巍生谈 2019-01-12 20:34:27




“Oh, God, please don’t let me trip over anything.”


That’s my first thought as I tiptoe around the electrical cords snaked across the operating room floor. It’s an early October morning at the Long Island Jewish Medical Center in New York. I’m decked out in a onesie-style baby blue protective suit, a hair mat, a bonnet to cover my beard, an additional mask for my mouth, and booties over my shoes.


None of this is designed for agility. It’s meant to protect the patient lying on the table less than five feet away from me. His exposed torso is peppered with small holes through which cancer surgery specialist Dr. James Sullivan and his team insert their medical instruments.

然而这间手术室里除了苏利文医生之外还有另一位主刀医师,只不过这位医生穿得比我们任何人都舒服些。它的中央吊杆和白色的手臂上戴着塑料的“袖套”,这位医生就是Intuitive Surgical公司的“达芬奇Xi”机器人手术系统了。乍一看还真不好说这里谁说了算。 

As it happens, there’s another surgeon in the room beside Sullivan—one more modestly garbed than either of us. Wrapped in plastic sleeves that cover its central boom and sprawling white arms is Intuitive Surgical’s da Vinci Xi robotic surgery system. It’s hard to tell who’s in charge


The instruments inside the patient include three separate, interchangeable components that can slice, shift, grasp, cauterize, or otherwise manipulate human tissue, as well as a movable high-definition camera that illuminates the body’s internal landscape in stunning 3D clarity. That’s a visual advantage that Sullivan says has revolutionized how doctors perform minimally invasive surgery—the kind that doesn’t require chopping someone open to remove a body part or collect samples.


Sullivan makes his way to a console on the left side of the OR, where he takes a seat in front of a viewfinder that looks like it belongs in a futuristic video game arcade. He places his middle fingers and thumbs into two pairs of rings on two movable arms. At the console’s floor are foot pedals, which function like a clutch in a manual car. With his fingers and feet, Sullivan will navigate the four instruments now inside the patient’s body—alternating between the pincer-laden surgical extensions and a 3D endoscopic camera. 


Over the next few hours, he’ll use the da Vinci to cut out a lymph node from the patient (who suffers from lymphoma) for lab testing.


Two hours later, I ask Sullivan how long it will be before the patient is discharged from the hospital. 


“Where do you live?” he asks.


“Bushwick, in Brooklyn,” I reply.


Sullivan chuckles. “He’ll be home before you.”

科幻作品中历来不乏机器人医生的身影。虽然我们离“有病找安卓”的日子还有很远,但机器人参与手术却已经不是什么新鲜事了——当然,如果你不是外科医生的话,或许会觉得挺震惊的。加州森尼维尔市的Intuitive Surgical公司的机器人手术系统早在2000年就率先获得了美国FDA的批准,不过它的流行却还是最近几年的事。很多外科医生表示,该系统使他们能更清楚地看到病人体内的情况,同时也能对医疗器械进行更好的控制。 

Futurist culture has no shortage of fever dreams starring robot doctors. This story isn’t about that. While we’re still a ways from the day when androids become our go-to physicians, robotic surgery is already commonplace—and probably surprisingly so, if you don’t happen to be a surgeon. Intuitive Surgical (ISRG, -0.51%) , headquartered in Sunnyvale, Calif., got the first-of-its-kind clearance for its robotic surgical system from the Food and Drug Administration back in 2000. But it has been largely in the past few years that its machines have exploded in popularity. Surgeons who tout the tech say it’s given them a far clearer view of what’s happening inside the body and greater control over their instruments.

Intuitive Surgical 的设备现在已经广泛应用于美国所有的顶尖医院中,其应用领域涵盖了肿瘤科、泌尿科、妇科、消化科等等,美国许多顶尖医疗机构和院校,如纽约的纪念斯隆凯特琳癌症中心、梅奥诊所、约翰霍普金斯大学和克利兰医学中心等都采购了该公司的机器人手术设备。截止到今年6月30日,全球已有4100多台达芬奇系统投入使用,其中有2,703台在美国,698台在欧洲,538台在亚洲,还有210台分布在世界其他地区。

Intuitive’s devices are now used at all of the top-ranked U.S. hospitals for cancer, urology, gynecology, or gastroenterology—including venerable institutions like New York’s Memorial Sloan Kettering Cancer Center, the Mayo Clinic, Johns Hopkins, and the Cleveland Clinic. More than 4,100 da Vinci base units have been installed worldwide as of June 30, including 2,703 in the U.S., 698 in Europe, 538 in Asia, and 210 in the rest of the world.


The systems aren’t cheap: The list price for the fourth-generation da Vinci Xi is $1.9 million, and that doesn’t include the cost of various surgical appendages, which can add tens of thousands of dollars more to the price tag. Still, the robots keep selling—and surgeons are increasingly adopting them in their practices.


The company says that more than 4 million minimally invasive surgeries have been performed with da Vinci systems since 2000—a new one begins every 42 seconds somewhere around the globe, Intuitive CEO Gary Guthart tells Fortune. The number of those procedures done worldwide spiked 15% in 2016 compared with the previous year, and Intuitive pro¬jects an additional 14% to 15% rise in the number by the end of 2017. Indeed, for certain more complicated procedures, such as radical prostate removal, robotic-assisted surgeries now account for nearly 90% of operations.

随着机器人外科医生的普及,2016年,Intuitive Surgical公司的全球营收入达到了27亿美元,其中有超过70%的销量是自然形成的,这也突显了该公司在这一快速增长的市场上作为先行者的优势。 

The boom has driven Intuitive to $2.7 billion in 2016 global revenue, with more than 70% of sales being recurring in nature—a fact that underscores the advantage that comes from being the first major player in a rapidly growing market.

达芬奇系统的火爆也吸引了投资人的关注。2017年,Intuitive Surgical公司的估值已经暴涨了70%,其市值已经接近400亿美元大关。

That’s been a draw for investors too; in 2017 alone, Intuitive’s valuation has soared more than 70%, pushing its market capitalization near the $40 billion mark.

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