Podcast Summary: Endocrine News Podcast – ENP108: AI and Robotics in Surgery

Date: December 17, 2025
Host: Aaron Lohr (A)
Guest: Dr. Hassan Heshmati (B)

Episode Overview

This episode explores the transformative role of artificial intelligence (AI) and robotics in surgery, with an emphasis on endocrinology and adrenal tumors. Dr. Hassan Heshmati, a seasoned endocrinologist and researcher, discusses the evolution, advantages, challenges, and future of robotic surgeries. The conversation examines key trends, outcomes, cost factors, and the continued role of human professionals in a rapidly changing surgical landscape.

Key Discussion Points and Insights

1. The Rise of Robotic Surgery in Medicine

• Rapid Integration: AI and robotic technologies have shifted from science fiction to everyday medical realities, particularly in surgical procedures.
• Historical Context:
  • First robotic surgery: 1985
  • Exponential growth in the last 15 years, particularly in the USA, Germany, and South Korea
  • U.S. stats: about 2,000 hospitals offer robotic surgery (15% of all surgical procedures in 2020); 876,000 robotic procedures in 2020
  • Leading uses: General surgery and prostate operations
  • Market size: $7B in 2024, projected $16B by 2032
  • [01:52] Dr. Heshmati:

    "Robotic surgery has been around for almost 40 years...you have an increase in the number of these procedures over the last 15 years, an exponential increase."

2. Advantages Driving Adoption

• Minimally Invasive: Smaller incisions and scars
• Enhanced Visualization & Precision: Better access to surgical sites, no hand tremor, greater flexibility
• Patient Benefits: Lower complication rates, less blood loss, shorter hospital stays, and possible remote access to top surgeons
  • [03:24] Dr. Heshmati:

    "You can have access to a top surgeon remotely. The surgeon can be in Australia, the patient can be in Spain, for example."

3. Focus on Adrenal Tumors

• The featured research zeroed in on adrenal tumors due to space limitations in conference presentations, though robotic surgery is also applicable to pituitary, thyroid, parathyroid, and pancreatic procedures
  • [04:32] Dr. Heshmati:

    "You can have robotic surgery for the pituitary gland, for thyroid, for parathyroid, for the adrenals, for the pancreas..."

4. Types of Surgical Robots by Level of Autonomy

• Supervised Autonomy / Master-Slave: No preprogramming; fully controlled by surgeon
• Collaborative Autonomy: Semi-active; preprogrammed robots with surgeon complementing actions
• Full Autonomy: Active systems work autonomously under surgeon supervision, intervention possible
  • [05:15] Dr. Heshmati:

    "The first type is supervised autonomy or master slave system... The second type is collaborative autonomy... The third type is full autonomy..."

5. Safety, Outcomes, and Costs

• Safety & Outcomes: At least as safe as traditional surgeries; often better due to less invasiveness and shorter hospital stays
• Cost Considerations:
  • Currently more expensive—around $2,000 more for adrenal tumors, driven by initial equipment ($1–2M) and annual maintenance ($100–$150K)
  • Potential for cost reduction with increased procedure volume
  • [06:06] Dr. Heshmati:

    "The safety of robotic surgery is as good, if not better than the traditional surgery... The cost of materials is between 1 and 2 million dollars and then you have to maintain the whole system annually."

6. Factors Affecting Future Growth

• Budget and Investment: Availability of funds for equipment and training
• Technological Advancements: Expansion beyond the da Vinci system
• Data Drives Progress: Combining AI analytics with surgery enhances performance and safety
• Demographic and Political Factors: Growing populations and health policy leadership may steer adoption
  • [07:41] Dr. Heshmati:

    "There are many factors that can influence the growth... One is the availability of the budget... the evolution of technology... new data... the political situation..."

7. The Enduring Role of Humans

• AI Limitations: AI relies on past data; does not generate novel ideas or oversight
• Ongoing Human Necessity: Inputting and maintaining data, system support, strategic decision-making
• Workforce Impact: Likely reduction in active operating room personnel, but humans remain irreplaceable
  • [08:59] Dr. Heshmati:

    "Artificial intelligence is using the available experience and data. It cannot generate ideas from scratch. So there is always a need for humans..."

Notable Quotes & Memorable Moments

• Trend Marker (Aaron Lohr, [00:00]):

  "We used to ask, what is the role of AI in medicine? Are we getting closer to a time where we'll be asking, what is the role of humans?"

• Global Perspective & Data Surge (Dr. Heshmati, [01:52]):

  "Approximately 2,000 hospitals are performing robotic surgery, and this represents approximately 15% of all surgical procedures in 2020."

• Remote Surgery Possibilities (Dr. Heshmati, [03:24]):

  "The surgeon can be in Australia, the patient can be in Spain, for example."

• Defining Autonomy (Dr. Heshmati, [05:15]):

  "There is always a need for humans to incorporate the data to support the system and to maintain the system."

• Future & Human Relevance (Dr. Heshmati, [08:59]):

  "Artificial intelligence is using the available experience and data. It cannot generate ideas from scratch."

Timestamps for Important Segments

• 00:00 – Introduction and episode focus
• 01:52 – Global data and trends in robotic surgery
• 03:24 – Advantages of robotic surgery
• 04:32 – Why focus on adrenal tumors?
• 05:15 – Types of surgical robots
• 06:06 – Safety, outcomes, and costs
• 07:41 – What drives future growth?
• 08:59 – What is the future role of humans?

Conclusion

This episode provides an informed and balanced exploration of how AI and robotics are revolutionizing surgical practice within endocrinology and beyond. Dr. Heshmati presents a clear-eyed look at both the remarkable advances and ongoing challenges—particularly around cost, infrastructure, and the irreplaceable need for human judgment, creativity, and oversight even in a future increasingly shaped by automation.

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