Thursday, October 14, 2010

Robotic Surgery- Kelly Riebesell

I. Introduction
       To be considered a robot in the industrial setting, a piece of equipment needs to be programmable.  The technician has to be able to teach the robot new things and able to leave it unsupervised while the robot performs those tasks.  The definition of a robot becomes a very broad topic when it includes forms of remote control by a human operator.  In the last few years, robots have been applied in a variety or clinical procedures.
II. Discovery
        Up until recently, the only options for surgery have been the traditional operation, which requires a large incision, and laparoscopy, which uses a small incision but is limited to very simple procedures.  Now, with the use of the da Vinci surgical system, surgeons are able to offer a minimally evasive option for even the most complex surgical procedures.
         With the da Vinci surgery, a robot is not placed at the controls; but the robotic surgeons sit at the console of the da Vinci surgical system while the robot's camera and surgical instruments are placed into ports inserted through a few small punctures.  The robot's binocular eye-piece lense provides a 3-D view inside the patient, and up to 15 times magnification.  The surgeon controls pencil-sized instruments on the robotic arms- each with a tiny wrist-like joint.  A specialized computer program translates the
movements at the controls into precise micro-movements.
          There are currently three types of robotic surgery systems: Supervisory-Controlled Systems, Telesurgical Systems, and Shared Control Systems.  In the Supervisory-Controlled System, the surgeon first does any prep work needed, he inputs the data in the robotic system, plans course of action, takes x-rays, tests the robot's motions, places the robot in an appropriate position, and watches the robot do the procedure to make sure everything goes as planned. The Telesurgical System is the second type of device used in modern robotic surgery.  The most common variety of this system, the da Vinci Robotic Surgical System, as stated earlier, enhances the surgery by providing a 3-D visualization within hard-to-reach places like the heart.  It also enhances the control of tiny instruments.  This advancement in technology allows surgeons to make quicker, more controlled, and more accurate movements by using the robotic arm with its wide range of motions.  It also allows surgeons to even perform these procedures at all, since many of the techniques performed by the robot assistants are highly skilled and extremely difficult for a human to do.  The Shared Control System is the third system that is used in robotic surgery.  In this system, the surgeon does most of the work, but the robots assist when needed.  Before starting the procedure, the surgeon programs the robot to recognize safe, close, boundary, and forbidden territories within the human body.
III. Advantages and Disadvantages
            The most significant advantage to robotic surgery is that the patient has a major decrease in pain and scarring.  Using the device's cameras and enhanced visual effects, doctors can make very small incisions on the patient.  With the da Vinci system's use of "arms" to operate, only a few centimeters is needed for each incision.  The smallness of the incisions also cause many other advantages.  Due to small precise cuttings, a patient's hospital stay is greatly reduced.  Far less recovery time is needed when a patient's scar is only three centimeters, than when a patient has a scar of almost ten times as large.  Another advantage is that the risk of infection or complication decreases as the incision does.  Robotic Surgery is also very advantageous to the surgeon.  The 3-D camera used on the machine gives doctors a better image than a real life image would.  Also, with hand controls, the surgeons can reach places in the body that are normally unreachable by the human hand.
           With all the system's advantages also comes it's disadvantages.  Since this is a new technology, the uses have not yet been well established.  Also, many procedure will have to be redesigned to optimize the use of the robotic arms and increases the efficiency.  However, time will most likely remedy these disadvantages.  One major disadvantage in this system is the cost, with a price of a million dollars.  One last major disadvantage in these systems is their size.  They are very large and have relatively cumbersome robotic arms.  This is an important disadvantage in today's already crowded operating rooms.
IV. Impact on the World/Humanity
             The recent discovery and use of Robotic Surgery is currently having a major impact on the world.  With this being a newer discovery, in time, it is hoped that it will have an impact on many more people and used very widely around the world.  Robotic Surgery has opened up a new and easier way to perform difficult and sometimes almost impossible surgeries.  With the use of robotics, there are new surgeries that can now be performed, and in the future it is hoped that Robotic Surgery can be saving lives.  Robotic surgery is minimally invasive and therefore is much safer for the patient, and much easier for the surgeon.  It's many advantages are worth the risk.  It does have its few disadvantages, but in time, most of those disadvantages will be remedied.
V. Journal Article Review
            A study was done with 32 consecutive patients that were scheduled to undergo robotic-assisted surgery.  These patients were at an age range of 23 to 76 and were consisted of 19 men and 13 women.  All 32 of these cases used the da Vinci Surgical System.  The result in these procedures was that there were no deaths, and the procedures were performed effectively, and the median hospital stay was only 2.2 days.  This experience suggests that robotic surgery is feasible and can be performed safely.  The main advantage in robotic assisted surgery is that it gives the surgeon a 3-D visual and better instrument manipulation than can be obtained with any other procedure.
VI. List of References
(Childress, 2007)
(Schroedter, 2006, p. 1)
(Ferrel, Orliaguet, Leifflen, Bard & Fleury, 2001, p. 56)
("Fighting Diseases with Microchips," 2002, p. 11)
      

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