Summary: Underlying the technical discourse is a philosophical inquiry into the role of machines: Should they mimic human actions or transcend them? Is precision enough, or must adaptability be preserved?
Conversational transcripts:
[22/10, 17:57]huv1: We are the provider of the drug interaction checker/CDS by the name of CIMS/MIMS Integrated. In India almost major corporate hospitals use our solution . More than 20K hospitals use our solution across Asia -Pacific
[22/10, 17:57]huv1: https://cds.mims.com/
[22/10, 17:57]huv1: You can get in touch with us for more details.
[23/10, 12:53]huv2: Couple of questions. One. Are the contents mapped to SNOMED CT (CDCI as extension). Two. What are the costs involved?
[23/10, 13:38]huv1: Sir, the work on SNOMED CT mapping is currently in progress. We plan to launch it first for Australia, followed by India. At present, ICD-10 is being used for Drug–Health /Disease alerts.
[23/10, 13:54]huv2: Okay.
And the costs involved?
[23/10, 14:07]huv1: Sir, the annual subscription fee depends on the number of modules subscribed, as well as the number of beds and sites. I will share the detailed information with you shortly.
[23/10, 14:20]huv2: Sure. Most digital systems would work on a per user basis. Number of beds and sites mean the model is facility driven.
[23/10, 18:02]huv2: Fascinating post by a college classmate…
[23/10, 18:23]hu3: So robotic surgery has so many other goodies apart from the precision that it was meant to deliver?
This will then justify the huge Capex sunk into it
[23/10, 18:40]hu4: Just my (unsolicited) 2cents to this:
Robotic surgery, insofar as orthopedic surgery (i refer here predominantly to THA, THR and Robotic Pedicle Screw Insertion) is concerned seems to be mostly gimmickry.
It definitely:
- Provides an increased 'feeling' of security
- A harder boundary for the margin of error
- Slightly faster turnaround for the patient
- lesser blood loss, faster TAT, perhaps less pain, earlier mobilization
But nothing that a reasonably thoughtful and experienced surgeon (say someone who has done ~100 of these procedures each) can't achieve by herself.
Also, in all humility, I feel, it disincentivizes adaptability. One starts running away from those super-complex cases (40 degree valgus etc) instead of seeking them out.
Happy to receive brickbats for this opinion.
[23/10, 18:42]huv2: Needless to say, I completely disagree. I reject the notion in its entirety.
[23/10, 18:42]hu4: That said, there are specific cases where it makes the patient's and the surgeon's life slightly easier:
Deformity correction in spine, skull base fixations and the like.
[23/10, 18:44]hu5: Any machine is supposed to be used to overcome difficult conditions for humans. If the humans are far better already, machines may not help. Whether AI or Robotics - both are best applied to overcome human limitations rather than trying to mimic actions which the humans do better.
[23/10, 18:46]hu4: Till the time it becomes less capex heavy, I remain guardedly skeptical.
(except for the specific instances I mentioned).
Hopefully, with the pace of innovation, we are soon going to enter an era of sustainable arthroplasties and pedicle screw insertions. I look forward with anticipation for that day.
[23/10, 18:46]hu6: There is a lack of meta analysis level of evidence of robotics used to perform various surgeries, though each robotics surgery has different maturity levels across the hospitals to make real world impact and outcomes combining the advancement of robotics and surgeons adaptation over the period of time
[23/10, 18:48]hu4: +1
Ultimately, in the balance of things, the net RoI is a function of the technological maturity of the solution, the indication for which it is used, the ecosystem in which it is being used etc.
[23/10, 19:44] hu3: I was told it is for areas where human wrist can't twist and turn. Like pelvis and prostate or chest mediastinum. The robot spins on 7 axes...I know x y z. How do you get another 4
[23/10, 19:52]hu4:
3 rotational, and 3 translational sir.
The remaining one I am not aware of.
My comments are specific to ortho.
Though my colleagues in Urosurgery might be more positive, especially those doing, as you mentioned, Prostrate, abdo onco, nephron sparing surgeries etc.
