Robotic surgery is a type of minimally invasive surgery that has many advantages as compared to traditional surgical methods. It can be used for a wide variety of surgical procedures from cardiovascular to Urological surgery. The historic time lines of major events associated with the development of robotics are covered describing the beginnings, present, and future of this robotic surgery technology. There are political and legal issues brought on by robotics which influences legislation and regulations as well as the need for legal protection for both surgeons and patients. The economic costs of the equipment, operative costs and patient considerations are questioned listing some disadvantages that can be associated with robotic surgery.
Positive and negative psychological considerations and sociological effects on both tenants and operators that can be felt throughout the world and positive and negative aspects will be covered. The cultural context and media influence from robotic surgery show that there are many people who can benefit from this technology from the elderly to sports athletes. Lastly, the implications of the environment of robotic surgery and moral and ethical implications will be discussed. Introduction Robotic surgery helps aid in surgical procedures and we will be covering the need, advantages, applications, history, political and legal, economical questions, costs, patient and psychological considerations, and implications f this state-of-the-art technology.
Computer-assisted robotic surgery systems (Rexes Campgrounds) Computer-assisted robotic surgery systems can be defined as a computer-controlled assistant that imitates movement by a surgeon to move tools in a variety of positions to carry out an assortment of surgical tasks. Surgical procedures have changed dramatically with the use of robotic surgery systems. In the United States, the majority of patients with endometrial cancer currently go through computer-assisted robotic librarianship surgery. Approximately more than 50% of endometrial cancer ere accomplished with robotic surgery in 2010, demonstrating a standard shift towards the use of robotic surgery (Holloway, 2012).
Today, robotic- assisted surgery systems are being utilized for a wide-ranging variety of surgeries, such as general, genealogical, oncologist, chiropractic, and urological. Robotic surgery: a form of minimally invasive surgery Robotic surgery or “minimally invasive” surgery is a skilled procedure for carrying out surgery that often leaves patients with less pain, a quicker recovery time, and minimal scarring as compared to traditional surgery. With biotic-assisted surgery, surgeons can complete minimally invasive librarianship tasks with the assistance of aerobically controlled surgical instruments attached to the robotic arms with more accuracy and preciseness leaving less room for error.
Most robotic surgery systems are not fully autonomous robotic devices, but are intended to help and assist the surgeon, rather than actually performing an entire surgical task without any human control. A human factor is involved and robotic surgery is used as a tool to assist the surgeon and the success of a surgery is still based mainly on he experience and particular skills of the surgeon and the medical support team that is assisting them, rather than relying solely on the robotic technology to carry out the surgery. In real time, all movements and incisions are entirely controlled by the surgeon and the robotic system allows the surgeon to achieve more enhanced movements and control.
The robotic surgery system’s sensors and controls adjust and measure the distance and pressure Of the surgeon’s movements, permitting the robotic arm motions to be scaled to move in conjunction to the surgeon’s hand with the preciseness f a fraction of an inch for every inch the human hand moves. This streamlines the most intricate movements during suturing, knot tying, resections and eliminates natural tremors associated with free-hand surgery. An exception to robotic surgery systems not being fully autonomous would be tumor-targeting systems. In this case the surgeon programs the robotic surgical system and when he is ready to perform the procedure, the robot takes over with full automation and carries out what the surgeon had programmed into the robot.
One type of robotic surgery is called the dad Vinci biotic system which is composed of three major modules: a AD vision system, an ergonomic console for the surgeon and the robotic component with four robotic arms. This minimally invasive surgery allows the surgeon to sit down at the ergonomic console controllers and view the surgery through a 3-D vision system in high definition. The surgeon then operates controls that are cabled ‘endowments surgical instruments that replicate the use of human hands and wrist motions. The robotic surgeon controls the camera with clutch maneuvers, uses master hand controllers, and activates power sources tit the use of foot pedals at the console.
