Robotic Surgery

Introduced in 1987, Robots were used in the first Laparoscopic surgery, a cholescystecotomy, to be exact. (Lee 45).Also known by names such as keyhole surgery, bandaid surgery, or minimally invasive surgery (MIS), Laparoscopic surgery is a surgical technique referring to operations within the abdomen or pelvic region. (Lee 45).More specifically speaking, it belongs to the field of endoscopy. (Lee 45).The first robots used in the surgery consisted of a Hopkins rod lens system, that was usually connected to a video camera (single chip or three chip), and a fiber optic cable system connected to a 'cold' light source (halogen or xenon) that was used to illuminate the area being operated on. (Vertut and Coiffet 97). Because incisions were made smaller, this robot-dependent surgery was known to be less invasive than preceding surgical methods. Because their was less intrusion in the body, the risk of infection was reduced, hospital stays were shorter, and recuperation time was reduced.(Vertut and Coiffet 97)Since this implementation of Robots as an assistant in delicate operations, numerous procedures have been performed laparascopically as both technology and skills of surgeons have advanced. Despite the advantages of using Robots in surgery, there were several disadvantages of using them. For example, the equipment used required a surgeon to move in the opposite direction of the target on the monitor in order to interact with the patient's area of operation so that hand-eye coordination, force feedback, and dexterity were not compromised.(Hohman 2) Additionally, other disadvantages were restricted degrees of motion, increased sense of touch, and increased sensitivity to hand movement, all problems in which modern robotics would aim to correct.(Hohman 2)

As robots began to become more prevalent in the medical field, Researchers at the NASA(National Air and Space Administration) Ames Research Center began work on an concept known as telepresence surgery; commonly known as telesurgery. (Vertut and Coiffet 68)Combining virtual reality, robots, and medicine this type of robotic surgery would defy traditional surgeon-patient relations. By the early 1990's scientist from the NASA-Ames team joined Stanford Research Institute (SRA) surgeons to develop a telemanipulator for hand surgery. (Vertut and Coiffet 68)Dr. Dave Williams of the Canadian Space Agency spearheaded a project that would test this specific type of Robotic surgery.(Vertut and Coiffet 68) With the use of satellites to relay the signals needed to connect a surgeon's console to a robot, Telesurgery would allow surgeon's to reasonably operate on a patient just about anywhere signals are received. (Vertut and Coiffet 68) In due time, surgeons and endoscopists joined the ambitious development team to give the project a full spectrum of experts.(Vertut and Coiffet 68) Williams, also an astronaut, reveals that NASA has no plans to test robotic surgery on any of the next few shuttle missions; however he would like to see it done one day in the future. (Hohman 3)Though NASA is not quite as comfortable as they would like to be with robotics in space, here on earth Robotic surgery is being heavily invested in. Canada, in particular, has invested in telesurgery heavily. (Vertut and Coiffet 69) Because of the country's vast land, including many rural communities, it is in Canada's best interest to give inhabitants an opportunity have the best and most modern healthcare. Dr. Williams speaks on this issue when saying "Depending upon where you are on Earth, there's a difference in the level of healthcare that exists--in many cases, just due to the geographic isolation of the area that you're in," to stress the necessity of Robotics in an area where immediate attention is hard to find when the need for it arises. (Hohman 1) As for now, robotic surgery is limited to the conventional settings of a hospital operating room. Despite this fact, robotic surgery is gaining widespread approval for certain procedures, most notably prostatectomies; a procedure in which the entire prostate is removed. (Lee 55)Samuel Morley, a man diagnosed with prostate cancer in February of 2004, was presented with several options of treatment. Because prostate cancer is a slow-growing cancer, one of his options was to do nothing. Another option was for him to allow implantation of radioactive seeds in hope that they would kill the cancer, and from there undergo standard open heart surgery. His third and final option was to try robotic surgery. When asked about his reasoning behind having robotics being used he said "it's not nearly as invasive. (Hohman 2) The surgeon can see a lot better inside the body." He went on to support his decision by saying "Open prostatectomy, on the other hand, is a deep and bloody surgery, where often by mistake, nerves are cut, or the ureter is cut, which can cause incontinence." (Hohman 2)Robots are equipped with 3D cameras that can see a lot further into the dark areas of the open cavity, allowing cuts to be made with much greater precision. (Lee 55)

Besides being used in stationed medical facilities, Surgical Robots are being developed for use in the Armed Services as well. The U.S. Army believed that wartime mortality would be greatly reduced through the use of robots. By bringing surgery to a soldier, a system known as MASH( Mobile Advanced Surgical Hospital) would aid in loading a soldier into a vehicle with robotic surgical equipment. (Vertut and Coiffet 69) From there a wounded soldier could be operated on by a surgeon in the mobile unit. (Vertut and Coiffet 69) Though it has not been tested or approved, the MASH system is definitely a step in the right direction.

A rapidly growing field, Robotic surgery has the potential to revolutionize healthcare. This developing technology will most likely change the way we think about robotics as a whole. Employing robots to hold instruments while a surgeon operates on a console is the main concept behind the use of Robotics in the operating room. (Vertut and Coiffet 69) All things that a surgeon normally does directly on a patient will be done by Robotic arms that will hold miniature cameras and surgical tools. With such a system, operations will be more precise and done in smaller areas. In fact, a surgeon may never actually touch the patient. Not only will this be a more effective way of operating on a patient, but, with the use video-game-like controls to operate Robots, procedures traditionally viewed as being delicate will be completed in no time using Robotics. (Hohman 3)

Though robotic surgery provides many advantages for certain conditions, it is not yet a main preference for all surgical treatments. The techniques used in robotic surgery to date are compatible with some heart surgeries, lung surgeries, and for a few other treatments, but are not compliant