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Robot-Assisted Surgery

Robot-assisted surgery

Definition

Robot-assisted surgery involves the use of a robot under the direction and guidance of a surgeon.

Purpose

Robot-assisted surgery provides many benefits in the surgical care of patients. Computer-assisted robots provide exact motion and trajectories to minimize the side-effects of surgical intervention. Surgeon-guided robotics allow the surgeon to access patient anatomy with smaller incisions.


Demographics

Patients undergoing surgical procedures classified as neurosurgery , orthopedic surgery , radio surgery and radiotherapy, prostatectomy, endoscopy, laparoscopy , cardiac surgery and craniofacial surgery may experience robot-assisted surgical techniques.


Description

Neurosurgery

A high level of accuracy is required when operating on the brain to avoid damage to the sensitive brain tissue. Biopsies and minor interventions are best assisted by the robotic device. Interventions include drilling into the skull and making an incision through the dura mater to gain brain tissue samples, empty cysts, or eliminate hemorrhage.


Orthopedic surgery

Applications such as cementless hip-replacement, total knee arthroplasties, and pedicle screw placement can benefit for the more accurate cutting and drilling provided by a robot. Femur bone-cutting devices provide improved drilling to carve a cavity in the bone for prosthesis implant. Pins inserted into the bone before surgery are used as landmarks for computerized tomography (CT) imaging. The CT image provides the surgeon with the necessary information for choosing an implant. The surgeon removes the head from the femur bone, eliminating the joint. The leg is secured in position and the robot is brought into position. A high speed cutter is then applied to create the cavity, and then followed by a smoothing tool. The surgeon manually inserts the implant into the femur and completes the cap implant into the pelvic bone.

Radiosurgery and radiotherapy

Radiation treatment is provided by a robot. The CT image or magnetic resonance image (MRI) is used to determine where the radiation treatment should be delivered. The robot aligns with patient anatomy, delivering specific doses of radiation to the intended location.


Prostatectomy

Removal of all or part of the prostate is another robot-assisted procedure. The robot controls instruments inserted through the urethra to the prostate gland. A diathermic hot wire cutting loop is guided to remove tissue in an appropriate pattern around the urethra. Fastening the guiding frame to the upper legs of the patient secures the device for accurate guidance.


Endoscopy

Endoscopy is used to examine patient cavities for the presence of polyps, tumors, and other disease states. The endoscope can be better passed through cavities such as the colon or trachea. Three-dimensional images of the cavity are obtained and used to dictate the path that will be taken to pass the endoscope. Sedation and heavy analgesia can be avoided.


Laparoscopy

In laparoscopic surgeries, three to four small incisions are made in the abdominal or thoracic cavity to insert the instruments and video equipment. The surgeon performs the operation from a remote console that provides the human machine interface. The console provides video monitoring images that are three dimensional. Joysticks are used to manipulate the tools within the chest cavity to complete the surgical procedure.


Cardiac surgery

Robots are being used in the coronary artery bypass grafting surgeries and cardiac valve replacement and repair surgeries. The harvesting of artery and vein grafts can also be accomplished with the aid of laparoscopic techniques.


Craniofacial surgery

Difficult bone cuts and bone tumor removals are accomplished successfully using robotic instruments. Preplanned trajectories are programmed into the machine. Precision cuts are made in the manner desired to achieve an esthetical and satisfactory result. As the surgeon manipulates the saw, he or she is guided along the path by a predetermined trajectory determined during an initial run on a model of the surgical site.


Aftercare

The patient should expect a faster recovery then that achieved by traditional surgery procedures.


Risks

With some of these procedures, a longer surgical time is required to achieve the same desired outcome as the traditional surgical approach. There is an increased risk of anesthesia related complications as surgical times increase. Additionally, if the robotic procedure is not completed successfully, the surgeon may need to complete the procedure with a traditional technique.


Normal results

Results for each procedure are comparable to or better than the standard surgical procedure.


Morbidity and mortality rates

Complications should be comparable to the standard surgical procedure, and even reduced. Some complications may only be associated with the robot-assisted procedure.


Alternatives

Alternative treatment is to use a traditional surgical approach without the use of robot assistance.

Resources

periodicals

Rembold, Ulrich, and Catherina Burghart. "Surgical Robotics: An Introduction." Journal of Intelligent Robotic Systems 30 (2001): 128.


Allison Joan Spiwak, MSBME

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?



These procedures are performed by surgeons trained in the operative technique with robotic assisted surgery. The expense associated with the purchase of robot-assisted equipment can limit the number of institutions able to provide robot-assisted surgery.

