Transcript Robotic surgery - Amirkabir University of Technology

Robotic surgery
Atefeh Jannatbabaee
Department of Biomedical Engineering
Amirkabir University of Technology
April 2008
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Open Surgery:
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Advantages
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Disadvantages
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3D vision
Tactile sensing
Short
instruments
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More blood loss
More pain
Long recovery
time
Damage to the
side tissues
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Endoscopic Surgery:
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Advantages:
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Disadvantages:
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Less blood loss
Less pain
Shorter recovery
time
Less damage
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2D vision
tactile feedback
Long instruments
Human
cameraholder
Long training course
for staff
Not efficient to all
surgeries
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Robotic features:
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Doing routine tasks efficiently
in shorter time
Doing jobs that human cannot
do!
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History :
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US military began a top secret
project in order to use robo
surgeons in the battlefields
cause of the shortage of
surgeons during wars
Dr Fred Moll established the
Intuitive Surgical Inc. in 1995
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Common robotic systems on
the market:
AESOP
 ZEUS
 Da Vinci
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AESOP
(Automated Endoscopic System for Optimal Positioning)
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A robotic arm used as a camera
holder; product of Computer Motion
Inc.
AESOP1000 : 6DOF ,hand and foot switch
control
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AESOP2000: Voice controlled
AESOP3000: an additional joint as an elbow;
7 DOF
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AESOP HR (HERMES READY):Voice control of
AESOP, prepheral devices such as room light
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ZEUS:
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Product of Computer Motion Inc.
First surgery in 1998
FDA approval in 2001
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Components:
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Surgeon_side :
Console:
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Patient_side :
2 robotic arms for manipulation of
instruments
1 camera arm
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Features:
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3D vision of Storz system
Note: the surgeon wears special glasses
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Tremor abolition
Motion scaling in the range of 2:1
& 10:1
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Da Vinci:
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Product of Intuitive Surgical Inc. in 1997
First Surgery by Himpens et al. in 1997
FDA approval in July, 2000
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Features:
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7 DOF
Surgeon at a console
Stereoscopic vision
Tremor elimination
Motion scaling
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Components:
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Robotic Cart
The Console
Endoscopic stack
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Robotic cart:
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2 meters high , 1 meter long and
1 meter wide
Approximately 544kg weight
Manual movement on wheels
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Robotic Cart
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The Arms:
A central arm to hold camera
Two lateral arms to hold
instruments
The arms are not sterile and are
draped with sterile bags.
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Robotic cart
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Camera system:
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There are two cameras with 0 and 30
angles
The camera system has a dual lens
system with two three-chip cameras
Projection of two images provides real
3D image in binocular viewer
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Robotic cart
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Instruments:
They have an 8 mm diameter
Endo-wrist instruments
6DOF of the tips and 1DOF within
instrument activity
They can be resterilized up to 10
times
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The Console:
Binocular viewer of the Insite
vision system:
The 3D image is viewed by
binocular viewer
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The Console
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Instrument Controllers:
The surgeon put his thumb and
forefinger in the loops of master
controller
Approximate motion of fingers operate
the instruments
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The Console
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Foot Pedals:
Central pedal: adjusts the camera
focus
Camera pedal : engages the camera
arm & disengages instrument arms
Clutch pedal: disengages instrument
arms
Third pedal: activates diathermy
Fourth pedal: usually inactive
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The console
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Control Panels:
First panel :adjustments of camera,
endoscope and motion scaling
Second panel: Start control
system, emergency stop button &
standby buttons.
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Endoscopic stack:
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2D monitor
CO2 insufflator
Light source
Camera unit
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Ergonomics:
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Ergonomic chair
Ergonomic controller
Head rest
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Operation Room:
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Clinical Impact:
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Robotic surgery used in:
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Areas of surgery have been improved:
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Radical prostatectomy
Areas of surgery in which MIS became
possible:
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Cardiothoracic surgery
Gastrointestinal surgery
urological surgery
Gynecological surgery
Coronary artery bypass grafting
Other thoracic procedures
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Good for:
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Precise tissue
manipulation
Improved
visualization
Magnification
Tremor
elimination
Surgeon
ergonomics
Bad for:
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Large areas
Tactile feedback
Speed
Team
ergonomics
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Two important issues about
Da Vinci:
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Cumbersome at bedside
Resident teaching issues
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Barriers:
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Size
Cost
Culture within the operating room
Ease of use
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The Future of Robotic
Surgery:
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Will make more difficult operations
possible
Will allow more surgeons to
perform advanced laparoscopic
surgery
The systems will be smaller and
much easier to use and have
semiautonomous control
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Need of Robots in telemedicine:
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Robots will be an integral part of health care delivery in
wars, explorations or in far distant locations
Intelligent robots will reduce the need for a physician
Rapid delivery of care
Independent of distance or environment
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