R. K. MishraWorld Laparoscopy Hospital

Gurgaon

Robot word was coined by Czech writer “Karel Capek” It stands for

artificial humans

Courtesy of Harald Fischer, Institute for Medical Technology and Biophysics, Frankfurt

World Laparoscopy Hospital

September 7, 2001, First transatlantic surgery took place from New York to Strasbourg.

Robotic Surgery Laparoscopic Surgery3 D Vision 2 D VisionMotion scaling Not possibleWrist Articulation Limited Range of MotionFluid Movement Rigid MovementTremor Filter Tremor MagnifiedRemote Sensing Technology Abdominal wall is FulcrumErgonomically Intuitive Poor Ergonomics25X Magnification 10X MagnificationMIES Not possibleHaptic Feedback Limited Tactile FeedbackTelesurgery with teleproctoring Not possible

World Laparoscopy Hospital

REMOTE PROCTOR INTERFACE TILEPRO VIEW IN SURGEON CONSOLE

TELEMENTORING - is remote guidance or teaching

TELEPROCTORING - supervision from a distance using error log technology

Robotic Appendectomy

Robotic Hernia

Hysterectomy and Myomectomy

•Not cost effective over standard laparoscopic approach for simple surgery.•Increased operative time observed•Not necessary where precise is dissection not required•Large Operating room space required•Good Patient Side assistant is required

World Laparoscopy Hospital

Some of the notable features of the Amadeus System are:•Multi-articulating arms,•Sound communication system, •Enhanced vision systems and •Real-time feedback to surgeons to know the impact of their movements while performing surgery.

Walking robot with legs

Miniaturization to extremes

Can roam within human body

Equipped with DNA joints and carbon nano tubes

Specific functions - Repairing/Destroying individual cells 1.63 cm31.63 cm3

Mounted with cameras, Mounted with cameras, temperature sensors, temperature sensors, microphones, micro toolsmicrophones, micro tools

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• Technology is always good - it is neither angel nor evil• It is up to us to breathe the moral and ethical life into these technologies• We should apply them with empathy and compassion for each and every

patient• Robotic surgery is one example of such technology that reduces operative

morbidity, hospital stay, and recovery, while improving clinical outcomes, but at what point do the BENEFITS justify the increased EXPENSE?

World Laparoscopy Hospital

World Laparoscopy Hospital