The death of the surgeon

28 February 2014 by Laurent Alexandre, urology surgeon, Chairman of DNAVision, author of « The death of death » (published by J-C Lattes)

It’s twenty-five years since the great French surgeon, Guy Vallancien, foretold the emergence of what he called ‘hypertechnological’ medicine, where surgical robotics would turn the traditional role of the physician upside down. People laughed at this prophesy. But back then, the Web, Google, smartphones, robots and the total sequencing of DNA were also unimaginable.


But in the space of just two decades, server power has multiplied a million times. Today, the world’s biggest supercomputer – Tihane 2 in China – can process 33 million billion operations a second and is no less than three million times more powerful than Deep Blue, which beat the World Chess Champion in 1997. And in Europe, the most powerful supercomputers, like the ones built by Bull, are achieving several million billion operations a second. Moore’s Law, which predicted the explosion in computing power while costs remained level, has enabled science fiction to become reality.

When it comes to medicine, the sheer complexity of surgical procedures seemed to preclude surgeons from one day being replaced by machines. Nevertheless, the first surgical robots – most notably Da Vinci – started to appear from the first decade of this century.

They are not yet autonomous and remain under the close control of the surgeon, who is always present behind the computer console. They still push up the cost of an operation by about 20% and increase the risk of some complications. Despite this, some 2,000 robots are now assisting surgeons around the world. Things are set to speed up: artificial intelligence and robotics are now progressing so fast that the next generation of surgical robots will surpass and ultimately replace surgeons.


The first Exa-scale computer – in other words, capable of a billion billion operations a second – is due to go live in 2019, and Intel is predicting that we will break through the Zetaflops barrier (a thousand billion billion operations a second) around 2029. The fact that Google has bought up the top eight robotics companies in a matter of months is a sure sign that this technology is about to take off. If you need any convincing of this, you just have to look on YouTube to see the breathtaking performance of Big Dog, one of the most exciting robots acquired by Google.

Traditional mechanical machines have progressed relatively slowly over the past two centuries: doubling their efficiency every 50 years. By way of contrast, the capacity of intelligent machines is exploding at just the rate you might expect according to Moore’s Law. Having long been the stuff of sinister science fiction, robotics is now set to change our whole world in just a few decades, and not just in surgery. By 2035, it’s likely that patients will refuse to be operated on by a human being, just as any of us might refuse to board an aircraft today whose on-board computer had been unplugged.

The death of the surgeon is more likely to be a metamorphosis, so long as they invest in tomorrow’s specialisms: NBIC(*), artificial intelligence, Big Data, robotics and biomechanics. In this way, surgeons will become the experts who design the robots. Without being too much of a Luddite, who rejects technology for its own sake, it is urgent that we reflect on the future of low and medium-skilled workers if surgical procedures – complex by their very nature – can be completely automated in twenty years. So which professions could cease to exist?

Laurent Alexandre

Laurent Alexandre, urology surgeon, Chairman of DNAVision, author of « The death of death » (published by J-C Lattes)

l.alexandre at

(*) The collective name for Nanotechnology, Biotechnology, Information technology and Cognitive sciences.

Source: Based on an original article published in LE MONDE SCIENCE ET TECHNO on 10 February 2014.

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