機器人有望接管手術室（節選）

????弗蘭克?克萊門特只瞄到了那臺機器人一眼。手術室的護士在除去他胸前的體毛后，問他是愿意直接接受麻醉，還是想先看一眼那臺等下會進入他體內，在他胸腔下方確定方位，切開患處，燒灼傷口，然后再將兩條動脈縫回他心臟的機器?？巳R門特想看看那臺機器。那是一臺蒙在塑料布下的機器人，四只帶有關節的手臂全部收攏在它的軀干前。再過幾個月，克萊門特就要迎來他的71歲生日了，而把自己托付給這樣的一臺裝置，讓他充滿了一種未來主義感。他為之心馳神往。接著，他感到有股溫熱感流遍全身——麻醉劑注入了他的體內——繼而陷入了藥物誘發的昏睡之中。

????克萊門特的身體被一件藍色的大褂蓋了起來，胸部在用來擴充腹腔的二氧化碳泵入下鼓脹了起來，皮膚則在術前準備時涂上的數層消毒劑下呈現出一種不自然的黃色。外科醫師埃里克?里爾捉起一把手術刀，在克萊門特的胸腔一側迅速做出了三個切口，切口緩緩張開，但是幾乎沒有流什么血。里爾將三支金屬管（專業術語叫作“套管”）分別置入三處切口內，轉動著插入胸腔，直到固定好位置為止。一名護士將那臺機器人推到了手術臺前，停放在病人的身體一側，然后握住它的機械臂，將它們拉到了克萊門特的上方；與此同時，另一名護士則將一只攝像頭、一部燒灼器和一把鉗子分別固定在機器人的幾只機械臂上。

????手術室內的一角，距離克萊門特約20英尺處，兩臺相當于冰箱大小的控制臺上，播放著克萊門特胸內的攝像頭傳回的影像。里爾在控制臺前坐了下來，身體前傾，雙眼在其中的一面顯示屏上凝視了一瞬，接著便將雙手伸入了控制臺內。之后，他讓我坐在了另一臺控制臺前，方便我觀察他的操作。

????外科手術領域的進步通常集中在如何改進手術本身的基本原理上——切開病人的身體來治愈患處。組織受到的損傷越小，患者痊愈得就越快——術后恢復所需的時間也更短，開支也更小。這在醫護界叫作“減少下游成本”，也正是這一因素驅使各大醫院不惜斥資200萬美元引入各類手術器械。外科醫師作為醫護界中要求格外嚴格的一支隊伍，早已采用了大量的機器人。來自醫療界的購入成為關鍵驅動因素的同時，病患也在帶動著這方面的需求?！夺t療品質學刊》（Journal for Healthcare Quality）去年發布報告稱，有41%的醫院網站都在宣傳機器人手術；其中又有31%在網站首頁上就有相關內容。備有機器人的醫院逐漸吸引了更多患者前來就診，部分醫院甚至因為采用機器人而直接促進了手術完成次數的增長。美國癌癥協會（American Cancer Society）開展的一項研究發現，根治性前列腺切除手術的完成次數在過去10年里出現了“顯著增長”，還有患者專程從外地遠途趕來找機器人做手術?，F如今，有五分之四的前列腺切除手術都是由機器人完成的。結果導致整個行業的發展面臨拐點。機器人“攻陷”手術室后，醫院、醫生、病患三方均在爭相適應著這一新興技術。

????Frank Clement glimpsed the robot only once. After the operating room attendant finished shaving his chest, she asked him if he wanted to be knocked out or if he would like to see the machine that would soon be inside him, navigating the space beneath his rib cage, cutting and cauterizing, and then sewing two of his arteries back into his heart. Clement wanted to see the machine. It was draped in plastic, its four jointed arms folded back toward its body. In a few months Clement would celebrate his 71st birthday, and the idea of submitting to such a device felt futuristic. He was fascinated. Then he felt a warm rush all over -- the anesthesia kicking in -- and he fell into a deep, drug-induced slumber.

????Clement's body disappeared under a blue smock, his chest swelled from the CO2 pumped in to keep it expanded, and his skin appeared an unreal yellow from layers of disinfectant painted on pre-op. The surgeon, Eric Lehr, grasped a scalpel and made three quick incisions on either side of Clement's rib cage, the cuts blooming open but hardly bleeding. Lehr placed three metal tubes, called cannulas, into the three wounds, twisting them into the chest until they were planted. An attendant wheeled the robot over to the operating table, positioned it alongside the patient, and took hold of the robot's arms, extending them over Clement while an assistant connected a camera, a cauterizer, and a clasping tool to three of the robot's appendages.

????In a corner of the room, some 20 feet from Clement, two consoles the size of refrigerators displayed video feeds from a camera in Clement's chest. Lehr took a seat and leaned forward, staring at one of the screens for a beat before slipping his hands into the controls. Then he offered me a seat at the next console so that I could watch him work.

????Advances in surgery usually attempt to ameliorate surgery's essential nature: cutting someone to cure him. The less severe the tissue damage, the faster the patient heals -- less time in recovery, less money spent recovering from the wounds. In health care this is known as "lowering the downstream costs," and it is what is driving hospitals to invest $2 million a pop for surgical machines. Surgeons -- a particularly exacting bunch -- have adopted robotics in droves. While physician buy-in is crucial, patients are also driving demand. Last year the Journal for Healthcare Quality reported that 41% of hospital websites advertised robotic surgery; of these, 37% did so on their homepage. Hospitals with robots are pulling in more and more patients, and in some cases, the existence of the robot actually increases the number of surgeries performed. A study conducted by the American Cancer Society found that the number of radical prostatectomies has "risen substantially" in the past decade, and patients travel great distances to be operated on with a robot. Today, four out of five prostatectomies are performed with a robot. The result is an industry at an inflection point. Robots have arrived, and hospitals, doctors, and patients are scrambling to adapt to this new technology.