The surgeon is able to use intuitive motion by being able to naturally move in the same direction as the robotic tools attached to the end of each robotic arm which is an advantage over traditional surgery. Another type of a robotic surgery system is the Cybernetic system. The Certify system differs from the dad Vinci or other robotic us racial systems because it is a tumor-targeting system that uses computer robotic mobility and high-intensity radiation to target tumors, rather than actually cutting the tumors out. When using the Cybernetic system, a surgeon usuries out the suitable level of radiation to provide, and a planning procedure is used to regulate the best way to eliminate the tumor.
The surgeon then analyzes the strategy, and once they are satisfied, the Cybernetic robotic surgical system takes over, repeatedly firing heavy doses Of targeted radiation right at a tumor, in a technique called ablation. ‘Unlike the Intuitive Surgical dad Vinci system, where the surgeon is actually driving the robot during the surgery, in the case of the Cybernetic system, it is fully automated,” says Robert Hill, SSP of Engineering at Accuracy (Kirkpatrick, K. , 2014). The benefits of using a Cybernetic robotic system is that it is a robotic knife that does not cut, which means there is less pain for the patient, recovery time is quicker, and there are less chances of infections due to surgery.
Cybernetic is completely noninvasive where it essentially won’t pierce the skin with a knife or other cutting instruments. Other robotic surgical systems include the ROI Robotic Arm Interactive Orthopedic System to help surgeons perform more precise orthopedic procedures for the knees and hips and SPORT (Single Port Orifice Robotic Technology) which is estimated to receive FDA approval in 2015. The need for robotic surgery Robotic surgery provides more accurate and precise movements compared to traditional surgical procedures permitting greater surgical technique, more insight and exposure, and a reduced amount of torturing and movement, which results in less post-operative pain.
By using smaller incisions and more precise instruments, robotic surgery usually offers advantages over traditional surgery in that it leads to minimal blood loss, a decreased risk for infections, and hospital stays are shortened. In addition to the minimally invasive surgery techniques and capabilities, robotic surgery is more efficient ND ergonomic by giving the bedside assistant more room to retract, grasp, suction, and pass SUtUres through a port to the assist the surgeon making it easier to perform their tasks. The surgeon is also seated at the controls of the robotic surgical system, eliminating the fatigue associated with standing during a traditional surgery. The different benefits of robotic surgical systems include: a magnified AD camera with high definition that is under the surgeon’s control.
Secondly, the robotic controls have a free articulating endowments mimicking the surgeons hands and wrists, but adds even more motions that the surgeon cannot easily do. The full articulating robotic arms facilitate the dissection and retraction of the specimen in complex surgeries and provide enhanced dexterity. Third, the robotic arm movements are precise and accurate with complete exclusion of the tremors or unwanted movement made by the hand of the surgeon. Lastly, the surgeon is in an ergonomic position while working in the console which reduces the muscle strain on the surgeon that is seen with traditional layperson surgeries resulting in less room for errors.
Due to the fact that the dad Vinci and other similar robotic systems are not fully autonomous, there is a human factor involved in the success rate for these type of robotic surgeries where the surgeon and staff performing the surgeries must be properly trained to carry out the procedures. With the proper training, comprehensions, and surgical expertise, robotic surgery is an effective and safe way to providing successful procedures that benefit patients. Since 2001 , the dad Vinci Surgical System has been implemented in more than 2,500 hospitals worldwide and it has been embraced by both surgeons and patients due to the wide variety of procedures that it could be used.
Robotic surgical systems provide a better ay to perform specific surgeries as compared to traditional surgical techniques. Advantages of robotic surgery compared to traditional methods The great advantages of robotic surgery include its superior precision, lower error rates, reduced blood loss, shorter hospital stays, faster patient recovery, and reduce pain compared to traditional methods. Robotic surgery allows us racial maneuvers that closely mimic traditional surgical techniques and it is more precise allowing surgeons with less advanced surgical skills the ability to perform more challenging surgical tasks such as suturing and knot-tying. Unlike traditional surgery, computer-assisted surgical procedures are considered to be minimally invasive.
With traditional surgery, in order for the surgeon to have enough room to operate and see, a bigger opening must be cut into the patient. With robotic surgery, such as the dad Vinci system, ports or several holes are made in the patient’s body so that the instruments attached to the robotic arms can be inserted. This permits for significantly smaller incisions (up to 6 to 8 centimeters or roughly 2. 5 to 3 inches or smaller) compared to traditional surgery which can require larger incisions of 5 to 20 centimeters or roughly 6 to 8 inches or more. Smaller incisions through robotic surgery lead to less scaring, faster recovery time, and a reduced chance to get an infection.
