机器人有望接管手术室（节选）

    弗兰克•克莱门特只瞄到了那台机器人一眼。手术室的护士在除去他胸前的体毛后，问他是愿意直接接受麻醉，还是想先看一眼那台等下会进入他体内，在他胸腔下方确定方位，切开患处，烧灼伤口，然后再将两条动脉缝回他心脏的机器。克莱门特想看看那台机器。那是一台蒙在塑料布下的机器人，四只带有关节的手臂全部收拢在它的躯干前。再过几个月，克莱门特就要迎来他的71岁生日了，而把自己托付给这样的一台装置，让他充满了一种未来主义感。他为之心驰神往。接着，他感到有股温热感流遍全身——麻醉剂注入了他的体内——继而陷入了药物诱发的昏睡之中。

    克莱门特的身体被一件蓝色的大褂盖了起来，胸部在用来扩充腹腔的二氧化碳泵入下鼓胀了起来，皮肤则在术前准备时涂上的数层消毒剂下呈现出一种不自然的黄色。外科医师埃里克•里尔捉起一把手术刀，在克莱门特的胸腔一侧迅速做出了三个切口，切口缓缓张开，但是几乎没有流什么血。里尔将三支金属管（专业术语叫作“套管”）分别置入三处切口内，转动着插入胸腔，直到固定好位置为止。一名护士将那台机器人推到了手术台前，停放在病人的身体一侧，然后握住它的机械臂，将它们拉到了克莱门特的上方；与此同时，另一名护士则将一只摄像头、一部烧灼器和一把钳子分别固定在机器人的几只机械臂上。

    手术室内的一角，距离克莱门特约20英尺处，两台相当于冰箱大小的控制台上，播放着克莱门特胸内的摄像头传回的影像。里尔在控制台前坐了下来，身体前倾，双眼在其中的一面显示屏上凝视了一瞬，接着便将双手伸入了控制台内。之后，他让我坐在了另一台控制台前，方便我观察他的操作。

    外科手术领域的进步通常集中在如何改进手术本身的基本原理上——切开病人的身体来治愈患处。组织受到的损伤越小，患者痊愈得就越快——术后恢复所需的时间也更短，开支也更小。这在医护界叫作“减少下游成本”，也正是这一因素驱使各大医院不惜斥资200万美元引入各类手术器械。外科医师作为医护界中要求格外严格的一支队伍，早已采用了大量的机器人。来自医疗界的购入成为关键驱动因素的同时，病患也在带动着这方面的需求。《医疗品质学刊》（Journal for Healthcare Quality）去年发布报告称，有41%的医院网站都在宣传机器人手术；其中又有31%在网站首页上就有相关内容。备有机器人的医院逐渐吸引了更多患者前来就诊，部分医院甚至因为采用机器人而直接促进了手术完成次数的增长。美国癌症协会（American Cancer Society）开展的一项研究发现，根治性前列腺切除手术的完成次数在过去10年里出现了“显著增长”，还有患者专程从外地远途赶来找机器人做手术。现如今，有五分之四的前列腺切除手术都是由机器人完成的。结果导致整个行业的发展面临拐点。机器人“攻陷”手术室后，医院、医生、病患三方均在争相适应着这一新兴技术。

    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.