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Currently, there are three kinds of robotic surgical assistant technologies available depending on the degree of human involvement required.
Supervisory Controlled Robotic Surgical Systems
The most automated robotic systems to be used for surgeries will be the Supervisor-Controlled Robotic Surgery systems, like the existing RoboDoc by Integrated Surgical Systems. The RoboDoc is used in orthopedic surgeries today. It needs to be positioned at the right location inside the patient by a surgeon and then it takes over the task of cutting the bone to the correct size for implant.This doesn't mean that the RoboDoc can perform without human control. Extensive preparatory work goes into each procedure before the robot can operate. The human controller inputs data into the robot with complete accuracy and the robot carries out these commands. There is no margin for error. The robot must also be monitored while it works for intervention in case of irregularities.
Since human bodies are not uniform, there can be no standard program for RoboDoc to follow. Extensive mapping of the patient's body with CT scans, MRI scans, X-ray scans, USG scans and fluoroscopy scans are required for accuracy. Marker pins may also be set on bones in some surgeries to guide the robot.
These pins must correspond to the maps created so the robot can complete the surgery without error. Only then can the navigation phase of the robot begin with the actual surgery.
The Da Vinci Robotic Surgical System
The Da Vinci Robotic Surgical system can only act under human monitoring. The Zeus, Aesop, Socrates and Hermes robotic assistants manufactured by Computer Motion (which merged with Intuitive Surgical in 2003) are examples of this type of robotic surgical assistants.It is a telesurgical device, requiring human direction for operation. In 2000, the FDA approved the robot for laproscopic procedures, allowing surgeons to get closer to the site than it was manually possible before. This made the $1.5 million device the first of its kind to be allowed in the American OT.
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The Da Vinci system consists of a control console and a surgical arm unit. The arm unit may have as many as 3 or 4 arms.
During the surgery, tiny incisions of the scale of the diameter of a pencil point are made in the abdomen. There are as many incisions as robotic arms on the da Vinci instrument. Stainless steel rods are inserted in the incisions, one with endoscopic cameras and the others with dissecting and suturing tools. There is no need for the surgeon to touch these devices personally.
At the control and viewing console a few feet away, the surgeon examines the stereoscopic images the cameras send back of the patient's interior. Joystick controls beneath the screen can be manipulated to operate the instruments inside the patient.
The instruments move in sync with each movement of the surgeon's hands. The surgery is completed without the need for larger incisions, and the instruments are removed and the cuts sutured.
Shared-Control Robotic Surgery Systems
The Shared-Control Robotic Surgery system requires the most human participation. It provides stability through active constraint while the surgeon manually operates the tools himself. Active constraint works by defining forbidden, boundary, close or safe areas on the surgical site, which must be researched and pre-programmed by the surgeon before a procedure.During the procedure, the robot offers more resistance as instruments leave the safe region, thereby providing support for accuracy of procedures.
We are still a long way from complete automation of surgeries, but with advancements of science there are endless avenues of innovation open to the medical field in the future.
DarrenAbout the Guest Author:
Darren is a passionate blogger about new technologies and works as a supplier of medical equipment in Australia.
