music playing through earphones if you wish. I did for my first one and didn’t bother after that. Couldn’t risk listening to “The Windmills of Your Mind again”. It didn’t really mask the noise anyway.

helvella profile image
helvellaAdministrator in reply to AlicesMother

Never ending or beginning on an ever spinning reel

Surely makes it feel as if time is standing still?

Don’t think they chose to suit the occasion. They just had a CD. My OH used to work in a crematorium and one family had arranged for some music from The Platters. There was barely concealed mirth when Smoke Gets in Your Eyes boomed out as the deceased was laid to rest.

helvella profile image
helvellaAdministrator

Adding this - which shows I should have searched before posting!

A Robot May One Day Draw Your Blood

Scientists have developed a “venipuncture robot” that can automatically draw blood and perform lab tests, no humans needed

Emily Matchar

Innovation Correspondent

July 13, 2018

smithsonianmag.com/innovati...

Robotic Phlebotomist Draws Blood, Automates Hematology Analysis

February 10th, 2020

medgadget.com/2020/02/robot...

My first thought on reading your post was “hmmm, maybe not…”🤔 But then I read the articles and changed my mind. The only concern I would have would be the force needed to punch the needle into a vein located by ultrasound, presumably a little deeper than the usual site. I guess a little local anaesthetic cream might solve that…

Heard of a good film on this subject. Drop Out. True story about Elizabeth Holmes. Quite futuristic when you consider fingerprick testing

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