The most significant advantages of robotic surgery over traditional surgery are the vision and motion that these computer-assisted robotic systems provide. Robotic systems enhance the vision of a surgeon and also provide a wider range of motion beyond the surgeon’s traditional capabilities. Robotic surgical systems come with a magnification camera allowing the surgeon to see in AD, giving more visual than traditional librarianship surgery. There is also an advantage with motion where the instruments mounted on three robotic arms provide seven degrees of motion – better dexterity than can be achieved with a surgeon’s own hands and wrists. ‘They move up and down, from side to side, and they rotate,” says Dry.
Filtrate, who is director of minimally invasive surgery in Brigham and Women’s Hospital in Boson’s division of gynecologist oncology (Harvard Health Publications, 2012). When comparing the cost associated with robotic surgery versus traditional surgery, hospitalizing cost involving robotic surgery appears to be cheaper and less expensive (Salmon, M. Bell, T. , Martin, J. , Aviva, K. , Grim, R. , Joshua, V. , 2013). A Canadian study that compared robotic surgeries and traditional surgeries for the same procedure found that the average hospital stays were four days shorter when robotic surgeries were performed, resulting in significant cost savings when compared to hospital stays after traditional surgery.
There are cases where robotic surgery does not have an advantage over traditional surgery where both traditional and robotic surgeries have limitations. A paradigm of potential limitations of robotic surgery was published by Scoria in the February 201 2 issue of Surgical Endoscope where it concluded that among morbidly obese patients, that although robot-assisted surgery was safe and intuitive, it did not seem to provide a real advantage over traditional surgery for the obese in terms of hospital length of stay and complication rates (Hottentots, 2012). Types of robotic surgery procedures Abdominal surgery, colon, and rectal surgery Almost all abdominal and gastrointestinal librarianship procedures are now being managed by robotic surgery.
Robotic-assisted surgery is used in abdominal surgeries including gastric bypass surgery, Nisei pontifications, ND schoolmistresses. In 1977, the first robot-assisted Nisei pontifications for gastrointestinal relax was performed (Schroeder, H. , Evergreen, R. , 2009). Collector procedures continue to present a challenge, in particular for restorative resection of mid and low rectal cancers. Although surgical robots have been successfully applied to a number of disciplines, most notably urological and cardiac procedures, robotic collector surgery remain in its infancy. The dad Vinci surgical robot has been used for general surgery procedures, and there has been an increase in the last few years in Loretta surgery but there is still no standardized technique.
The several techniques that have been used include the Hybrid technique: the librarianship manipulation of splenetic flexure followed by robotic docking for the dissection of the pelvis and completion of the procedure, the Single- docking technique that incorporates monopolizing the second and third robotic arm for the different parts of the procedure utilizing Single docking at the left lower quadrant, and Double-docking technique which incorporates docking from the left homebodies for dissection of the splenetic flexure and then hanging the docking to the left lower quadrant and placing an extra port at the right homebodies for pelvic dissection. The suggestions for robotics in collector surgery are still in development and many collector surgeons are greatly adopting robotics and trying to determine the limitations where the robot can be applied.
Recently, evidence suggests that the safety and viability of computer-assisted robotic collector surgery has been recognized. The advantages of robotics in collector surgery are particularly beneficial for rectal dissection. However, the lack of potential randomized controlled trials mimed to calculate the long-term outcomes, safety, feasibility, and cost effectiveness will provide crucial data on the practice of robotic collector surgery (Laudably, H. , Eldon, A. , Razor, l. , 2012). Cardiovascular, Urological and Genealogical surgery Cardiac surgery gained the benefits of robotics through the use of smaller, less invasive incisions resulting in less pain, shorter length of stay, and quicker recovery times.
