Robot Surgeons: For Prostate Cancer and Gastric Bypass?
07 February 2006
- Robot Surgeons: For Prostate Cancer and Gastric Bypass?
Pancreaticojejunostomy and the Peustow procedure (suturing the jejunum to the pancreatic duct to provide drainage of pancreatic juice into the intestine in patients with obstruction of the pancreatic duct).
The da Vinci Surgical System has enjoyed a lot of publicity recently. Here is an excerpt from an article in
“And that’s the key to its success,” Boggess added. “The robot takes us a big step beyond traditional laparoscopy. It allows us to operate more naturally, the way we do in open surgeries, but still preserve a minimally invasive approach with small incisions.”
As in laparoscopy, robotic surgery involves small incisions of one-fourth to three-fourths of an inch, into which sleeves are inserted as ports for placement of specialized instruments and a video camera.
“Robotic surgery allows us to virtually place our hands inside the patient without the need for large incisions,” Boggess said.
After sleeve placement, the robot, much like a post with three arms, is wheeled over and its center arm docked to a port that holds the camera and the other arms docked to the instrument ports.
However, surgery with the da Vinci does not mean close proximity to the patient. Unlike with laparoscopy, the surgeon is seated across the room from the patient, with arms inserted into the nearby console, fingers on stirrup-like holders and eyes fixed on lenses for sharp magnified images of the surgical site. Focus is adjusted via foot pedals.
While laparoscopy allows manipulation of instruments up, down and side-to-side, surgery with the da Vinci allows more natural wrist movement.
The robot’s arms have wrists with eight degrees of freedom that allow the surgeon “to bend around corners and work in ways that are much more natural,” said Boggess. This allows full range of motion and the ability to rotate instruments 360 degrees through tiny incisions. Direct and natural hand-eye instrument alignment is similar to open surgery, with “all-around” vision and the ability to zoom in and out.
Another advantage with da Vinci is the elimination of tremor. Surgeons can scale, or ratio, their finger movement to that of the robotic instrument. A movement of inches at the console can be scaled down to centimeters in the patient.
So even a surgeon with a tremor can perform flawlessly with the da Vinci surgical robot. The robot is actually an improvement in many ways, on the natural human surgeon--but it depends on the human surgeon. It is an augment, not a replacement.
These machines are quite expensive, and still experimental for many procedures. Nevertheless, in settings where medical provision is by private pay, these machines should gain in use. In settings of government provided medicine, the machines will take much longer to attain wide use, due to cost constraints.
Eventually, cardiothoracic surgeries and intracranial surgeries will be done routinely by robot, due to the delicate nature of those procedures.
Modern machines are capable of doing things that our grandfathers would not have imagined. Years in the future, our grandchildren will say much the same thing about their machines, referring to us and our own limited imaginations. This technological acceleration can be thought of as an intimation of the singularity. posted by al fin
For additional "Medical Robot" News & Articles visit: MachineBrain.com
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