Everybody’s talking robotics. But robots are built to do one task w/precision, need simple, consistent anatomy to operate surgically, like w/cholecystectomy. This brain AVM extends from cortex to ventricle, is supplied by convexity arteries + deep perforators, sits next to motor strip. Good luck Optimus….

Cholecystectomy and "consistent anatomy" are not words that ever belong together.

Gen surg is rightfully mad at this post. There are a ton of anatomic variants relevant to chole. Only -60% of hepatic arteries are textbook, so individually rare variants are v common in aggregate. Also several common biliary variants. Terrible example of consistent anatomy.

Brain surgeons be like ALL OTHER SURGERY IS SIMPLE WITH ZERO ANATOMICAL VARIATION

Watch this #SevenSeries video showing this bifrontal craniotomy, transsulcal approach, resection of precentral arteriovenous malformation, on our website @BarrowNeuro by clicking on this link… @PrecisionNeuro_

Wow. This will not age well. And I’m just a plumber….until we as a profession learn that pushing others down to feel lifted up confirms stereotypes and distracts from WHY we chose any surgical specialty….we will continue to lose. Do better Sir.

How many cholecystectomies have you done?

Cholecystectomy be like-"why always me!?"

biliary anatomy is incredibly variable. this is why nobody likes neurosurgeons

Good luck for all who are going to be operated by Optimus.

That cholecystectomy comment… i’ve done quite a few bile duct injury repairs thanks to this simple consistent anatomy you speak of.

I think the predictions (for example from Elon Musk) that robots will replace surgeons within 5-10 is absolutely insane. In my opinion, the predictions come from a gross misunderstanding of surgery and physiology.

Not correct. Trust me. I’ve done thousands Biliary anatomy × cystic duct × hepatic arteries × portal vein = ~2,500 potential anatomical combinations And that’s before adding cystic artery variants No two cholecystectomies are truly the same Video: stone in distal cystic duct

I worry this is a short-sighted, incumbent perspective that will hurt us. Today is the absolute worst this technology will ever be. We neurosurgeons need to take profound leadership of the tech (as we usually do) The next 10 years of our lives will be defined by how we interface with embodied autonomous systems I recently wrote about what autonomous vehicles need to learn from healthcare, in @NoemaMag. Cars are just the furthest ahead.

There is no standard biliary anatomy, anomalous anatomy is more common than what regarded as "standard".

@Unneurocx @Tesla_Optimus

🧠 Complex anatomy is where robotics should assist—not replace—the surgeon’s judgment.

I never tire of watching you work

Short to mid term no. Long term yes

I don’t know what you are trying to prove. Yes, surgical robots today are for specific defined tasks. They have nothing to do with the field of physical AI and where it is going. Amazes how shortsighted some people are.

Robots also do injure the common bile duct

Yeah I believe the future of robotics but there are fields that requires more time and this is one of those.

“Consistent anatomy like w /cholecystectomy”, obviously the gentleman has never dealt with the anatomy of severe cholecystitis ..!

Irrational exuberance.....

Dr. Lawton ,a very good point. The idea of using a robot in such complex brain surgeries might still be a long way off, or perhaps never become a reality.

Nothing you showed couldn’t be done better with (and with less tremor) on the robot.

A couple of examples regarding “simple, consistent anatomy”. I guess you need a brain problem to fix brain problems, make sense.

The meningioma surgery in the middle of my head should be performed by the logical-minded Mr. Michael T. Lawton MD and his experienced team rather than an AI robot. I should have looked around the world's current brain surgeons earlier. My mistake. I was naive. Sincerely: Vilmos

Anything a human can do, a robot with AI will eventually be able to do

👁️ this one’s interesting.

this is magic. thank you for your work doc

The thing about cholecystectomy is that no two are ever the same. This area of the body has some of the most variable anatomy in the human body. Most doctors probably learned this in anatomy as first year medical students. Looks like twitter is giving you a refresher.

The tremors we are seeing during the whole video would be avoided.

I wonder what Robert Spertzler's take is on this issue. I'm confident he'll be more on your side. Both of you inspired thousands of us to be good surgeons. Unfortunately, in the long run, physical AI with good actuators will have incredible dexterity to deal with complex cases.

How far off are robots that handle anatomy varying this much case to case? The gap looks less like hardware precision and more like perception and judgment in messy one-off situations. General purpose robots hit that wall long before the scalpel does.

Stay in your lane bud