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     Volume 5 Issue 122 | December 1, 2006 |

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Robotic Surgery

Edward Apurba Singha

The da Vinci Surgical System makes three incisions, each 1 cm in diametre. This way, the patient experiences less pain and bleeding, which means a faster recovery

Technology has a profound impact on every phase of human life. Day by day people try to lead a more tech-oriented life. Nowadays, most of us are concerned with communication technology because it is an inevitable part of our daily life. Consequently, we pay little attention to the outstanding progress of medical technology. It has been anticipated that due to the advancement of artificial intelligence and information technology, unprecedented success is imminent in medical science.

Currently it could be said that people increase their performance by handing over some of their responsibilities to machines. Precisely speaking, human beings start depending on extreme machines called robots. We have already observed robots deployed in manufacturing plants, space exploration and rescue operations to work side by with humans. Now robots are being used to inspect the internal components of the human body and are employed in life saving surgery.

Invention of surgical robots is a breakthrough in modern medical science and further development is underway to create fully functional robots. First generation surgical robots are not fully autonomous and need human intervention. These machines still require a human surgeon to operate them and to give them instructions. There are different methods such as remote control and voice activation by which these surgical robots are controlled.

The underlying reasons to introduce robotics in medical science are precision and to avoid fatalities due to human error. Medical robots have been used to position an endoscope, perform gallbladder surgery, and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be able to perform close-chest heart surgery and minimise the risk. Today several robotic systems are developed to perform critical body surgery namely da Vinci Surgical System, ZEUS Robotic Surgical System, AESOP Robotic System, etc.

Using joysticks, a surgeon can perform surgery that requires a lot of precision

The U.S. Food and Drug Administration (FDA) approved the first robotic system called da Vinci Surgical System on July 11, 2000. Obviously, this technology developed by Intuitive Surgical embodies some advanced features than its predecessor. It allows the human surgeon to get closer to the surgical site than human vision will allow, and work at a smaller scale than conventional surgery permits. The $1 million da Vinci system consists of two primary components: A viewing and control console, and a surgical arm unit. In gallbladder surgery, da Vinci Surgical System made three incisions in the patient's abdomen no larger than the diameter of a pencil, which allows for three stainless steel rods to be inserted. The rods are held in place by three robotic arms. One of the rods is equipped with a camera, while the remaining two are fitted with surgical instruments that are able to dissect and suture the tissue of the gallbladder. Unlike conventional surgery, doctors do not touch these instruments directly during operation.

Surgeons at the control console, a few feet apart from the operating table, look into a viewfinder to analyse the 3-D images captured by the camera inside the patient. The images show the surgical site and the two surgical instruments mounted on the tips of two of the rods. They resemble a Joystick and the surgical arms, located just under the screen, are used by the surgeon to manipulate the surgical instruments. Each time one of the surgical arms is moved, a computer sends an electronic signal to one of the instruments, which moves according to the movements of the surgeon's hands.

The $ 750,000 ZEUS System made by Computer Motion has a similar setup to that of the da Vinci system. It has a computer workstation, a video display and hand controls that are used to move the table-mounted surgical instruments. In the U.S., this system is not permitted to use beyond clinical trials but the German doctors have already used this system to perform coronary bypass surgery.

The ZEUS system employs the assistance of the Automated Endoscopic System for Optimal Positioning (AESOP) Robotic System. Released by Computer Motion in 1994, AESOP was the first robot approved by the FDA for assisting surgery in the operating room. AESOP is much simpler than the da Vinci and ZEUS systems. It's basically just one mechanical arm, used by the physician to position the endoscope-a surgical camera inserted into the patient. Foot pedals or voice-activated software allows the physician to position the camera, leaving his or her hands free to continue operating on the patient.

Doctors also use foot pedals or voice-activated software to manoeuvre cameras, leaving their hands free to operate

Robotic surgical systems have much significance over traditional surgical process. It cuts down the number of personnel required to accomplish a surgery. On the other hand, doctors get flexibility to execute their tasks by operating designated machines and in the same time reduce trauma to the patient. For instance, heart bypass surgery now requires that the patient's chest be “cracked” open by way of a 1-foot (30.48 cm) long incision. However, with the da Vinci or ZEUS systems, it is possible to operate on the heart by making three small incisions in the chest, each only about 1 cm in diametre. Because the surgeon would make these smaller incisions instead of one long one down the length of the chest, the patient would experience less pain and less bleeding, which means a faster recovery.

Chronological advancement of computer systems unveiled the idea of tele-surgery. As the name implies it involves a doctor performing delicate surgery miles away from the patient. Robotic systems must respond instantly according to the doctor's instructions. The systems experienced delay due to the distance, which is the major setback in tele-surgery. If scientists are to fix this problem, tele-surgery will become the most exciting technology in this century.

The author is a computer engineer





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