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Great stuff Gator,

Your statements kept bringing to mind Clayton Christensen's (CC) innovation process. Disruptive innovations start at the low end, supported by your observation that robotic surgery is not better and has definite drawbacks for the surgeon. Robotic surgery is very new and not better, yet the buyers demand it, so they (the market) sees a value provided that is not yet recognized.

In his "The Innovator's Prescription" CC says that medical procedures are going the way of highly organized teams who do the same procedure over and over, perfecting it and optimizing it down to the finest points. It is a well supported argument in the book, and he thinks that this is one of the ways that medicine will be disrupted: fewer general surgery teams and more highly focused teams doing similar procedures over and over. It's kind of the way surgery has evolved any way. There was a time when all surgeons were general and now we have specialists in tightly focused areas.

Obviously the need for general surgery will never go away just because of the complexity of the body and all the possibly things that can be addressed by surgery. But surgical tools like MAKO offer the promise of surgical assistance that is repeatable and dependable, and in the future more extendable. I personally believe that in the future they will allow far more refined surgery than can currently be done. They will likely bring the benefits of microsurgery to every tissue everywhere in the body. They have a lot of work to do on the supporting procedures, but they have great promise for new surgical solutions that will be invented by the generation that is now being trained on robotic tools.

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