QUESTIONS TO ASK THE DOCTOR



  • Is there an institution in the vicinity which uses robot-assisted surgery?
  • Is the surgeon experienced in robot-assisted surgical techniques?
  • What benefits would the robot-assisted surgery provide?
  • What complications can be avoided and which may be encountered with robot-assisted surgery?

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"Robot-Assisted Surgery." Gale Encyclopedia of Surgery: A Guide for Patients and Caregivers. . Retrieved November 21, 2018 from Encyclopedia.com: https://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/robot-assisted-surgery

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Robotic Surgery

ROBOTIC SURGERY

Throughout the world, computer scientists are working to perfect robots to assist in and ultimately perform surgery. With the help of such robots, surgeons have more control and precision in performing operations. Plus, small robotic tools can reach places that human hands cannot. The first robotic surgical system was approved for use by the U.S. Food and Drug Administration in 2000. Called the da Vinci Surgical System, it was developed by Intuitive Surgical in California.

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Robot-Assisted Surgery

Robot-Assisted Surgery

Definition
Purpose
Demographics
Description
Aftercare
Risks
Normal results
Morbidity and mortality rates
Alternatives

Definition

Robot-assisted surgery involves the use of a robot under the direction and guidance of a surgeon.

Purpose

Robot-assisted surgery provides many benefits in the surgical care of patients. Computer-assisted robots provide exact motion and trajectories to minimize the side effects of surgical intervention. Robot-assisted surgeries can use three-dimensional imaging and surgical tools to operate in a closed environment through smaller incisions. For example, traditional methods of cardiac surgery usually required a six-to-eight inch incision in the sternum and the use of a heart-lung machine to maintain the functions of the heart and lungs while they are stopped for the surgery. Robot-assisted surgery has furthered the use of the keyhole approach, in which multiple small incisions are made between the ribs. With robot-assisted surgery, the surgeon is also able to make more precise movements using motion scaling. In this practice, an image is enlarged and the movements of the surgeon’s hands are translated by the computer into smaller movements. This allows surgeons to perform more precisely, which can be especially important when the surgery is to be performed on particularly small parts of the body.

Demographics

Patients undergoing surgical procedures classified as neurosurgery, orthopedic surgery, radio surgery and radiotherapy, prostatectomy, endoscopy, laparoscopy, cardiac surgery and craniofacial surgery may experience robot-assisted surgical techniques.

Description

Neurosurgery

A high level of accuracy is required when operating on the brain to avoid damage to the sensitive brain tissue. Biopsies and minor interventions are best assisted by the robotic device. Interventions include drilling into the skull and making an incision through the dura mater to gain brain tissue samples, empty cysts, or eliminate hemorrhage.

Orthopedic surgery

Applications such as cementless hip-replacement, total knee arthroplasties, and pedicle screw placement can benefit from the more accurate cutting and drilling provided by a robot. Femur bone-cutting devices provide improved drilling to carve a cavity in the bone for prosthesis implant. Pins inserted into the bone before surgery are used as landmarks for computerized tomography (CT) imaging. The CT image provides the surgeon with the necessary information for choosing an implant. The surgeon removes the head from the femur bone, eliminating the joint. The leg is secured in position and the robot is brought into position. A high speed cutter is then applied to create the cavity, and then followed by a smoothing tool. The surgeon manually inserts the implant into the femur and completes the cap implant into the pelvic bone.

KEY TERMS

Arthoplastic— Manufactured replacement joint.

Cardiac surgery— Surgery performed on the heart.

Craniofacial surgery— Surgery of the facial tissue and skull.

Endoscopy— Used to visualize internal structures of the body, such as the trachea, esophagus or intestines.

Laparoscopy— Surgery on internal structures through small incisions and visualized with the laparoscope.

Neurosurgery— Surgery performed on the brain.

Orthopedic surgery Surgery performed on the bones. May include joint replacements and surgery of the vertebrae.

Prostatectomy— Performed for the treatment of prostate disease including prostate cancer.

Radio surgery and radiotherapy— Used in the treatment of cancerous growths or kidney stones.

Radiosurgery and radiotherapy

Radiation treatment is provided by a robot. The CT image or magnetic resonance image (MRI) is used to determine where the radiation treatment should be delivered. The robot aligns with patient anatomy, delivering specific doses of radiation to the intended location.

Prostatectomy

Removal of all or part of the prostate is another robot-assisted procedure. The robot controls instruments inserted through the urethra to the prostate gland. A diathermic hot wire cutting loop is guided to remove tissue in an appropriate pattern around the urethra. Fastening the guiding frame to the upper legs of the patient secures the device for accurate guidance.

