Beginning from trephination which according to historians was the oldest operation performed even in prehistoric times to minimally invasive operations with use of technology that have now become the norm in modern era, the field of surgery has evolved by leaps and bounds. Various aspects of technology assisted surgery have been dealt with in this paper along with the different types of technologies in use like computer assisted and robotic surgeries. Traditional and modern methods have been compared and their pros and cons have been discussed in detail along with the application of technology in various surgical branches.
Keywords: surgery, technology, robotics.
Introduction
It has been well said: necessity is the mother of invention.
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James McEwen, Geof Auchinleck and Dr. Brian Day were the pioneers in the field of technology assisted surgery; they developed a robot named Arthrobot which was first used in an orthopedic procedure in 1983. At the same time efforts were also made to design a surgical scrub nurse robot and a robotic arm. In 1985 robots went one step further and helped perform a brain biopsy under CT guidance, the robot that performed the procedure was named Unimation Puma 200 (Berlinger, 2006).
In 1989 Computer Motion was set up and started working towards revolutionizing surgical procedures. The credit for the first pure robotic surgery in the world goes to PROBOT which was developed at Imperial College London and was used in prostatic surgery in the year 1992. In the same year ROBODOC developed by Integrated Surgical Systems was used in hip replacements. Computer Motion developed AesopTM which was considered to be the third hand of the operating surgeon and could hold an endoscopic camera. This was mainly utilized in minimal laparoscopic surgery and was controlled by foot pedals. New users found it hard to master the pedals. However, in 1993 Aesop 1000 was granted FDA approval becoming the first surgical visual aid device to be granted such recognition. In 1996 an improved version which could be controlled by voice command was developed and named Aesop 2000 .Improved dexterity of arm was the main feature of AESOP 3000 which was developed in 1998. Aesop HR has the ability
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The da Vinci Surgical System developed by Intuitive Surgical was actually developed to help perform surgical procedures in adverse environmental conditions or remote places or zones of conflict where the safety of a surgical team could be compromised. But, as the system was used in practical situations it became evident that it would be best to use it in minimally invasive surgical procedures. The da Vinci converts the movements of a surgeon into electronic signals which are then relayed to instruments which are then able to perform surgical steps without the effect of tremors if any in the surgeon’s movements. It is also incorporated with a camera which relays a stereoscopic picture to the monitor through which the surgeon can see the events in real time. This system was approved by FDA in 2001. The various surgical procedures that the da Vinci has performed include heart bypass operations, renal transplant procedure, gall bladder operations and laparoscopic surgeries. The Endowrist was also developed by the same company and it resulted in a design which was similar to a human hand and could perform all the movements in all ranges like the surgeon’s hand but it was more flexible, accurate and provided better manipulation of instruments as compared to a human
Al). This includes the increase in dexterity, the restore of proper hand-eye coordination, and improvement of visualization (Meyers et al.). In Cameron Scott’s article from the Healthline News, “Is da Vinci Robotic Surgery a Revolution or a Ripoff?,” he states that robotic devices including the da Vinci surgical device succeeds well in urology and the removal of prostate. Prostate removal is extremely difficult for open surgery practice, however the da Vinci made is easier with about 90 percent of these kinds of surgeries are now done robotically (Scott). Some evidence even suggest that with robotics used in prostatectomy, there is less blood loss, faster recovery, and fewer internal scarring (Scott.). There are many other examples from hospitals and manufactures that support the uses of robotic surgery and its benefits. However, even though these new technologies of robotic devices are supposedly be helping patients and making surgeries less invasive, they are still many concerns of how they should be properly regulated.
The 21st century can rightfully be considered as the era of technology when the new inventions and discoveries will most likely affect all the segments of human life. At this point, some of the breakthrough inventions of our times have been in the medical field. Robotic surgery has become an almost common practice in the advanced medical world and new uses for robotic assisted surgery are everyday set in place. However, such developments also attract different interests and implications.
The Da Vinci Surgical System is a large purpose-built robot controlled by a surgeon that performs minimally invasive surgical procedures on patients. The system incorporates an ergonomically designed surgeon's console, a patient-side module with four interactive robotic arms, each with interchangeable surgical instruments and a 3-dimensional endoscopic vision system. Powered by high-tech supercomputers, the surgeon's hand movements are scaled, filtered and then converted into precise movements of the surgical attachments. The designers of the system are a team of doctors, engineers and biomedical engineers at a company called Intuitive Surgical.
Robotic surgical devices are a surgical instrument for enhancing robotic surgery which generally includes an elongate shaft with an ultrasound probe. Robot assisted surgery, allows doctors to perform many types of complex procedures with more precision, flexibility and control than is possible with conventional techniques. Robotic surgery is usually associated with just surgerieys The robotic surgical manipulator has a drive plate that bears against the gimbal assembly. The drive plate has two degrees of rotational freedom about a center of motion that is coincident with an intersection of the axes of the gimbal assembly. A surgical robotic system, comprising: a. a port traversing the body of a patient, wherein the port is capable of creating an insufflation seal; b. A robotic device sized to be positioned within a patient by way of the port, the device
Originally there were two robotic systems, one was the Zeus System and the other was the Da Vinci System. The Da Vinci system quickly overtook the Zeus system, and the company that developed the Zeus system is now under control Intuitive Surgical Systems. (Fischer, 2012) The Da Vinci System has advanced since its birth, and is more prominent today. This robot has gone through many redesigns to keep up with the changing field of medicine. The Da Vinci robot is able to perform surgeries with the help of a surgeon guiding the robot. This makes surgery easier, efficient, and recovery time is decreased. The robot has revolutionized how surgeries now take place, because they are less intrusive and help patients have a faster recovery time; however, these robots are very expensive for hospitals and the cost to have a surgery using one of these robots differs from one hospital to another. These robots are the future of medicine, and soon the robot will be able to perform all types of surgeries with the help of a surgeon. Currently the Da Vinci System can be used to perform a laparoscopic cholecystectomy, prostatectomy, colectomy, hernia repair, pulmonary lobectomy, cardiac surgeries, gastric bypass, and hysterectomy. These are a significantly greater amount of procedures that can be performed, in comparison to laparoscopy.
