Robotic surgery, new advances

1. BY Dr. Ritesh Dhanbhar

2. Introduction
• Robots used in operating room to assist surgeon in performing
surgery.
• Surgeon views patient via visual terminal and manipulates
robotic surgical instruments via control panel.
• Views of operative area are transmitted from cameras inserted
into body.

3. Introduction
• Robotic surgery systems are still relatively uncommon.
• These systems have potential to improve safety and
effectiveness of surgeries.
• Three major advances aided by surgical robots are remote
surgery, minimally invasive surgery and unmanned surgery.

4. TYPES
1. Supervisory controlled robotic surgery system.
2. Tele surgical system.
3. Da Vinci surgical system.
4. ZEUS robotic surgery system.
5. Automated Endoscopic System For Optical Position (AESOP) robotic
surgery system.
6. Shared control robotic surgery system.
7. Cyber Knife System

5. • Most automated system.
• Specific set of instructions required.
• Robot programing .
• Maping of patient in 3 ways :
1.Planning
2.Registration
3.Navigation
• Used in hip and knee replacement procedures.

6. • Also called remote surgery.
• Surgery is performed by robotic system controlled by surgeon at
distant site.
• Advantages:
1. Assisting and training surgeons in developing countries
2. Collaborating and mentoring during surgery by surgeons around
the globe

7. • First FDA approved robotic system in American operating
rooms
• Provides 7 degree of freedoms in instruments.
• Surgeon directs motion of robots.
• Componants:
1.Viewing and controlling console.
2.Surgical arm unit (4 arms).

8. • Uses:
1. Prostrate cancer surgery.
2. Hysterectomy.
3. Mitral valve repair.
4. Thoracic Surgical procedures

10. • Made up of ergonomic surgical control console and 3 table
mounted robotic arms.
• Voice control and touch screen interfaces with 2 monitors are
used in surgical control console.
• Used in :
1. Micro surgical tasks.
2. Endoscopic surgery.

12. • Automated Endoscopic System For Optical Position
• End effector:
Endoscope coupled to a robotic arm assembly which
move endoscope relative to patient.
System includes:
1. Computer: controls movement of the robotic arm.
2. Cart
3. Spring loaded mount plate: Allows robotc arm to be
rotated and adjusted relative to cart and patient.

14. • Robotic system monitors surgeon performance and
provides stability and support through active constraint.
• Surgeons must first go through planning, registration and
navigation phases with operative area.
• Only after inputting that information into robot's system
robot can offer guidance.

15. • Minimizes soft tissue damage:
If instrument enters soft tissue boundary region robot will
offer resistance, indicating the surgeon should move away
from that area.
If the surgeon continues cutting toward soft tissue, robot
locks into place.

17. • Delivers multiple beams of radiation to the tumor.
• Beams of radiation can be projected in any direction.
• Prior to procedure patient is imaged using HRCT scan, to
determine dimension and location of tumour.
• Image data is transferred to the CyberKnife System’s
workstation.

18. • CyberKnife software used to calculate required dose and
direction of radiation beam.
• Each treatment session will last between 30 and 90
minutes

20. 1. Outer space mission.
2. Deep sea exploration.
3. Polar expeditions.
4. Dampen tremer using embedded filters.
5. Free movement of hands.

21. 6. Less pain, bleeding.
7. Faster recovery.
8. Enhanced precision.
9. Decreases fatigue of doctors.

22. 1.If error is coded to robot it may harm human during surgery.
2.Robotic assisted heart surgery can take nearly twice amount of
time that a typical heart surgery takes.
3.Robotic systems are very expensive.
4.No tectile sense of tissues.

23. 5. Delay in transmission of data, compromises quality of
surgery.
6. Because no two patients have exact same body
structure, it's impossible to have standard program for
robot to follow.

24. • Although in its infancy, robotic surgery has proven value, in areas of
inaccessible conventional laparoscopic procedures.
• It has the potential to expand surgical treatment modalities beyond the limits
of human ability.
• Although feasibility has largely been shown, more prospective randomized
trials evaluating efficacy and safety must be undertaken.
• Further research must evaluate cost effectiveness or a true benefit over
conventional therapy for robotic surgery to take full root.