Due to these reasons, cardiac surgeons most commonly use robotic surgery such as the dad Vinci surgical system for coronary artery bypass (CAB) and material valve repair or replacement. This approach eludes the morbidity associated with a storerooms incision and even permits cardiac revitalization without cardiopulmonary bypass (CAB) or cordillera (Murphy, D. , Hall, R. , Tong, R. , Geol., R. , Costello, A, 2008). Robotic surgery using the dad Vinci surgical system has been increasingly accepted around the world, particularly for patients undergoing urological procedures. In Urology, radical protectorates is becoming the fastest growing and the standard procedure in numerous medical centers in the united States.
Robotic surgery has also been applied to ecosystems, helplessly, tracheotomy, renal surgery, radical enforcement, donor enforcement, archaeology, urinary diversion and pediatric urology. In genealogy, the most widely used application for robotic surgery is for hysterectomies. The dad Vinci robot is also used in epistemological fistula repair, acropolises recontamination, and can safely and adequately used in the treatment of endometrial, ovarian and cervical cancers. A mastectomy is an advanced surgical procedure for the uterus that needs multilayer allophonic suturing and the robot could be very helpful in situations which require nucleation and suturing. Head and neck surgery The uses of robotics have been used in the field of head and neck surgery.
Due to a narrow working space, various procedures that are impossible to perform using traditional surgery can be done using robotic surgery which includes conventional endoscopies surgery, removing lesions and preserving surrounding healthy structures maximally for maintenance of function (Park, Y. , Kim, W. , Hung, B. , De Virgil, A. , Lee, S. , Kim, S. , 2013). The dad Vinci robotic system can position its arm near a patient to reach inaccessible region easily. The surgeon has comfortable sitting position at console to work on the tenants head or neck. With AD, endoscopies, microscopic image and sensitive controls the desired procedure can be done even from a remote place.
Currently, robotic surgery for the head and neck is being used for resections and reconstruction of tumors at base of tongue and larynx, avoiding matriculation for access which has its own morbidity. With trans-auxiliary approach, thyroid, Para thyroid adenoma and neck lymph node can be operated without giving scar on the neck. Robotic surgeries involving the head and neck can also involve the oral cavity, orphaning, hypnotherapy, pharynxes, and misanthropy. Orthopedic Surgery Currently, robotics have become commonplace in surgical procedures due to their high accuracy, preciseness, and repeatability. The Acrobat Sculptor is an example of surgical robotics that can be used with uncomplimentary knee replacement.
The Acrobat Sculptor is a simulative robotic surgical system that uses the computer tomography (CT) data as input, and is able to assist with bone resection for AKA surgery in a consistent manner to minimize variability Amassed, M. , Jeffrey, Z. , Harris, S. , Cob, J. , (2013). Computer- controlled robotic surgical systems provide a better level of precision in treatment than doctors alone can provide. The benefits for robotic surgery are not limited to cardiovascular, urological, genealogical, head and neck, and orthopedic procedures. Robotic-assisted surgery can also be applied to pancreatic, liver, gallbladder, gastric bypass, barbaric, gastric banding, lung, and other cancers or conditions.
In general, robotic surgery allows surgeons the ability to perform delicate and complex procedures using minimally invasive surgical techniques that may have been very difficult to do using traditional surgical techniques. The benefits such as a shorter hospital stay, less blood loss and scarring, faster recovery times, and fewer complications re just some of the advantages for robotic surgery. Surgeons and their staff are able to perform their jobs more efficiently and effectively with more flexibility, precision, and control to help the patient, so both the surgeon and patient receive value from robotic surgical techniques. The Historical Development and Context of the Technology (Trash Young) Robotic surgery has come a long way over time. There have been many developments in the applications and uses for robotic surgery.
