ROBOTIC SURGERY

Abstract---- The field of surgery is entering a time

of great change, spurred on by remarkable recent

advances in surgical and computer technology. Only

recently have robotic systems made their way into

the operating room . It has various applications in

gastrointestinal surgery, cardiothoracic , urology

etc… By adapting this technology the surgical operations are made easy.

Keywords---- da Vinci system – the da Vinci Surgical

System is a robotic surgical system made by

Intuitive Surgical and designed to facilitate complex

surgery using a minimally invasive ; Telesurgical—

Remote surgery (also known as telesurgery) is the

ability for a doctor to perform surgery on a patient

even though they are not physically in the same

location. ; neuroArm –microsurgical robot; CASPAR—robot to replace knee joints

I. Introduction

Robotic surgery a computer-assisted surgery . It

is a technological development that currently used

in surgical operations . leonardo da vinci was the

one gave the idea that robots can be used in

surgical operations . The computer translates the

surgeon’s movements , which are then carried out

on the patient by the robot . It was developed to

overcome limitations of Minimally Invasive

Surgery(MIS) where in the surgeon uses a

computer console to manipulate the instruments attached to multiple robot arms.

II. Robotic Surgery

Fig. 1 Robot Hand and an Human Hand

Robotic surgery procedure is similar to

laparoscopic surgery . It also can be performed

through smaller surgical cuts than traditional

open surgery . Once it is placed in the abdomen ,

a robotic arm is easier for the surgeon to use

than the instruments in endoscopic surgery. The

robot reduces the surgeon’s movements (for

example , moving 1/2 inch for every 1 inch the

surgeon moves ), which reduces some of the

hand tremors and movements that might otherwise

make the surgery less precise. Also , robotic

instruments can access hard-to-reach areas of your

body more easily through smaller incisions

compared to traditional open and laparoscopic

surgery.

III. Types of Robotic Surgery

Following are the types of robotic surgery

systems:

A. Supervisory-Controlled systems

The surgeon undertakes considerable

preparation work , inputs data into the robotic

system , plans the course of action , takes x-rays,

tests the robot's motions, places the robot in the

appropriate start position and oversees the robotic

action to ensure everything goes as planned. Eg:

Its commonly used in orthopedic surgeries.

B. Telesurgical systems

Remote surgery (also known as telesurgery) is the

ability for a doctor to perform surgery on a patient

even though they are not physically in the same

location. It is a form of telepresence. Remote surgery

combines elements of robotics, cutting

edge communication technology such as high-speed

data connections and elements of management

information systems. While the field of robotic

surgery is fairly well established, most of these robots

are controlled by surgeons at the location of the

surgery. Remote surgery is essentially

advanced telecommuting for surgeons, where the physical distance between the surgeon and the patient

is immaterial. It promises to allow the expertise of

specialized surgeons to be available to patients

worldwide, without the need for patients to travel

beyond their local hospital. Eg: Artery repair and

valve repair can be done without long recovery

times or bodily injury.

C. Shared-Control systems

In this system, the human does the bulk of

the work, but the robot assists when needed. The

robot provides stability and support . Safe regions

are the main focus of the surgery.

D. Robotic Radiosurgery Systems Robots are also used in delivering radiation

for the treatment of tumors. These systems use

robotics to control highly focused beams of

ionizing radiation to precise locations within the

body.. This reduces the risk of damage to

surrounding tissue

IV. Application

A. Cardiothoracic Surgery

It is the field of medicine involved in

surgical treatment of diseases affecting organs

inside the thorax . Endoscopic coronary artery

bypass operations are being performed with the

da Vinci system. Mitral valve repairs and

replacements have also been performed

B. Gastrointestinal Surgery Refers to a practise of surgery that focuses on

the upper parts of the gastrointestinal tract.

Robotic approaches to Surgeries such as colon

resection, pancreatectomy, esophagectomy have

been performed.

Fig. 2 Robotic Abdominal Surgery

C. Neurosurgery

Neurosurgery is the medical specialty concerned

with the prevention, diagnosis, treatment, and

rehabilitation of disorders which affect any portion of the nervous system including the brain,

spinal cord, peripheral nerves, and extra-cranial

cerebrovascular system. MD Robotic's NeuroArm

is the world’s first Magnetic resonance imaging (

MRI)- compatible surgical robo

D. Orthopedics

Orthopedic surgery or orthopedics is the branch

of surgery concerned with conditions involving

the musculoskeletal system. The Acrobot

Company Ltd. sells the "Acrobot Sculptor", a

robot that constrains a bone cutting tool to a

pre-defined volume . Another example is the

CASPAR robot produced by U.R.S.-Ortho GmbH

& Co. KG , which is used for total hip

replacement, total knee replacement and anterior cruciate ligament reconstruction.

E. Pediatrics

Pediatrics is the branch of medicine that

deals with the medical care of infants, children,

and adolescents.Surgical robotics has been used

in many types of pediatric surgical procedures

including: tracheoesophageal fistula repair,

cholecystectomy, nissen fundoplication, morgagni's

hernia repair, kasai portoenterostomy, congenital

diaphragmatic hernia repair, and others. The

results are less pain , faster recoveries, shorter hospital stays, smaller scars, and happier patients

and families.

F. Radiosurgery

Radiosurgery is a medical procedure that

allows non-invasive treatment of benign and

malignant tumors. The CyberKnife Robotic

Radiosurgery System uses image guidance and

computer controlled robotics to treat tumors

throughout the body by delivering multiple

beams of high-energy radiation to the tumor

from virtually any direction. Mounting the radiation source on the robot allows very fast

repositioning of the source , which enables the

system to deliver radiation from many different

directions without the need to move both the

patient and source as required by current gantry

configurations.

G. Urology

Urology is a medical and surgical specialty

that deals with diseases of the urinary tract .

Robotic surgery in the field of urology has become very popular , especially in the United

States . It is also utilized for kidney cancer

surgeries and to lesser extent surgeries of the

bladder . New minimally invasive robotic devices

include ultrasound probes for selective excisions

of kidney tumors , steerable flexible needles for

use in prostate brachytherapy.

V. Benefits of Robotic Surgery

The most significant advantage of Robotic

Surgery to the patient is the decrease in pain

and scaring. It reduces trauma to the patient by

allowing surgery to be performed through small

ports or "keyholes" rather than large incisions ,

resulting in shorter recovery times , fewer complications and a reduced hospital stay.

The patient may experience the following

benefits

1. Reduced trauma to the body 2. Less anesthesia

3. Often less blood loss and need for

transfusions

4. Less post-operative pain and discomfort

5. Less risk of infection

6. Shorter hospital stay

The surgeons have the following benefits

1. Enhanced 3-D Visualization 2. Greater Surgical Precision

3. Simplifies many existing MIS surgical

techniques

4. Makes difficult MIS operations routine

VI. Complications of Robotic Surgery

1. Flawed design

2. Malfunction of hardware and software

components

3. misinterpretation and incorrect or

inadequate specification

4. increase in cost , complexity , or both

VII. Conclusion:

90% of the operation carried on by a robot is

a successful. This idea is not yet famous because

of high cost associated with it. Though some

hospitals are implementing them in certain rare

surgeries such as cardiothoracic surgery ,

gynecologic surgery, abdominal surgery etc… It’s a

boon to the upcoming generations.

Reference :

[1] ROBODOC history. Robodoc.com. Retrieved on 29

November 2011.

[2] The Robotic Surgeon Protomag.com. Retrieved on 29

November 2011.