Robotic Surgery Niraj Bhalakia CS 30 Section 11 George Washington University
Table of Contents Introduction n n General Brief History Advantages n n n Minimally invasive For the surgeon Cost efficiency Types of Robotic Systems n n n AESOP Robotic System da Vinci Surgical System ZEUS Robotic Surgical System
Introduction
Robotic surgery is basically the use of robotic arms or tools during operation Human interaction is still necessary for robotic operations n We do not have actual autonomous robots that function like actual surgeons…yet Current surgical robots are controlled by voice, remote, or joystick controls The use of robotic arms allows for accuracy and precision that is unmatched by a surgeon’s hands
Brief History The earliest robotics in surgery were used for treatment of brain tumors April 1985 – trials of neurosurgery using a Unimate Puma 200 robot arm n This robot was only used to hold a fixture at the correct position so surgeon could do procedure April 1991 – first true robotic operation performed where robot was actually used to insert a cutting device into the patient and remove tissues
Advantages
Minimally Invasive Robotic surgery does not require as much incisions or cuts as does conventional surgery n Example: Conventional bypass surgery requires a 1 foot long incision along the patient’s chest. Robotic surgery needs 3 or 4 incisions, each only about 1 cm in diameter. Smaller incisions less pain and bleeding for the patient faster recovery and less cosmetic distortions
For the Surgeon Robotic surgery is much faster than conventional surgery n Decreases the fatigue that surgeons would experience during conventional surgery that would last for several hours “Increases” the margin for error n n Even the steadiest hands experience some tremor Some of the approved systems have been programmed to compensate for tremor so robotic arm stays steady
Cost Efficiency Robotic surgery allows for fewer personnel in the operating room n n Most operations today need about a dozen people in the operating room: 2 or 3 surgeons, an anesthesiologist, and several nurses Robotic surgeons only need one surgeon, an anesthesiologist, and 1 or 2 nurses due to the fact that this surgery will be minimally invasive and their will be less equipment needed as mechanical arms will do most of the work With advancing technology and increasing accuracy, surgeon will get farther and farther from patient, and invasiveness of the procedures will get less and less
Types of Robotic Systems
General Layout of Robotic Operation
Endowrist technology – movement of surgeons wrist is mimicked by the mechanical arm
AESOP Robotic System AESOP – Automated Endoscopic System for Optimal Positioning n n Basically, one robotic arm, which holds the endoscope Foot-pedals or voice activated software allow the physician to control endoscope, leaving his/her hands free to perform operation Developed by Computer motion First FDA approved robot for operating room assistance
da Vinci Surgical System Three primary components n n n Vision system – technology that allows surgeon to get closer to the surgical site than human vision will allow Surgical cart – contains the Endowrist instruments with robotic arms (2 for actual surgery; 1 for camera that is inserted into patients - endoscope) Surgeon console – controls for Endowrist instruments Developed by Intuitive Surgical
da Vinci Surgical System Summary of process n Surgeon looks into viewfinder to examine 3 D images that is projected by a camera inside the patient Under the viewfinder screen, the surgeon sees the instruments held by the arms and the surgical site n Underneath the screen are the controls for the Endowrist instrument Each time a joystick is moved, a computer sends an electrical signal to an instrument, and moves the robotic arm in sync with surgeon
Surgeon’s view using da Vinci system Instruments used by the da Vinci system
ZEUS Robotic Surgical System Has similar setup to the da Vinci system n n A computer workstation A video display Hand controls to move table mounted surgical instruments Endoscope inserted into patient Developed by Computer Motion
NOTE: these systems have been FDA approved for only a few select surgeries All these systems show great promise n For example, the ZEUS system has already been used in Germany to perform minimally invasive coronary bypass surgery
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