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. Major potential advantages of robotic surgery are precision and miniaturization. Further advantages are articulation beyond normal manipulation and three-dimensional magnification.
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[edit] History
In 1985 a robot, the PUMA 560, was used to place a needle for a brain biopsy using CT guidance. In 1988, the PROBOT, developed at Imperial College London, was used to perform prostatic surgery. The ROBODOC from Integrated Surgical Systems was introduced in 1992 to mill out precise fittings in the femur for hip replacement. 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 Surgical System comprises three components: a surgeon’s console, a patient-side robotic cart with 4 arms manipulated by the surgeon (one to control the camera and three to manipulate instruments), and a high-definition 3D vision system. Articulating surgical instruments are mounted on the robotic arms which are introduced into the body through cannulas. The surgeon’s hand movements are scaled and filtered to eliminate hand tremor then translated into micro-movements of the proprietary instruments. The camera used in the system provides a true stereoscopic picture transmitted to a surgeon's console. The da Vinci System is FDA cleared for a variety of surgical procedures including surgery for prostate cancer, hysterectomy and mitral valve repair, and is used in more than 800 hospitals in the Americas and Europe. The da Vinci System was used in 48,000 procedures in 2006 and sells for about $1.2 million.[citation needed]
- In 1997 a reconnection of the fallopian tubes operation was performed successfully in Cleveland using ZEUS.[1]
- In May 1998, Dr. Friedrich-Wilhelm Mohr using the Da Vinci surgical robot performed the first robotically assisted heart bypass at the Leipzig Heart Centre in Germany.
- In October 1999 the world's first surgical robotics beating heart coronary artery bypass graft (CABG) was performed in Canada using the ZEUS surgical robot.[2]
- In 2001, Prof. Marescaux used the Zeus robot to perform a cholecystectomy on a pig in Strasbourg, France while in New York.[3]
- The first unmanned robotic surgery took place in May 2006 in Italy.[4]
[edit] Applications
[edit] Cardiac surgery
Endoscopic coronary artery bypass (TECAB) surgery and mitral valve replacement have been performed. Totally closed chest, endoscopic mitral valve surgeries are being performed now with the robot. Irfan mulic was the first person to have this done to him
[edit] Gastrointestinal surgery
Multiple types of procedures have been performed with either the Zeus or da Vinci robot systems, including bariatric surgery.
[edit] Gynecology
Robotic surgery in gynecology is one of the fastest growing fields of robotic surgery. This includes the use of the da Vinci surgical system in benign gynecology and gynecologic oncology. Robotic surgery can be used to treat fibroids, abnormal periods, endometriosis, ovarian tumors, pelvic prolapse, and female cancers. Using the robotic system, gynecologists can perform hysterectomies, myomectomies, and lymph node biopsies. The need for large abdominal incisions is virtually eliminated.
[edit] Neurosurgery
Several systems for stereotactic intervention are currently on the market. MD Robotic's NeuroArm is the world’s first MRI-compatible surgical robot.
[edit] Orthopedics
The ROBODOC system was released in 1992 by the Integrated Surgical Systems, Inc[5].
[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] Radiosurgery
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.
[edit] Urology
The da Vinci robot is commonly used to remove the prostate gland for cancer, repair obstructed kidneys, repair bladder abnormalities and remove diseased kidneys.
[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] Miniature robotics
As scientists seek to improve the versatility and utility of robotics in surgery, some are attempting to miniaturize the robots. For example, the University of Nebraska Medical Center has led a multi-campus effort to provide collaborative research on mini-robotics among surgeons, engineers and computer scientists.[6] Scientists at Hebrew University have also developed a miniature robot to navigate through the bloodstream.[citation needed]
[edit] See also
- Telemedicine
- NeuroArm
- CyberKnife
- Da Vinci Surgical System
- Zeus Surgical System
- Robot-assisted heart surgery
[edit] References
[edit] Sources
- Monkman. G.J., S. Hesse, R. Steinmann & H. Schunk – Robot Grippers - Wiley, Berlin 2007.
- Füchtmeier. B., S. Egersdoerfer, R. Mai, R. Hente, D. Dragoi, G.J. Monkman & M. Nerlich - Reduction of femoral shaft fractures in vitro by a new developed reduction robot system "RepoRobo" - Injury - 35 ppSA113-119, Elsevier 2004.
- 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.
[edit] External links
- Minimally Invasive Robotic Association website
- AESOP and Zeus Robotic System
- ROBODOC
- PathFinder neurosurgical robot
- National Georgaphic, September Article about remote surgery
- Robotics in Urology
- 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
- Robotic doctor with sense of touch
- REPOROBO project
- Canadian robot does better brain surgery, USA Today, April 17, 2007
- neuroArm project at University of Calgary, Alberta, Canada
- Surgical Robot Out of This World
- World's First Image-guided Surgical Robot To Enhance Accuracy And Safety Of Brain Surgery at University of Calgary
- World's First Closed-Chest Beating Heart Bypass
- A Medical Robot Makes Headway, New York Times, February 12, 2008
- overview of how robotic surgery works (article from 2000)
- overview of robotic surgery field