Now think about why Franca Melfi began to deal with robotic surgery, it has something paradoxical: in the early 90s, when medicine was still mainly a matter for men and the equivalence “great surgeon great cut” dominated, the operations in which robots could be involved they were not considered something to invest in in a particular way. So, it was the tacit equivalence that a woman also took care of it.
Today, of that surgery which is the present 5.
0 and will increasingly become the future, Professor Melfi is both a pioneer and an undisputed leader. First in the world to have performed a thoracic surgery of this type (in 2001, on a 54-year-old patient with lung disease), the first woman in Italy to preside over the Hurry (Italian Society of Thoracic Endoscopy), is Director of Minimally Invasive Thoracic Surgery and Multidisciplinary robotic center of the Aoup of Pisa. And we could add: coordinator of the Scientific Technical Committee of the Polo of Robotic Surgery of the Tuscany Region, university professor and award-winning researcher with international awards such as the Bio WomenTech, awarded to women engaged in biotechnology. In short, for having also started by virtue of an underground gender discrimination, it could be said that Professor Melfi is doubly an example and a stimulus in the context of technological innovation.
How can robotic surgery be described to the layman?
«In the collective imagination in the operating room the surgeon stands next to a table on which the patient is lying, with the anesthetists behind him and all around the instrumentalists who pass the irons. In the surgery we are talking about, however, the surgeon is not next to the patient but is distant, in a sort of control room, from which he is connected through a console to small robotic arms, cannulas, which in turn move measuring instruments. less than one centimeter. The surgeon therefore has a sort of prosthesis on his hands, but the tools are the same: scissors, forceps, scalpels. There is the possibility of sewing and so on ».
In terms of minimally invasive and precision the advantages are evident. Is there a downside?
“From my point of view of course there are only advantages. I would add that when I started practicing this type of surgery the machines were – compared to now – rudimentary: at the time we did not even know all the potential of the instrument, and at the beginning I was struck above all by the immensely expanded vision, which for the kind of surgery that I perform (in the chest, next to vital organs) is essential. But the strengths are not only in the micro-invasiveness and in the amplified view, but in the fact that with this type of machines it is possible to perform very complicated interventions with a much more complex precision and ability to “look”: in addition to the downscaling movements c ‘is the fact that, for example, various possible complications can be foreseen and thus prevented. Precisely on this front the improvements will be continuous and the accuracy ever greater ».
Does the human factor matter? And concretely how the relationship between traditional and robotic surgery will be modulated Artificial Intelligence and digital surgery?
«The human factor is always decisive, of course. However, we are in command of the machine. Furthermore, we will never completely forget the use of the scalpel, and we must clarify that doing robotic surgery does not mean not doing open surgery: the gestures are identical, and the same vision of anatomical relationships is needed. One of the most interesting areas to investigate – and which engineering colleagues who are experts in AI deal with (Artificial Intelligence, ed) – is precisely what concerns the interaction between natural and artificial intelligence, between man and machine: the concrete way in which they enter into relationship, starting from the brain areas that are activated. On my own, I can see its enormous potential: in a very short time the integration with robotics will be complete. Probably I imagine, in the near future, to be able to do for example in the operating room through the use of AI simulation and training. But simulating surgery also means, as we mentioned earlier, seeing the difficulties, being able to plan it and be able to prepare for complications. By integrating all these tools in the operating room, we will be able to offer the highest quality to patients, because that’s what we are talking about “.
And speaking of training instead?
«It is clear that quality of surgery and training go together. In this regard, I would cite some data published by Lancet a few years ago: even considering basic surgery alone (I emphasize, basic: we are not talking about sophisticated interventions and robotics) we have enormous difficulties worldwide in covering the necessary interventions on over 2 million people. And even the surgeons that should be trained are several zeros higher than the current ones. I believe that through robotics, also understood as the possibility of training and operating remotely (because with 5G, which practically eliminates latency times, today it is possible) we could reduce the gap that exists both in providing care and in training. In this regard, I would like to say a few words apart on the possibilities of gender training: recently I was invited to speak at a conference organized by my colleagues in Kuwait, and there as in the entire Gulf area, and in many other areas of the world, access to training for women is a problem. Here, robotics and the remote offer unique possibilities also from this point of view ».
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