Some of these developments have made history in the medical field. Though there have been many developments, robotic surgery is a newer technology that has remises in the medical industry and is still developing. There are many companies in the world that are working on developing new technologies and machines that can help in the medical field. There are many medical facilities that are using robotics every day. There are some procedures that are done today solely with robotics. These methods have become common practices. We will look at the history and development of robotic surgery. Let’s start with the basics; the term robot was introduced in 1 921 in Karee Cape’s play Russo’s universal Robots. Robot, taken from the Czech robots, meaning forced labor, has evolved in meaning from dumb machines that perform menial, repetitive tasks to the highly intelligent anthropomorphic robots of popular culture. ” (Allowance, http://www. Incubi. Ml. NIH. Gob/Mac/ articles/PMC1356187/) Though robots are considered unintelligent machines they have come a long way through time. There have been several different advances in robotics that have benefited many people. One of the major benefits of these developments is that people were introduced to less invasive surgery, allowing doctors and surgeons to perform surgeries that resulted in smaller incisions from using the robotic equipment. The first robotic used in surgery was the Puma 560, in 1985. The Puma 560 was developed by Kook.
The Puma 560, pictured to the left, was developed to perform neurological biopsies. This machine allowed for better precision when performing the biopsies. Because of the precision of the Puma 560, in 1987 the first robotic librarianship procedure was done. The Puma 560 was able to perform this procedure with smaller incisions, less risk for infection, and quicker recovery times. In 1 989, Computer Motion was founded. Computer Motion was a medical device company that produced high tech robotic systems. Computer Motion wanted to help in the revolution of robotics in surgeries to help improve medical care and procedures used by doctors and surgeons. The Puma 560 led to the development of UPROOT.
UPROOT was developed in 1 988 at the Imperial College of London. UPROOT, pictured to the left, was developed to help in removing prismatic tissue. This system used online video monitoring with simulation. This machine showed success in robotic imaging and the removal of the prostate. Not only a success in prostate removal, but also showed that robotics can be successful in soft tissue surgeries. During he time of developing the UPROOT there was another company that was working on another robotic system that would make medical history. Integrated Surgical Systems was the company that was also developing a surgical robot at the same time UPROOT was being developed. They introduced Robotic in 1992.
Robotic was designed to assist in orthopedic surgery. Originally Robotic was used for total hip arthroscopy. This robot gave the doctors the opportunity to plan their surgeries and perform with more accuracy. Robotic was first accepted in Europe, but not in the U. S. It was not accepted in the U. S. Until October 9, 1992 when the FDA finally proved the Robotic. This was the very first robot that was approved by the FDA for surgical procedures. (Allowance, http://BMW. Incubi. Ml. NIH. Gob/ Mac/articles/PMC1356187/) The very first hip replacement was performed by Robotic in November 1992. There were then ten more orthopedic surgeries performed after that.
There were several other robotic developments that were stepping stones in the development of robotic surgeries. Some of the machines include the Aesop”‘ 1000, Aesop”‘ 2000, Aesop 3000 and the Zeus Robotic Surgical System. All of those robotic systems were developed by Computer Motion. Aesop”‘ 1000 was the first robotic assistant that was commercially used in 1993. Aesop 1000 had foot pedal control and was difficult for many first time users. In 1996, it was modified to have voice control and was called Aesop”‘ 2000. Then the Aesop”‘ 3000 Was developed and had voice control and an arm. The picture to the left is a picture of the Aesop 3000. The Zeus”/ Robotic Surgical System was introduced in 1998.
The arms of this system attached to the sides of the operation table. The doctor would use a small hand held joystick to maneuver the arms. The Zeus’* was used in 1999 in London for the first close chest cardiac bypass. It was then used in 2001 for a tell-surgery by a doctor in New York performing a cyclometer’s on a patient in France. (Kumar, w. Vi. Billion. Org). The system that is used most today is The dad [email protected] Surgical System. The dad [email protected] Surgical System was developed by Intuitive Surgical Inc. In 1997. In 2000, the FDA approved The dad [email protected] System for librarianship surgery, making this system the first robotic surgical system to be approved.
In 2001, the FDA also approved The De Vinci system to perform general non-cardiac thermoplastic procedures and for librarianship removal of the prostate. There were about 1 500 robotic surgeries completed in 2000 and over 20,000 surgeries in 2044. The dad Vinci system is consisted of a surgeon console, patient-side cart, a three-dimensional Endoscope, and the [email protected] attachment and other attachments. The surgeon console is the station at which the surgeon controls the robotic machine. This is normally placed away from the operating table and IS connected to the robot with cables. The images are transmitted from the endoscope to the console.