[23/10, 19:56]hu4: On a techno-philosophical note, the idea of “robotics” takes on distinctly different meanings across surgical domains.
In abdominal surgery, it functions primarily as a motion reproducer, a precise mechanical extension of the surgeon’s intent, filtering out tremor and minimizing other glitchy actions etc.
In contrast, in orthopedic surgery, robotics serves more as a boundary setter and plane definer, a system that establishes the geometric framework and navigational pathways within which the surgeon operates.
[23/10, 20:21]hu5: Surgical robots have varying *degrees of freedom (DOF)*, with common systems having 6 or 7 DOF to replicate human wrist and hand movements. A 6-DOF system provides motion in six directions—three for translation (up/down, left/right, forward/backward) and three for rotation (roll, pitch, yaw).
Adding a seventh DOF is typically achieved through a robotic instrument's articulated "wrist" that can mimic the surgeon's hand movements, allowing for more precise and flexible manipulation within the body.
*6-DOF*: This is the most common configuration, representing the six independent movements of the human hand and wrist:
*Three translational movements (moving forward/backward, up/down, and left/right)*
*Three rotational movements (pitch, roll, and yaw)*
*7-DOF:* This is achieved by adding a seventh "degree of freedom" with an articulated instrument tip, such as a robotic "wrist" that can bend and twist. This allows the robot's tool to perform the *same complex actions as a human hand and wrist, such as grasping and cutting.*
[23/10, 20:23]hu5: *Surgical robots are best suited for complex and minimally invasive procedures, particularly in urology, gynecology, and general surgery*. Common applications include prostatectomies, hysterectomies, gallbladder removals, and various colorectal and thoracic surgeries. The precision and dexterity offered by robotic systems are ideal for delicate operations involving narrow spaces, sensitive organs, and complex anatomical structures.
[23/10, 20:25]hu4: Wow, fascinating, sir!!
Thank you for the detail.
[23/10, 20:29]hu4: Also, just as a theoretical aside, are the degrees of freedom then multiplicative or additive for joints placed serially?
e.g. a robotic joint with 6 deg of freedom coupled to another serial joint with another 6 degrees of freedom would offer 12 or 36 degrees of freedom?
(though, from an engineering standpoint, I'm assuming, it would be super-overkill).
[23/10, 20:48]hu5: No, the movements will remain in the same planes/axes - total will always be 6 or 7 as per the design(s).
[23/10, 20:52]hu5: To give another example, Magnetoencephalography (MEG): *6-axis MEG sensors* The "6-axis" term for a magnetometer in an MEG system refers to its ability to measure magnetic fields and field gradients, specifically *three axes of magnetic field measurement (\(B_{x},B_{y},B_{z}\)) and three axes of magnetic field gradient measurement (\(dB_{x}/dx,dB_{y}/dy,dB_{z}/
These gradiometers are more sensitive to nearby magnetic sources, improving spatial localization.
[23/10, 20:58]hu4: beautiful! ❤️
So, when we differentiate this field vector matrix, we would get the Hessian?
[23/10, 21:00]hu4: Never realized there was such a degree of nuance to this seemingly simple concept.
I'll make sure the next time you are teaching this, I'll grab a seat and listen 🫡
[23/10, 21:07]hu4: And the field grad. would then help us calculate the originator source?!
without needing to directly measure it?
To give a very fragile analogy then, sort of like a magnetic echolocation?
[23/10, 21:07]hu7: I am fascinated with magnets. But when I play with them for sometime, it kinda makes me fuzzy in the mind.
[23/10, 21:10]hu4: My 'fuzzy' is current electricity.
I have simply never understood how we arrive at an equivalent config in a star <--> delta config.
CC licence: https://commons.
