Transcript ROBOTIC SURGERY - Itprojectsforyou

Robot-assisted surgery is the latest development in the larger
movement of endoscopy, a type of minimally invasive
surgery, the idea being that less invasive procedures
translated into less trauma and pain for patients. Surgery
through smaller incisions typically results in less scarring and
faster recovery. It's not that robots are changing the basics of
surgery. Surgeons are still cutting and sewing like they have
been for decades.
Robots represent a new computer-assisted tool that provides
another way for surgeons to work.
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In 1985 a robot ,the PUMA 560,was used to place a needle for
brain biopsy using CT guidance.
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In 1988,the PROBOT ,developed at Imperial College London,
was used to perform prostate surgery.
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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.
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Artemis
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da Vinci and Zeus
Schurr et al at Eberhard Karls university’s section for
minimally invasive surgery have developed a master-slave
manipulator system that they call ARTEMIS . This system
consists of two robotic arms that are controlled by a surgeon
at a control console . Dario et al at the MiTech laboratory of
Scuola Superior Sant’ Anna in Italy have developed a
prototype miniature robotic system for computer-enhanced
colonoscopy.
They are comprehensive master- slave surgical
robotic system
In the da Vinci system, there are essentially 3
components:
 a vision cart that holds a dual light source and dual
3chip cameras,
 a master console where the operating surgeon sits, and
 a movable cart, where 2 instrument arms and the
camera arm are mounted .
The ZEUS surgical system is
made of an ergonomic surgeon
console and three table-mounted
robotic arms, which perform
surgical tasks and provide
visualization during endoscope
surgery. Seated at an ergonomic
console with an unobstructed view
of the OR, the surgeon controls the
right and left arms of ZEUS, which
translate to real-time articulation
of the surgical instruments. A third
arm incorporates the AESOP
endoscope positioner technology,
which provides the surgeon with
magnified, rock-steady
visualization of the internal
operative field.
Fig: Zeus system
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Fig: surgeon console
Touch screen monitor
Support arms and surgeon
handles
Mounting areas : for
speakers
Access to controller front
panels
Mounting shelves for
housing control units
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Industry standard mechanism-easy sterilization
Instrument reusability
Quick instrument changes
Rapid setup
Visualization
Six degrees of freedom
Seating accommodation
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System overview
. surgeon console
. patient side cart
. insite vision camera with endoscope
Safety concerns remain the centre of focus. To
start the procedure, the surgeon’s head must be
placed in the viewer. Otherwise the system will lock
and remain motionless until it detects the presence
of the surgeons head once again. Included in the
power source is a backup battery that allows the
system to run for twenty minutes, giving the
hospital enough time to re-establish power . Each
instrument has a chip that prevents the use of any
instrument other than those made by Intuitive
Surgical. These chips also store information about
each instrument for more precise control and keep
track of instrument usage to determine when it
must be replaced.
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Precision.
Miniaturization.
Smaller incisions.
Decreased blood loss.
Less pain.
Quicker healing time.
Articulation beyond normal manipulation.
Three- dimensional magnification
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efficiency has not yet been well established
High cost(price tag of million dollars)
Cubersome robotic arms(miniaturization required)
lack of compatible instruments and equipment
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General surgery
Cardiothoracic surgery
Cardiology and electrophysiology
Gastrointestinal surgery
Neurosurgery
Orthopedics
Pediatrics
Robotic surgery is in its infancy. Many obstacles
and disadvantages will be resolved in time and no
doubt many other questions will arise. Many of the
current advantages in robotic surgery ensure its
continued development and expansion. Although
these systems have greatly improved dexterity, they
have yet to develop the full potential in
instrumentation or to incorporate the full range of
sensory input. More standard mechanical tools and
more energy directed tools need to be developed.
Some authors also believe that robotic surgery can
be extended into the realm of advanced diagnostic
testing with the development and use of improved
equipment. The possibilities for improvement and
advancement are only limited by imagination and
cost.
Although still in its infancy, robot assisted surgery
has already proven itself to be of great value,
particularly in areas inaccessible to conventional
laparoscopic procedures. It remains to be seen,
however, if robotic systems will replace conventional
laparoscopic instruments in less technically
demanding procedures. It has the potential to expand
surgical treatment beyond the limits of human ability.
Whether or not the benefit of its usage overcomes the
cost to implement it remains to be seen and much
remains to be worked out. Further research must
evaluate cost effectiveness or a true benefit over
conventional therapy for robotic surgery to take full
root.
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