MILAN, Italy; April 1, 2017: Gastroenterologists rejoice! Innuendo Technologies has finally announced that long-awaited FDA approval of the di Michelangelo robot is expected early this spring! The di Michelangelo® System is the first robotic platform designed specifically to perform fecal disimpaction. Before we delve into what this means, a little history behind the robot is needed: Surgical robots were developed in the 1990s but didn’t receive FDA approval for use until 2000. Usually reserved for delicate surgery in hard-to-reach areas of the body (e.g.: prostate removal), the robot is controlled by a surgeon using a console that can be placed far away from the patient but allows precision control of the robot’s tiny operating arms inside the human body. Currently, robotic platforms cost about $2 million each, and increase the cost of surgery by several thousand dollars when compared to traditional laparoscopic procedures.
The di Michelangelo Robotic Disimpactor 5000, shown with standard da Finger™ attachment.
Manual fecal disimpaction is a simple, cost-effective procedure that is usually done at a patient’s bedside to relieve the pain and bowel obstruction caused by a distended rectum full of feces; a condition that usually happens to patients who are debilitated, bed-bound, often with neuromuscular weakness, or taking narcotics. It is literally performed by inserting a gloved finger into the anus and pulling out the hard impacted stool from the rectum. Although crude and often unpleasant, the procedure can be life-saving for certain patients. If too painful for the patient to tolerate at the bedside, the physician can sometimes arrange the procedure to be done under anesthesia in an operating room or endoscopy suite setting.
A recent survey of area gastroenterologists found almost universal agreement that manual disimpaction using the doctor’s finger was both distressing to the doctor and patient, as well as gross. “There is always the potential for splatter,” notes Dr. Hans Enyuanus, Chief of Gastroenterology at Farfrumpoopin University in Munich, Germany. Dr. Enyuanus was one of the pioneers of robotic fecal disimpaction using the di Michelangelo® System, having performed over 2000 cases so far. “The new attachments allow all of this to happen,” states Dr. Enyuanus. “Prior to the development of da Finger™ system, existing robots were too sharp and pointy to be inserted into the anal canal,” he noted in this exclusive interview with Retroflexions.com.
Dr. Hans Enyuanus from Germany prepares to perform a robotic fecal disimpaction.
Critics, such as Professor Pierce Urbung’ol from the Royal Dookie College in Dublin, Ireland, point to the fact that using such an expensive piece of technology to remove stool from a patient’s rectum (a job that can simply be achieved with a finger, glove, and some lube) is a misuse of precious resources. Prof. Urbung’ol also warns that the new procedure may cost the healthcare system millions annually: A standard manual disimpaction costs about $37 and can be performed in about 30 seconds by anyone with a finger, while a robotic disimpaction costs the system approximately $6800, and takes over one hour and a team of 6-8 people to perform. “The robot is really cool, and everyone is going to want to use the new technology. This may lead to widespread overuse of robotic disimpaction,” said the Professor.
However, not everyone is convinced that this is a misuse of healthcare dollars: Dr. Enyuanus states, “Let the administrators come do the disimpaction next time to save the hospital $6000, I’d rather sit 20 feet away at the console where I can’t smell the three-month-old turd that the robot just pulled out of Mrs. Smith’s rectum. I’m a highly-trained specialist for cryin’ out loud!” Back here in Long Island, NY, a local gastroenterologist (who only agreed to speak to us anonymously) admitted he was jealous of his surgical colleagues who got to “play with the cool robot all the time,” and bragged that he has already booked five robotic disimpactions in the next week, despite never having used the robot before. “How hard could it be? I used to be pretty awesome at video games back in college,” said the anonymous physician.
With the widespread acceptance of robotic fecal disimpaction on the horizon, expect a rush of new attachments to come to the market soon. In fact, just as this article was going to press, Dr. Remo Uasso, CEO of Innuendo Technologies, announced the latest attachment, da Deuce™, engineered to remove even the toughest, most tenacious impacted masses of stool. Dr. Uasso states “da Deuce™ is guaranteed to handle the most stubborn, largest impactions known to modern medicine, the kind of stool boulders that even the strongest, most determined medical interns would sprain their fingers on!”
Coming soon: da Deuce™ by Innuendo Technologies.
If you haven’t realized it by now, this entire article is parody. The di Michelangelo robot does not really exist. Don’t try any of this at home, or at work. Hopefully you had a good laugh…Happy April Fool’s Day!
Images ©2017 Intuitive Surgical, Inc. Images are for illustration only and do not represent any real product or person.
Hand images www.freeimages.com/dafe ba
About Frederick Gandolfo, MD
