Biomedical Engineering Reference
In-Depth Information
9
Minimally Invasive Robotic
Surgery
In minimally invasive surgery (MIS), operations are carried out by surgeons using slender
instruments and viewing equipment inserted into the body through small incisions. MIS
has become an established practice over the years and, for certain surgical procedures, has
become
de rigueur
. In recent years, however, minimally invasive robotic surgery (MIRS)
is making inroads into this practice with ever-increasing frequency. This revolutionary
approach to surgery has been made possible by recent radical improvements in robotic
methods and techniques. For the surgeon, this computer-enhanced technology and robotic
precision ensures a level of surgical precision that was never previously possible. The
use of robotics is changing medicine dramatically. As technology continues to advance
and patients experience the benefits of robotic surgery, the demand for robotic procedures
will continue to increase.
The most significant advantage of robotic surgery, certainly as far as the patient is con-
cerned, is reduced pain and scarring, since, by using cameras and enhanced visual effects,
doctors can make the smallest of incisions. The da Vinci™ and ZEUS™ systems both use
'arms' to operate and, in order for these arms to get inside the body and operate, they only
need an incision of a few centimeters. It is reported that some cardiac bypass surgeries
were successfully done using only three incisions, each about 1 cm in length. Typically,
for that type of surgery, an incision of about 30 cm in length is required. It is this and its
many other advantages that justifies the use of MIRS, notwithstanding the fact that it is
still in the process of being fully tried and tested. Due to the small and precise incisions,
the patient's hospital stay is greatly reduced and the patient in the case just mentioned
required only 12 hours recovery period before being discharged. Typically, a person
needs far less recovery time from a 3 cm scar rather than one which is 10 times larger.
Also, the risk of infection or complications decreases commensurately with incision size.
Besides the obvious rewards to the patient, robotic surgery is also very advantageous
to the surgeon and the hospital itself. In the ZEUS™ Surgical System, an 'arm' on
the machine is dedicated to the automated endoscopic system for optimal positioning
(AESOP) which is a 3D camera used in robotic surgery. It can be zoomed in by either
voice activation or pedals located at the surgeon's feet. Doctors who have used this actually