Endoscopy

Endoscopy is used to examine patient cavities for the presence of polyps, tumors, and other diseases. The endoscope can be better passed through cavities such as the colon or trachea. Three-dimensional images of the cavity are obtained and used to dictate the path taken by the endoscope. Sedation and heavy analgesia can be avoided.

THE DA VINCI SURGICAL SYSTEM

Approved by the U.S. Food and Drug Administration in 2000, the da Vinci surgical system is the most popular surgical robotic system used in hospitals as of 2008. According to the company that manufactures the system, Intuitive Surgical, over 210 are used in hospitals throughout the world. The system has four robotic arms which move the cameras and tools the surgeon controls from a consol. While the da Vinci costs over one million dollars, many surgeons who use the system say that is has become an indispensable aid to complicated surgical procedures. Moreover, it has been estimated that hospitals save money overall because the length of post-surgical hospitalization is cut in half.

Laparoscopy

In laparoscopic surgeries, three to four small incisions are made in the abdominal or thoracic cavity to insert the instruments and video equipment. The surgeon performs the operation from a remote console that provides the human-machine interface. The console provides video monitoring images that are three-dimensional. Joysticks are used to manipulate the tools within the chest cavity to complete the surgical procedure.

Cardiac surgery

Robots can be used in the coronary artery bypass grafting surgeries and cardiac valve replacement and repair surgeries. The harvesting of artery and vein grafts can also be accomplished with the aid of laparoscopic techniques.

Craniofacial surgery

Difficult bone cuts and bone tumor removals are accomplished successfully using robotic instruments. Pre-planned trajectories are programmed into the machine. Precision cuts are made in the manner desired to achieve an aesthetically satisfactory result. As the surgeon manipulates the saw, he or she is guided along the path by a predetermined trajectory determined during an initial run on a model of the surgical site.

Aftercare

The patient should expect a faster recovery then that achieved by traditional surgery procedures.

QUESTIONS TO ASK THE DOCTOR

  • Is there an institution in the vicinity which uses robot-assisted surgery?
  • How experienced is the surgeon with robot-assisted surgical techniques?
  • What benefits would the robot-assisted surgery provide?
  • What complications can be avoided and which may be encountered with robot-assisted surgery?

Risks

With some of these procedures, a longer surgical time is required to achieve the same desired outcome as the traditional surgical approach. There is an increased risk of anesthesia related complications as surgical times increase. Additionally, if the robotic procedure is not completed successfully, the surgeon may need to complete the procedure with a traditional technique.

Normal results

Results for each procedure are comparable to or better than the standard surgical procedure.

Morbidity and mortality rates

Complications should be comparable to the standard surgical procedure, and even reduced. Some complications may only be associated with the robot-assisted procedure.

Alternatives

The alternative to using robot-assisted surgery is for the surgeon to employ a traditional surgical approach.

Resources

BOOKS

DiGioia, Anthony et al, eds. Computer and Robotic Assisted Hip and Knee Surgery. New York: Oxford University Press, 2004.

Faust, Russel A., ed. Robotics in Surgery: History, Current and Future Applications. New York: Nova Science Publishers, 2007.

Stiehl, James B., Werner H. Konermann and Rolf G. Haaker, eds. Navigation and Robotics in Total Joint and Spine Surgery. New York: Springer, 2004.

PERIODICALS

Bates, Betsy. “Robots Can Assist in Improving Care.” Internal Medicine News 39.17 (Sept 1, 2006): 1–3.

Diks, J., D. Nio, V. Jongkind, M. A. Cuesta, J. A. Rauwerda and W. Wisselink. “Robot-Assisted Laparoscopic Surgery of the Infrarenal Aorta; The Early Learning Curve.” Surgical Endoscopy 21.11 (Nov 2007): 2118–2120.

Allison Joan Spiwak, MSBME

Robert Bockstiegel

Cite this article
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"Robot-Assisted Surgery." The Gale Encyclopedia of Surgery and Medical Tests. . Encyclopedia.com. 21 Nov. 2018 <https://www.encyclopedia.com>.

"Robot-Assisted Surgery." The Gale Encyclopedia of Surgery and Medical Tests. . Encyclopedia.com. (November 21, 2018). https://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/robot-assisted-surgery-0

"Robot-Assisted Surgery." The Gale Encyclopedia of Surgery and Medical Tests. . Retrieved November 21, 2018 from Encyclopedia.com: https://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/robot-assisted-surgery-0

Learn more about citation styles

Citation styles

Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

http://www.chicagomanualofstyle.org/tools_citationguide.html

American Psychological Association

http://apastyle.apa.org/

Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.