ROBOTIC SURGERY:- By.Tirth Joshi Group:611

House workMilitary manufacturing surgery

History:- 1.In 1997 a reconnection of the fallopian tubes operation was performed successfully in Cleveland using ZEUS. 2.In May 1998, Dr. Friedrich-Wilhelm Mohr using the Da Vinci surgical robot performed the first robotically assisted heart bypass at the Leipzig Heart Centre in Germany.heart bypassLeipzig Heart CentreGermany 3.On 2 September 1999, Dr. Randall Wolf and Dr. Robert Michler performed the first robotically assisted heart bypass in the USA at The Ohio State University.heart bypassUSAThe Ohio State University 4.In October 1999 the world's first surgical robotics beating heart coronary artery bypass graft (CABG) was performed in Canada by Dr. Douglas Boyd and Dr. Reiza Rayman using the ZEUS surgical robot.

Worlds First Robotic Telesurgery September 2001: Tele- chole (gall bladder removal) Surgeon in New York, Patient in France Round trip distance = 8,700 miles Round trip data time = 200 ms Collaborators: Prof Jacques Marescaux, New York & European Institute of Telesurgery, Strasbourg stm

Essential Robotic Components 5 Stereo Vision Stereo Mag Endoscope 7-DOF Instrument Diverse, Small Instruments Fine Control Ergonomic Station

THE DA VINCI SURGICAL SYSTEM:- A product of the company Intuitive Surgical, the da Vinci Surgical System is perhaps the most famous robotic surgery apparatus in the world. It falls under the category of telesurgical devices, meaning a human directs the motions of the robot. The da Vinci uses technology­ that 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 $1.5 million da Vinci system consists of two primary components

Components of da Vinci System Doctor uses 2 masters that each control a mechanical arm of the robot One of the three arms is an endoscope arm Provides over a thousand frames per second of the instrument position to get rid of possible background noise Endoscope is also programmed to regulate the temperature of the tip to prevent any fogging during the procedure Surgeon can switch to different views easily by the touch of a foot pedal

Components (cont…) Other two arms are equipped with specialized tools called EndoWrist detachable instruments Through the incisions, the video camera and robotic arms eliminate hand tremors from the surgeon Robot arms also have wider range of motion than the human hand- rotating in 7 different planes and can rotate around completely

DIFFERENT KINDS OF ROBOTIC SURGERY:- Type-1 supervisory-controlled systems:- supervisory-controlled systems follow a specific set of instructions when performing a surgery. The human surgeon must input data into the robot, which then initiates a series of controlled motions and completes the surgery. There's no room for error -- these robots can't make adjustments in real time if something goes wrong. Surgeons must watch over the robot's actions and be ready to intervene if something doesn't go as planned.Surgeons

DIFFERENT KINDS OF ROBOTIC SURGERY:- Type-2 Shared-control Robotic Surgery Systems:- Shared-control robotic systems aid surgeons during surgery, but the human does most of the work. Unlike the other robotic systems, the surgeons must operate the surgical instruments themselves. The robotic system monitors the surgeon's performance and provides stability and support through active constraint.robotic

DIFFERENT KINDS OF ROBOTIC SURGERY:- Type-3 Telesurgerical system:- The use of a computer console to perform operations from a distance opens up the idea of telesurgery, which would involve a doctor performing delicate surgery miles away from the patient. If the doctor doesn't have to stand over the patient to perform the surgery, and can control the robotic arms from a computer station just a few feet away from the patient.computer

The ZEUS Robotic Surgical System (ZRSS) was a medical robot designed to assist in surgery, originally produced by the Americanrobotics company Computer Motion. Its predecessor, AESOP, was cleared by the Food and Drug Administration in 1994 to assist surgeons in minimally invasive surgery. The ZRSS itself was cleared by the FDA seven years later, in ZEUS had three robotic arms, which were remotely controlled by the surgeon. medical robotsurgeryAmericanComputer MotionFood and Drug Administrationminimally invasive surgery

