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Definition and Types of Robotic Surgery

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    Have you ever been in a hospital operating room full of doctors in masks and gowns? If not, take a look at this picture. Wouldn’t you feel better If this number decreases, leaving only one or two doctors maximum? (pic1) Wouldn’t be less stressful and more comfortable if you don’t hear them discussing and talking above your head? Through searching within different topics, today I bring you out a very interesting one. Most probably, many of you haven’t heard about it before: robotic surgery. Today, I would like to inform you about the definition and the types of robotic surgery, their advantages and their disadvantages. et us start by introducing robotic surgery. Defined by Allrefer. com: « Robotic surgery is a technique in which a surgeon performs surgery using a computer that remotely controls very small instruments attached to a robot». () In his article, What are the types of robotic surgery? , Mike selvon explains about the diverse categories of robotic surgery system. According to him, three main typess are found: Supervisory-Controlled systems, Telesurgical systems and Shared-Control systems. Supervisory-Controlled systems are the most automated one.

    It does require a significant amount of preparation to set up to perform each surgery. A specific set of commands, unique to both the patient and the procedure being performed, is first entered into the system by the surgeon and support team. This is accomplished with extensive mapping of the body using three-dimensional medical imaging. Just prior to the surgery, the system is then registered to match the patient’s body to the mapping in the surgical system. Finally, the surgery begins. Once the surgery is under way, the robotic system will automatically execute the procedure.

    Robodoc system is the most famous one in this type. (pic3) When it comes to shared control system, the system will assist in performing surgical procedures, however the human surgeon will perform most of the work, actually operating the surgical tools by hand. The system will monitor the activities of the surgeon. It then assists by helping to stabilize and support the surgeon’s movements using a technique called active constraint. Before getting started, the surgeons program the robots to recognize safe, close, boundary and forbidden territories within the human body.

    Telesurgical system is the last one, With this system, a surgeon actually directs the actions of robotic arms. In effect, the robot becomes an extension of the surgeon. (pic 4)The system consists of surgical arms within a surgical suite and a separate viewing and control console. The surgeon will view the surgical field in a three-dimensional viewing screen and will manipulate the robotic arms from hand-held controls within the console. Another surgeon in the surgical suite will change out tools on the robotic arms as needed during the procedure.

    Small incisions will be made in the body and the tools will then be inserted. Once this step is complete, the surgeon can then operate. This technology allows surgeons to make quicker, more controlled and more accurate movements by using the robot arm with its wider range of motions. The most important system in it is the Da vinci robotic Surgical System(pic 5), which enhances the surgery by providing 3-D visualization deep within hard-to-reach places like the heart, as well as enhancing control of tiny instruments. Now, let us move to talk about the advantages of robotic surgery.

    Robots in the field of surgery have dramatically changed procedures for the better. The major benefits for the patient are decreased blood loss, less pain, and quicker healing time. According to Bonsor and Strickland in their article how Robotic Surgery will work? Explains that The use of Robotic surgery instead of usual operation done nowadays will increase precision, and decrease pain. By using cameras and enhanced visual effects, doctors can make the tinniest of incisions. This also implies less recovery time. In fact, according to hoise. om, The San MAtteo Hospital in Pavia, Italy performed a cardiac bypass surgery that included three incisions, each about one centimetre in length. Usually, in the normal type of surgery, the incision is about 30centimeters in length. The surgeon Dr. Mauro Rinaldo who performed the operation explained that his patient was released from the hospital after 12hours of recovery only. Robotic surgery is also beneficial to the surgeon and hospital. In the robots a camera is found, It is a 3D camera used in robotic surgery. It provides a better image than real life. This will help the surgeons in microscopic surgery’s that deal with nerves.

    Moreover, the most important advantage to using robots in surgery is in long operations. Surgeons often get exhausted easily when performing microscopic surgery’s that last hours. As a result, their hands will shake. However, the robots used in robotic surgery are programmed that the computer will ignore the surgeon tremor if it happens. Now that you know the advantages of robotic surgery, let’s look for its disadvantages. The main two disadvantages of robotic surgery are high cost and machine dependent. First, the surgery linked to robots is a new concept; it is complex and very expensive.

    According to medscape. com, the cost of a robotic surgery is almost 1 million dollars which makes it almost impossible and unaffordable. Moreover, the large size of the system. The robot is bulky and is the large size of the system in an overcrowded-operating room. The robotic arms and bulky, and there are many instruments needed in the small space. The solution would be either to provide larger operating rooms or to minimize the robotic arms and instruments. However, both solutions requires a lot of money. Second, robots are machines, they lack a brain.

    Being controlled by machines, robotic surgery can fail during a operation causing healthy tissues to be destroyed. This can lead to brutal results, sometimes causing death. Moreover, machine needs to be upgraded. And here comes the question: how much will hospitals and healthcare organizations have to spend on upgrades and how often? And how much will the doctors be able to accept, practice and expertise with the equipment being always upgraded? Because if he’s not practiced, the robotic surgery will take more time from the typical one, and here, we are risking a patient life being under anesthesia for a long time.

    In conclusion, Robotic surgery as I have showed is considered an important new technology having many advantages and disadvantages. According to Dr. Krummel: «Surgery is going digital, it’s no longer about blood and guts but bit and bytes. I don’t think surgical robotics is an end technology, but a step along the way to something bigger. What might be a bit troubling, thought, is that the first part of the progress curve seems long and flat. But, that’s how it’s been with so many big advances. »

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