FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Robotic Surgery

Reijo Jäsmä, Amir R Razavi

Dept. of Biomedical Engineering

FoKurs – Tekniska System Inom Kirurgin, 2007

Past, Present

and

Future

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Overview

Introduction

Working Applications

Strengths and Limitations

Ethical and Safety Considerations

Challenges, Future and Conclusion

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Introduction

Robots and Robotics The Czech brothers Karl and Josef Capek, were first to use the word "robot" in 1920.

Isaac Asimov introduced the word "robotics" in (1942) in the short science fiction story "Runaround".

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Introduction

Definition: Robot“A reprogrammable multifunctional manipulator, designed to move material, parts, tools or specialized devices through variable programmed motions for the performance of a variety of tasks” [Robot Institute of America]

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Introduction

Definition: Robotic systems for surgery There are computer-integrated surgery (CIS) systems first, and “medical robots” second. The robot itself is just one element of a larger system designed to assist a surgeon in carrying out a surgical procedure..” [Taylor, 2003]

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Introduction

MotivationStarted with the weaknesses and strengths of minimally invasive surgery (MIS)

Smaller incisions, shorter post-operative time, reduced infection, faster rehabilitation, lesser pain, better cosmetics, ...

Eye-hand coordination, difficulty in moving arms, degree of motion

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Introduction

HistoryPuma 560: for placing a needle for a brain biopsy while guided by CT scan (1985) followed by PROBOT and ROBODOC.

NASA started to develop telepresence surgery in 80s; the main research force behind the development of surgical robots.

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Working Applications

Robotics in Surgery Autonomous robots

Master-Slave robots

Computer assisted

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Available systems da Vinci robotic system.

Zeus Robotic xyxtem

...

Working Applications

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Surgery domains Cardiology

Gynaecology

General surgery

Urology

Orthopaedics

Paediatrics

Working Applications

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Robot-assisted surgery in Sweden Karolinska university hospital

Lund University hospital

University hospital in Malmö

Linköping university hospital (not installed yet)

Working Applications

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Strengths Physical separation

Wrist action

Tremor elimination

Optional motion scaling

Three-dimensional stereoscopic image

Electronic information transfer (Telesurgery)

Strengths and Limitations

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Limitations Sensation

Confined operative field

Anesthesia complications

Break down

Increased operation time

Cost of equipment

Sterlization

Strengths and Limitations

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Limitations Cost

The average base cost of a da Vinci Surgical System is €1,000,000 million.

Approximately €110,000 maintenance cost a year

Operating room cost, €100.90 per hour

Hospital stay cost, €432 per day

Time away from work, €83 per day

Strengths and Limitations

Ref: Jennifer Brooks, University of North Carolina, November 9, 2006

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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When there is a marginal benefit from using robots, is it ethical to impose financial burden on patients or medical systems?

If a robot-assisted surgery fails because of technical problems, is it the surgeon who is responsible or others?

If units are placed in different countries, what happens to the ethical and regulation considerations?

Ethical and Safety Considerations

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Haptic feedback

A safe, easy sterilizable, accurate, cheap and compact robot

Reliable telesurgical capabilities

Compatibility with available medical equipment and standardizing

Introducing autonomous robot surgeons

Challenges and Future

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Using robots in surgery is a rather young science

Finding domains that benefit significantly from robots is the key to further development

There is a need for more long-term studies on the outcomes of robots in surgery

Solving challenges such as ethical and legal considerations is vital

Conclusion

FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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Thanks for your attention!Moahahahhaaaaa