The Use of Robotics in the Operating Room

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Table of Contents

Advantages and Disadvantages of Robotic Surgery
The future
Conclusion
References

What is Robotics? Imagine an operating room with many machines and television monitors and no human surgeon. It would feel like an ET movie wherein robots operate on humans. But such a situation has become reality and is getting popular in many parts of the world. The word Robotics was coined by Isaac Asimov in 1938, in fiction. Later on, in 1958 Robots were made in real and since then they have been used for various purposes from deep-sea exploration to space travel. The first Robotic Surgery was performed in 1985. In 1992 the first Robodoc was introduced to be used in hip replacement surgery. The surgery performed by the Robodoc proved to be more precise than a conventional doctor (Faust 2006 p.8). As with a computer, precision and minimal possible errors are the highlights of using robotics in surgery. Robotic surgery is performed by a four-armed robot that permits surgeons to control the micro-actions of minute surgical gadgets through the smallest apertures in the body of the patient. Surgeons control the robot’s arms and hand from a control board away from the operating table. The robots have a jointed flexible wrist design that allows their hands to twist and bend with more dexterity than human hands, allowing the doctor to create key-hole size slits and position fine stitches accurately. Conventional open surgeries need 8-10 inch opening and can result in considerable blood loss, prolonged and painful healing, and other complications.

The da Vinci surgical system is the first and one of the famous Robotics surgical systems used in the operating room. The smaller slits and superior accuracy that are achievable with the Da Vinci Surgical System decrease the risk of complications. The robotic hands hold surgical instruments and a camera with high magnification that enhances the surgeon’s visibility and presents three-dimensional scrutiny of the area where surgery is performed. Patients benefit the most due to such accuracy in robotic surgery. They do not have to endure pre and post-surgery trauma and pain since the incision is very small and has less blood loss compared to open surgery. Technology as such has developed the entire process that can be recorded and allows doctors to further analyze the patients’ response to treatment and understand the methods and procedures that are most successful. Many establishments use robots to make virtual rounds, observing the patients from their workplace and residence through telemedicine and tools that convey wellbeing at a distance. Patients can anticipate exceptional precision and a much faster recuperation with this radical technology (Ropp, 2001).

Tele-robotic Surgery and Tele-mentoring – Yulan Wang, with the funding from DARPA (Defensive Advanced Research Projects Agency), developed the first computer-assisted camera which was triggered by voice for laparoscopic surgery that substituted a surgical assistant called AESOP short for Automated Endoscopic System for Optimal Positioning. The concept was further developed by various other doctors in the following years. In 2001, the first transatlantic telerobotic surgery was performed. The doctors were seated in New York City and were controlling the robots over a high bandwidth fiber optic to minimize the transmission delay to the operating room in Strasbourg, France. This surgery was successful and the world realized the significance of Tele-Robotics and Tele-mentoring. Robotics technology is being used successfully in Urologic Surgery, Neurosurgery, Cardiothoracic surgery, Paediatric General and thoracic surgery, Advanced Gynecologic surgery, Head and Neck Surgery, Surgery of Upper Airways, and Transoral robotic surgery.

Advantages and Disadvantages of Robotic Surgery

The best advantage of Robotic surgery / telerobotic surgery is its accuracy and minimal incision. Patients suffer fewer traumas before and after the surgery due to very less blood loss and smaller cuts to heal. The patients take less time to recuperate. The easily movable wrists of robots make certain types of surgeries, which need the smallest and accurate movements, possible without much risk. Since the entire process is recorded and displayed magnified on a screen, monitoring and controlling such surgeries by experts even from distant areas is possible. This is a big advantage to military and remote areas without specialized doctors, hospitals, and facilities. The risk of tremors by a human surgeon can be completely avoided by robotic surgery. When compared to laparoscopic surgery also robotic surgery is advantageous due to the smaller size of equipment used to make minute movements required for many types of complicated surgeries. Since the entire body is under scan during the surgery, any unexpected changes can also be promptly monitored, and if required open surgery can be done. Robotics can be used for laparoscopic as well as open surgeries. Human limitations to reach certain areas of the body and the difficulty to position the patient such that the surgeon can operate on the patient with ease make certain types of surgeries complex, risky, and almost impossible. Robotics can overcome such issues and can operate from any position and in minute detail. Another major advantage is that the learning and experiments are done through virtual reality. So while learning no harm is done to any human or animal. If anything goes wrong it can be easily monitored and open surgery can be done without delay. Recording robotics surgery makes sure that the entire process is available for reference and the progress can also be monitored with the help of the computer. As far as the doctor is concerned, the best possible image of the area operated upon is obtained and the doctor is saved from the physical fatigue involved in long hours of surgery.

The major disadvantages are that the robotic equipment requires a lot of space and is not easy to transport to another place. This space constraint limits the surgeon’s physical presence in the operating room in case any intervention is required. As mentioned earlier, the surgery is monitored, recorded, and controlled by the surgeons in a distant space that may or may not be near the operating room. Another problem of robotics is that it requires technical expertise and machinery both of which are expensive. Therefore limited surgeons will be available who can operate, monitor and control such machines. Further, the number of hospitals that can afford the technology is few. The control signals’ transmission can be another problem in remote areas. A time delay in transmission is very risky for the patient. Another major issue is whether or not a computer/robot can be fully relied upon to operate on a human. Robotics is an upcoming technology and it is still in the process of evolution. Hence its reliability is relative to a particular area in which robotics has been successful thus far. Being computer robotics will have to be frequently upgraded which is a problem for the institutions using it. Finally, as with any emerging technology, an element of unknown risk is involved currently with robotic surgery which makes many patients and even doctors turn skeptical towards the technology (Faust 2006 p.8-11).

The future

Cutting down the equipment size and expense on the technology is the major challenge of future robotic surgery. Since robotic surgery is in its formative years, issues such as training requirements, licensing, legal responsibility upon malpractice, and interstate permits for tele-surgeons are yet to be explored. Research is going on for transmitting touch sensation from robotic gadgets back to the surgeon, stitch-less anastomoses, and programmed surgery rather than the currently prevailing controlled surgery. The potential for expansion and enhancement is limited only by cost and imagination (The Future of Robotic Surgery 2004).

Conclusion

Robotics in surgery offers great advantages to the patients as well as the doctors. Accuracy, ability to reach deep organs, flexible wrists, process recording, and being able to operate across distances all make the future of robotics promising. Areas that will benefit the most from robotics include remote areas without expert doctors. Time will prove that robotics is the future of surgery.

References

Faust, R.A. 2006. Robotics in Surgery: History, Current and Future Applications. New York: Nova Publishers
Ropp, K.L. 2001 Robots in the Operating Room.
The Future of Robotic Surgery 2004. Web.

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The Use of Robotics in the Operating Room

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