With the utilization of robotics in complicated surgeries, surgeons are able to perform the required tasks with the use of precision offered by robots. The utilization of robotics minimizes surgery trauma, increases dexterity, offers a wider range of motion, and allows improved access to obstructed organs. The da Vinci Robot is a revised, upgraded and an enhanced machine from its predecessors and its original design made by Leonardo da Vinci. A company in California was able to evolve the design of the da Vinci robotic system. Four models were made by Intuitive Surgical, the standard original model, model S, model Si, and the most recent one, model Xi. The da Vinci Surgical System is now a worldwide system that is utilized for
Surgery today is a field of study that relays on technology greatly. Whether it's a simple appendectomy, or a 16 hour open heart surgery, Surgeons have to work with technology. Technology has made surgery easier, post op healing faster, and patient care more convenient for both doctors and patients. These listed results have pushed scientist to continue to experiment and push through barriers to increase and further technolgies role in surgical medicine.
One cutting-edge present technology that this paper will explore is the da Vinci Surgical Robotic System [1], which is being used at Johns Hopkins [2]. This system performs minimally invasive cardiac surgery; it makes the cuts more precise and saves lives. In the future, robotic surgery will become more advanced, as sensory feedback in the da Vinci system could be a future breakthrough that could revolutionize the whole concept of robotic surgery. We envision an improved da Vinci system, with sensory feedback, very precise
The term 'telesurgery' is used to describe surgical procedures that are performed by a surgeon at a distance from the patient through a virtual interface. Still in its experimental stages and limited to minimally-invasive surgical procedures, telesurgery promises to one day bridge physical
Robotic surgery involves performing laparoscopic or minimally invasive surgery (MIS) through the usage of the da Vinci robot, presented by Intuitive Surgical Corporation in 2000. This approach combines the advantages of both the laparoscopic procedures and open surgery and its application in medicine is associated with a major breakthrough in the area of complex surgical operations, such as those of the esophagus, liver, etc. (Ramirez & Lotan, 2015). Until recently, these procedures were performed using an open technique of conventional operation, in which the surgeon was required to cut a broad platform to gain access to the internal organs to overcome the insurmountable technical difficulties. Currently, however, the utilization of the
Technology is transforming the medical field with the design of robotic devices and multifaceted imaging. Even though these developments have made operations much less invasive, robotic systems have their own disadvantages that prevent them from replacing surgeons all together. Minimally Invasive Surgery (MIS) is a broad notion encompassing a lot of common procedures that existed prior to the introduction of robots. It refers to general procedures that keep away from long cuts by entering the body through small, usually about 1cm, entry incisions, through which surgeons use long-handled instruments to operate on tissue inside the body. Such operations are directed by viewing equipment and, therefore, do not automatically need the use of a robot. Yet, it is not incorrect to say that computer-assisted and robotic surgeries are categories that fall under minimally invasive surgery (Robotic Surgery, n.d.).
Doctors are notorious known as a dexterous, meaning they demonstrate neat skill especially with the hands. This is why people trust and prefer doctors to be there surgeons. Many problems and situations lead to this preference. Consequently, arguing if the hospitals should acquire any type of robots to improve the procedures and outcome of an operation.
Introduced in 1987, Robots were used in the first Laparoscopic surgery, a cholescystecotomy, to be exact. (Lee 45).Also known by names such as keyhole surgery, bandaid surgery, or minimally invasive surgery (MIS), Laparoscopic surgery is a surgical technique referring to operations within the abdomen or pelvic region. (Lee 45).More specifically speaking, it belongs to the field of endoscopy. (Lee 45).The first robots used in the surgery consisted of a Hopkins rod lens system, that was usually connected to a video camera (single chip or three chip), and a fiber optic cable system connected to a 'cold' light source (halogen or xenon) that was used to illuminate the area being operated on. (Vertut and Coiffet 97). Because incisions were made
The most widely used system – the da Vinci robotic platform - consists of three components: the surgeon’s console, which directs the movements of the robotic arms, the visualisation apparatus and the patient-side cart, which in the latest system has four arms. Four to five trocars are used, including one through which a 8-mm or 12-mm three-dimensional endoscope is placed. Instruments are introduced through these ports, three of which can be controlled by the robotic arms and one or more controlled by human assistants. After the introduction of port sites and docking the patient side
The medical field has revolutionized the health and well being of society. Throughout the decades, the medical field has been through sweeping changes that leave society astonished. It seems like each year that passes by, there is a new technological advancement that modernizes the medical field. Not only do these advancements modernize medicine, but they in return aid doctors, nurses, and specialists by improving their effectiveness within the field. About ten years ago, the da Vinci Surgical System was introduced to hospitals and the medical field, in general because the FDA had finally approved the system within the United States (Dunkin). The da Vinci Surgical System, also known basically as robotic surgery, introduced the use of a