Here's a comprehensive summary and thematic analysis of the conversation titled:
---
*🧠Summary: "UDLCO CRH: Degrees of Freedom in Cognitive Embodiments Engaged in User-Driven Robotic Surgery"*
*🔑 Key Concepts & Terms*
- *Robotic Surgery*: THA, THR, pedicle screw insertion, prostatectomy, skull base fixation
- *Degrees of Freedom (DOF)*: 6-DOF and 7-DOF systems, translational and rotational axes
- *Cognitive Embodiment*: Surgeon-machine interaction, adaptability, motion reproduction
- *Clinical Decision Support (CDS)*: CIMS/MIMS, SNOMED CT, ICD-10 mapping
- *Technological Maturity*: Capex concerns, ROI, surgical domain specificity
- *Neurotechnology*: Magnetoencephalography (MEG), magnetic field gradients, Hessian matrix
- *Philosophical Reflections*: Human-machine boundaries, surgical ethics, techno-skepticism
---
*🎯 Thematic Analysis*
*1. Human vs Machine Capabilities*
The dialogue explores whether robotic systems truly enhance surgical outcomes or merely replicate what skilled surgeons already achieve. While some argue robotics offer marginal gains (e.g., reduced blood loss, faster recovery), others question their necessity in routine procedures.
> *Theme*: _Augmentation vs redundancy_
*2. Degrees of Freedom as a Cognitive Extension*
The discussion on DOF highlights how robotic systems mimic human wrist and hand movements, enabling complex manipulations in constrained anatomical spaces. This is framed as a form of embodied cognition—where the robot becomes an extension of the surgeon’s intent.
> *Theme*: _Embodied cognition in surgical robotics_
*3. Domain-Specific Utility*
Robotics are perceived differently across specialties. In orthopedics, they serve as geometric boundary setters; in abdominal surgery, they act as motion reproducers. This duality reflects how technology adapts to the cognitive and physical demands of each field.
> *Theme*: _Contextual embodiment of technology_
*4. Evidence and Skepticism*
The lack of meta-analytic evidence and high capital expenditure (Capex) fuels skepticism. Participants call for more robust data to justify the investment, especially in routine procedures.
> *Theme*: _Evidence-based adoption vs techno-optimism_
*5. Neuropsychiatric Parallels*
The conversation veers into neurotech, drawing analogies between MEG sensors and robotic DOF. Concepts like magnetic field gradients and Hessian matrices evoke parallels with cognitive mapping and source localization—suggesting a convergence of surgical robotics and neuroimaging.
> *Theme*: _Neurocognitive modeling in surgical systems_
*6. Philosophical Reflections*
Underlying the technical discourse is a philosophical inquiry into the role of machines: Should they mimic human actions or transcend them? Is precision enough, or must adaptability be preserved?
> *Theme*: _Techno-philosophy of surgical embodiment_
---
Copilot summary above.
Perplexity summary below:
### Summary
This conversation transcript captures a multi-threaded discussion among healthcare professionals on clinical decision support tools and robotic surgery advancements. It begins with a promotional pitch for CIMS/MIMS drug interaction software used in Asian hospitals, including queries on SNOMED CT mapping and pricing, then shifts to debating the value of robotic systems in orthopedics, urology, and beyond, exploring their precision, ROI, and limitations.
**Key Words:** Robotic surgery, degrees of freedom (DOF), SNOMED CT, ICD-10, drug interaction checker, orthopedics (THA, THR, pedicle screws), CapEx, ROI, precision, adaptability, urology (prostatectomy), MEG sensors, human limitations, technological maturity.
### Thematic Analysis
The dialogue blends practical healthcare tech adoption with philosophical inquiry into human-machine augmentation.
**Technology in Medicine** dominates, contrasting software tools like CIMS for diagnostics with robotics' role in overcoming surgical constraints (e.g., 7-DOF for wrist-like maneuvers in tight spaces), while questioning over-reliance in routine cases like orthopedics versus benefits in complex urology or spine procedures.
**Skepticism vs. Optimism** emerges through debates on gimmickry, cost-effectiveness, and evidence gaps (e.g., lack of meta-analyses), highlighting tensions between innovation's promise and real-world ROI.
**Educational Exchange** runs throughout, with technical explanations (e.g., translational/rotational DOF, field gradients in MEG) fostering curiosity, underscoring themes of adaptability, human expertise, and ethical tech integration in surgery. Overall, it reflects a forward-looking yet cautious view on AI/robotics enhancing, not replacing, skilled practitioners.
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