This grape new Internet meme has gone viral. David Hughes (@david8hughes), who is neither a grape nor a surgeon as far as I can tell, tried to summarize this meme by Tweeting: “THREAD: There’s been a lot of talk about the grape they did surgery on and I just want to clear a few things up for those of you who might be a bit confused about all this.” And then proceeded to provide the details:
And they did surgery on it.
— David Hughes (@david8hughes) November 24, 2018
Yes, they did. The origin of the meme is the following video from 8 years ago showing surgeons using a da Vinci Surgical System to, you guessed it, do surgery on a grape:
It wasn’t clear if the grape really needed surgery. Rather the grape may have been an example of something rather small, delicate, and slippery on which to demonstrate the performance of this robotic surgery system. After all, “they did surgery on a watermelon” may not have been as effective to demonstrate the same degree of precision. Also, they probably wanted to use something that was more expendable (sorry grapes), less gory, and with fewer privacy concerns than a human patient or an orange.
A sequel to the 2010 video emerged 4 years later in 2014, presumably starring a different grape. As with the first video, this second video didn’t seem to draw that much attention from the Interwebs. Then in May of this year, a Tweet from the Peter MacCallum Cancer Center in May of this year stated along with pictures: “BEHIND THE SCENES. Here’s some pictures from today’s shoot with Peter Mac’s Director of Robotic Surgery @declangmurphy showing @ScopeTV11 how our da Vinci Xi robot works, performing precision surgery on a grape. #roboticsurgery #robot #davinciXi.”
Still not a grape reaction until teh week of Thanksgiving, when the videos and the Tweet for some reason started “raisin” a whole lot more attention. That’s when bunches and bunches of Tweets, YouTube videos, Instagram posts, and shared pictures began to appear, including every type of permutation of “they did surgery on a grape” that you can imagine and pictures of grapes in all kinds of positions, some of them compromising. You’ll notice that the replies to the Peter MacCullum Cancer Center tweet really picked up on November 24. Indeed, something has certainly gone viral when a single word Tweet like the following gets over 254K likes:
— e. • stream epiphany (@maknaerule) November 23, 2018
Let’s assume that none of the Tweets, Instagram posts, and YouTube videos are sarcastic, because after all sarcasm never happens on social media. Right? Why should you care that they did surgery on a grape? Well, the purpose of the videos was to show how a surgeon sitting at a computer console and using controllers to manipulate robotic surgical equipment may be able to perform some very fine and precise surgical motions, including peeling and suturing a grape. Remember the How I met Your Mother gang talking about robots versus wrestlers? Well, surgeons working with robots have been growing since 2000, when the da Vinci Surgical System, manufactured by Intuitive Surgery, became the first robotic surgery or robot-assisted system approved by the U.S. Food and Drug Administration (FDA). Since then the number of robot-assisted surgeries and robotic surgery technology developers have continued to grow each year.
Surgeries on fruit is not the only way that hospitals are promoting the use of robot-assisted surgery. Many hospital websites are touting their robot-assisted surgery programs. The promise of robotic surgery is that it will allow surgeons to reach the areas of interest and operate through smaller incisions. The thought is that robotic arms can perform movements that human hands alone cannot and attached cameras with associated technology can provide views beyond those seen by human eyes and scopes alone. Other types of associated technology may be able to help steady hand movements and provide guidance to the surgeon. Plus, such systems may allow the surgeon to sit in more comfortable positions during the surgery. All of this could reduce bleeding, complications, and recovery time as well as open up other exciting computer-assisted possibilities.
However, as Tara Kirkpatrick, MD, and Chad LaGrange, MD summarize in a commentary for the Agency for Healthcare Research and Quality, while studies have shown some short-term benefits of robot-assisted surgery, they have yet to demonstrate significant longer-term advantages over more traditional surgical techniques. Moreover, although the commentary describes robot-assisted surgery as “generally safe,” it does raise concerns about the added risk of mechanical and technological failure. Then there is the issue of cost. A 2010 Perspective article in the New England Journal priced the da Vinci System at about $2 million, which would be a really expensive way to peel your grapes and a substantial investment for hospitals and surgical centers to make. Not all organizations can afford such systems. And for the ones that can afford the systems, are there enough advantages to justify the cost? Will an organization that spends money to purchase a robotic system then have incentives to use the system more than necessary to justify the investment? With such systems not available to all surgeons, training opportunities are currently limited, meaning that many surgeons may not have enough experience to become skilled and proficient. Plus, what happens when the systems change and evolve with new emerging standards, configurations, and technologies? How can it be ensured that surgeons trained on one system can readily switch over to other systems?
Ultimately, it will still be most important to choose the right surgeon, one with the appropriate amount of training, experience, skill, and empathy. Technology can help a good surgeon but it won’t replace one. After all, even if you have thin skin, you aren’t a grape.