Robotic surgery

Robotic surgery is the use of robotsin performing surgery. Two major advances aided by surgical robots have been remote surgeryand minimally invasive surgery. Major potential advantages of robotic surgery are precision and miniaturization. Further advantages are articulation beyond normal manipulation and three-dimensional magnification. At present, surgical robots are not autonomous, but are always under the control of a surgeon. They are used as tools to extend the surgical skills of a trained surgeon.

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 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 femurfor hip replacement surgery. Further development of robotic systems was carried out by Intuitive Surgicalwith the introduction of the da Vinci Robotand Computer Motionwith 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 approvedand used in over 300 hospitals in the Americasand Europe. The Da Vinci was used in at least 16,000 procedures in 2004and sells for about 1.2 million dollars.

In 2001, Marescaux used the Zeus robot to perform a cholecystectomyon a patient in Strasbourg, Francewhile in New York.

Applications

Cardiac surgery

Endoscopic coronary bypasssurgery and mitral valvereplacement have been performed.

Gastrointestinal surgery

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

Gynecology

Reproductive surgery and ablative surgery including hysterectomyhave been performed.

Neurosurgery

The PUMA was the first system for stereotacticinterventions. Another robot is the Neuromate (Integrated Surgical Systems).

Orthopedics

The ROBODOC system has been accused to have led to a series of complications in Germany [1].

Pediatrics

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

Urology

Surgical studies have been done with the Zeus and the da Vinci models.

Limitations

Current equipment is expensive to obtain, maintain, and operate. Surgeons and staff need special training. Data collection of procedures and their outcomes remains limited.

External link

• Da Vinci Robot
• AESOP and Zeus Robotic System
• ROBODOC
• Article about remote surgery

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.

This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Robotic+surgery Wikipedia article Robotic surgery.