ZEUS system[edit]edit The first prototype of the ZEUS was demonstrated in 1995, and tested on animals in Two years later, in 1998, it carried out its first tubal re-anastomosis procedure, and its first coronary artery bypass surgery (CABG) procedure. By 2000, the ZEUS was equipped to hold 28 different surgical instruments, and in 2001 it received FDA approval.re-anastomosiscoronary artery bypass surgery

Features The ZEUS was designed for minimally invasive microsurgery procedures, such as beating heart surgery and endoscopic coronary artery bypass grafting (E-CABGTM). The system was also used to initiate more complex procedures, like a mitral valve surgery IDE study. [4] The ZEUS' robotic arms not only mimic the surgeons hand movements, but also scale down the movement, allowing the surgeon to easily make precise and small cuts. [2]microsurgeryheart surgerycoronary artery [4] [2]

The arms also correct for tremors in a surgeon's hands, which are normal even without fatigue, though a highly trained surgeon will be able to lessen the negative effects. However, some surgeries can last for hours, in which case the surgeon's arms will get tired, and the resulting tremors from fatigue can make the surgeon create false cuts, which can be devastating during a delicate operation. To handle this, the ZEUS is designed to track and nullify these tremors while still responding to the movements/commands of the surgeon's hands.

ADVANTAGES:- 1. Telesurgery:- The use of a computer console to perform operations from a distancecomputer 2. Having fewer personnel:- Having fewer personnel in the operating room and allowing doctors the ability to operate 3.Less pain:- the patient would experience less pain, trauma and bleeding, which means a faster recovery.

ADVANTAGES:- 1. Telesurgery:- The use of a computer console to perform operations from a distancecomputer 2. Having fewer personnel:- Having fewer personnel in the operating room and allowing doctors the ability to operate 3.Less pain:- the patient would experience less pain, trauma and bleeding, which means a faster recovery.

ADVANTAGES:- 4. Enhanced precision:- surgery with the help of robots may help to remove these errors. Robotics help to make the surgery with high precision and high accuracy 5. Decrease the fatigue:- It helps to decrease the fatigue that doctors experience during surgeries that can last several hours.

DISADVANTAGES:- 1. Time:-Robotic assisted heart surgery can take nearly twice the amount of time that a typical heart surgery takes. 2. Cost:-At this early stage in the technology, the robotic systems are very expensive. 3. Efficiency and Compatibility:-current operating room instruments and equipment are not necessarily compatible with the new robotic systems.thus there is less efficiancy and compatibility

Application:- 1.Cardiothoracic surgery:- Robot-assisted MIDCA Band endoscope coronary artery bypass (TECAB) surgeries are being performed with the da Vinci system 2. Gynecology:-Robotic surgery in gynecology is one of the fastest growing fields of robotic surgery. gynecology 3. Orthopedics:-The Acrobot Company Ltd. sells the "Acrobot Sculptor", a robot that constrains a bone cutting tool to a pre-defined volume.Acrobot Company Ltd.Acrobot Sculptorbone

Application:- 6. Pediatrics:-Surgical robotics has been used in many types of pediatric surgical procedures including: tracheoesophageal fistula repairtracheoesophageal fistula 7. Radiosurgery:-The CyberKnife Robotic Radiosurgery System uses image-guidance and computer controlled robotics to treat tumors throughout the bodyCyberKnifeRadiosurgery 8. Urology;-Removing the prostate gland for cancer, repair obstructed kidneys, repair bladder abnormalities and remove diseased kidneys.prostate cancerkidneys bladder

Conclusion:- Although still in its infancy, robotic surgery is a cutting-edge development in surgery that will have far-reaching implications. While improving precision and dexterity, this emerging technology allows surgeons to perform operations that were traditionally not amenable to minimal access techniques. As a result, the benefits of minimal access surgery may be applicable to a wider range of procedures. Safety has been well established, and many series of cases have reported favorable outcomes. However, randomized, controlled trials comparing robotic-assisted procedures with laparoscopic or open techniques are generally lacking.