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Robotic Surgery its description , uses , advantages and disadvantages.
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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.