YouTube is a great educational resource. By watching a few videos, one can learn just about anything, from how to tie a fancy knot to how to assemble an internal combustion engine. The website also features numerous videos concerning various do-it-yourself medical procedures. Recently, my colleague Amy Foust and I viewed a fascinating video about an inexpensive surgical robot built by Designer Frank Kolkman using off-the-shelf components and easily accessible technologies like 3-D printing and laser cutting. This got us thinking: Is do-it-yourself surgery using homemade robots really a good idea?
Mr. Kolkman’s robot took about five months to develop and cost roughly $5,000. Its arms are 3-D printed and its electronics, which control its various motors, are essentially the same as those that drive traditional 3-D printers. Other parts were sourced online, and a PlayStation 3 controller is used for guidance.
According to its creator, the robot is theoretically capable of performing lower abdominal keyhole surgery. However, the point of the build is not to have it perform real surgeries but, rather, to provoke alternative ways of thinking of medical innovation by taking it outside its current socioeconomic framework. Mr. Kolkman explained that the robot serves as an experiment in “open surgery,” which questions whether do-it-yourself surgical tools outside the scope of regulated healthcare systems could plausibly provide more accessible healthcare.
Obviously, there are some benefits to having the ability to quickly and cheaply build a surgical robot. One such benefit is the nearly endless possible customization to meet specific patients’ needs. Another is the creation of specialized equipment that would not otherwise be manufactured because it would never be sufficiently popular or profitable to justify the expense of mass medical device production. And, of course, open surgery would—at least in theory—make healthcare more accessible to certain populations.
However, with these benefits also come a plethora of potential downsides. One major disadvantage is the lack of safeguards like those in the traditional regulated healthcare system. Because science values repeatability and limit testing, before a new medical device is released for public consumption through the regular development pipeline, benchtop and/or clinical testing help identify the device’s limitations and contraindications. Open surgery, on the other hand, would allow users to sidestep these important regulatory safeguards and turn themselves and others—including members of vulnerable populations like children and the elderly—into guinea pigs.
Another drawback is the increased risk of unmanageable complications during surgery. Since end users would likely have little to no formal medical training and an extremely limited response capability, their chances of successfully addressing complications decrease substantially. And add to this mix the strong possibility that some end users may operate on themselves while under the influence of painkillers and while experiencing heavy blood loss, and you’re left with a recipe for disaster.
Finally, there are significant risks even if the surgery is 100 percent successful. Using a homemade robot would likely constitute the unlicensed practice of medicine—a third degree felony in Florida. See Fla. Stat. §458.327. And although penalties for practicing medicine without a license can vary from jurisdiction to jurisdiction, those convicted generally face prison sentences ranging from one to eight years.
This is by no means an exhaustive list of all the downsides and legal issues associated with do-it-yourself surgery. And though people aren’t yet going under the scalpel of homemade robots, technology is rapidly advancing and it’s only a matter of time before they start. So brace yourselves. Because when that time comes, our regulatory and judicial systems will face new challenges unlike anything we’ve ever seen before.