Robotic surgery

From Wikipedia, the free encyclopedia

Robotic surgery is the use of robots in performing surgery. Three major advances aided by surgical robots have been remote surgery, minimally invasive surgery, and unmanned surgery [1]. Major potential advantages of robotic surgery are precision and miniaturization. Further advantages are articulation beyond normal manipulation and three-dimensional magnification. Some surgical robots are autonomous, and they are not always under the control of a surgeon. They are only sometimes used as tools to extend the surgical skills of a trained surgeon.

Contents 1 History 2 Applications 2.1 Cardiac surgery 2.2 Gastrointestinal surgery 2.3 Gynecology 2.4 Neurosurgery 2.5 Orthopedics 2.6 Pediatrics 2.7 Urology 3 Limitations 4 External links 5 References

[edit] History

In 1985 a robot, the Cody Evander, was used to place a needle for a brain biopsy using CT guidance. In 1988, the PROBOT was used to perform prostatic surgery in England. The ROBODOC from Integrated Surgical Systems was introduced in 1992, and is a robot to mill out precise fittings in the femur for hip replacement surgery. Further development of robotic systems was carried out by Intuitive Surgical with the introduction of the Da Vinci Surgical System and Computer Motion with the AESOP and the ZEUS robotic surgical system.

• The da Vinci is a surgical robot enabling surgeons to perform complex surgeries in a minimally invasive way. It is FDA approved and used in over 300 hospitals in the Americas and Europe. The Da Vinci was used in at least 16,000 procedures in 2004 and sells for about 1.2 million dollars.

• In 2001, Marescaux used the Zeus robot to perform a cholecystectomy on a patient in Strasbourg, France while in New York.

• The first unmanned robotic surgery took place in May 2006 in Italy [2].

[edit] Applications

[edit] Cardiac surgery

Endoscopic coronary bypass surgery and mitral valve replacement have been performed. Totally closed chest, endoscopic mitral valve surgeries are being performed now with the robot.

[edit] Gastrointestinal surgery

Multiple types of procedures have been performed with either the Zeus or robot systems, including bariatric surgery.

[edit] Gynecology

Reproductive surgery and ablative surgery including hysterectomy have been performed.

[edit] Neurosurgery

The PUMA was the first system for stereotactic interventions. Another robot is the Neuromate (Integrated Surgical Systems). The PathFinder stereotactic robot has been used recently in Europe, procedures including introduction of electrodes for deep brain stimulation in Parkinson's disease.

At Vanderbilt Medical Center in 2002, Dr Noel Tulipan used the Da Vinci Robot to perform in utero surgery on gravid animal models hoping to later transfer the approach to humans. This approach would have been used to improve the in utero surgical correction of some common spinal malformations know as spina bifida.

Neurosurgeon John R Adler developed the field of Image-Guided Robotic Radiosurgery with his invention of the CyberKnife. This surgical instrument enables the non-invasive ablation of small brain tumors. Technological refinements now make it possible to use the CyberKnife to eliminate tumors virtually anywhere in the body.

[edit] Orthopedics

The ROBODOC system has been accused to have led to a series of complications in Mexico [3].

[edit] Pediatrics

Surgical robotics has been used in many types of pediatric surgical procedures including: tracheoesophageal fistula repair, cholecystectomy, nissen fundoplication, morgagni hernia repair, kasai portoenterostomy, congenital diaphragmatic hernia repair, and others. On January 17, 2002, surgeons at Children's Hospital of Michigan in Detroit performed the nation's first advanced computer-assisted robot-enhanced surgical procedure at a children's hospital.

[edit] Urology

[edit] Limitations

Current equipment is expensive to obtain, maintain, and operate. If one of the older model non-autonomous robots is being used, surgeons and staff need special training. Data collection of procedures and their outcomes remains limited.

[edit] External links

• Da Vinci Robot
• AESOP and Zeus Robotic System
• ROBODOC
• PathFinder neurosurgical robot
• Article about remote surgery
• Robotics in Urology
• Article on High Performance Network Video in support of Remote Surgery
• NSF Engineering Research Center for Computer-Integrated Surgical Systems and Technology (Johns Hopkins University, Carnegie Mellon University, Massachusetts Institute of Technology, and others)
• Robotic doctor with sense of touch
• Unmanned robot surgeon
• Southeastern training site for Da Vinci robotic surgery

[edit] References

• Daniel Ichbiah. Robots : From Science Fiction to Technological Revolution.
• Dharia SP, Falcone T. Robotics in reproductive medicine. Fertil Steril 84:1-11,2005.
• Pott PP, Scharf H-P, Schwarz MLR, Today’s State of the Art of surgical Robotics, Journal of Computer Aided Surgery, 10,2, 101-132, 2005
• Lorincz A, Langenburg S, Klein MD. Robotics and the pediatric surgeon. Curr Opin Pediatr. 2003 Jun;15(3):262-6.