Just as computers revolutionized the later half of the twentieth century, the field of robotics has the promise to equally alter the way we live in the twenty first century. We have already seen how robots have modified the manufacturing of cars and other customer goods by streamlining and speeding up the assembly lines. Robots have also enabled us to see places that humans are not yet able to visit, such as other planets and depths of the ocean never before explored. And just as computer controlled diagnostic instruments have been used in medicine for years to provide vital information through ultrasound, computer-aided topography, and other imaging technologies, robotic technology is making it’s way to operating rooms all over the globe. When we speak robots doing the tasks of humans we often talk about the future, but the future of robotic surgery is already here.
On July 11, 2000, the Food and Drug Administration approved the first robotic system for use in American operating rooms (Schaaf par.2).
This system is not true independent robot that can perform surgical procedures on it’s own, but it lends a mechanical helping hand to the surgeon during delicate procedures. This System, named the da Vinci Surgical System, allows the human surgeon to get closer to the surgical site than human vision will permit and work at a smaller scale than conventional surgery permits.
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While sitting at the console, a few feet from the operating table, the surgeon looks into a viewfinder to examine the 3-D images being sent by a camera inside the patient. The images show the surgical site and the two surgical instruments mounted on the ends of two robotic arms. Joystick like controls, located at the console beneath the screen, are used by the surgeon to manipulate the surgical instruments, which moves in sync with the movements of the surgeon’s hands. This technology translates the surgeon’s movements into precise real-time movements of the surgical instruments inside the patient without hand tremors. The pencil sized instruments feature computer-enhanced mechanical wrists that are designed to have the same dexterity as the surgeon’s forearm and wrists ant the operative site. These mechanical wrists give the surgeon the ability to reach around, beyond, and behind delicate body structures. The wrists can roll, pitch, bend, and grip just as if it were a human hand. The da Vinci system provides the surgeon with the control, range of motion, tissue manipulation capability, and 3-D visualization of open surgery all while working through 1-cm incisions in the patient.
Robotic surgery has many advantages. For instance, heart bypass surgery now requires that the patient’s chest be cracked open by way of a one-foot long incision. However, with the da Vinci system, it is possible to operate on the heart by making three small incisions to the chest, each approximately 1-cm in diameter (Schaaf par.12).
Because the surgeon would make these smaller incisions instead of the one-foot long incision down the length of the chest, the patient would experience less pain and less bleeding, which means faster recovery. According to Al Hinman, the CNN Medical Corespondent, Lazare Winn, the first patient ever to undergo a robotic, endoscopic heart bypass, was out of bed and celebrating his 70th birthday just days after surgery (par. 6).
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This procedure if done conventionally would have taken months of painful recovery.
Another advantage of robotic surgery is cost efficiency. In today’s operating rooms, you will find two of three surgeons, an anesthesiologist, a surgical technician, and a couple of nurses, all needed for the simplest surgeries. Most surgeries require nearly a dozen people in the operating room. With surgical robots some of these much-needed personnel will no longer be required. In the future surgery may only require one surgeon, an anesthesiologist and one or two nurses. Doctors will have the capability to use a surgical robot to accomplish the tasks that once took a crowd of medical staff to perform. Having fewer people in the operating room could lower the cost of healthcare.
Robotic surgery has also opened up the idea of tele-surgery, which would involve a doctor performing delicate surgery miles away from the patient. It was during the height of Desert Shield and Desert Storm in the Middle East that the talk of robotic surgery sparked great interest in the mind of many people. Facing the challenges of treating its injured in inhospitable territory, the United States military came up with the idea of having a surgeon in one location, operate on a soldier hundreds of miles away in a high-tech mobile operating unit. With the da Vinci Surgical System the surgeon doesn’t have to stand over the patient to perform surgery, but he or she must be within a few feet of the patient in order to remotely control the robotic arms in real time. The major obstacle in tele-surgery has been the time delay between the doctor moving and the robotic arms responding to those movements.