Cecelia Grogan Sara Pedley Jill Gordon

 Describe robotic-assisted surgery in pediatric clients  Describe hardware  List, Describe, and Evaluate software  Describe and review the information system  Describe advantages and disadvantages  Examine related ethical/legal issues  Describe the technology-related competencies of the professional nurse working with robotic-assisted surgery in pediatric clients  Describe the functions of the informatics nurse working with robotic-assisted surgery in pediatric clients

 Robotic surgery:  is the use of robots in performing surgery  Allows patient to achieve shorter surgery, recovery, and duration of stay  Historically, robotic surgery was:  Developed first as programmable industrial manipulators  Pioneered by George Devol- late 1940s and early 1950s (Krummel, Holman, & Ford, 2004)

 Cases to date of robotic assisted pediatric surgery:  Fundoplication  Cholecystectomy  Oophorectomy  Splenectomy  Urachal resection  Lymphadenectomy  Tumor biopsy  Diaphragmatic hernia repair  Biopsy mediastinal mass  Heller myotomy  Choledochal cyst excision  Kasai (Krummel, Holman, & Ford, 2004)

 Types of robots used:  AESOP  CyberKnife  RoboDoc  Acrobot  NeuroMate  Zeus  DaVinci Da Vinci Robot Da Vinci Robot (Cao & Rogers, 2006)

 comprehensive master-slave surgical robots with multiple arms  operated remotely from a console with video assisted visualization and computer enhancement  evolved from the telepresence machines developed for NASA and the US Army  3 components  vision cart that holds a dual light source and dual 3-chip cameras  master console where the operating surgeon sits  moveable cart, where 2 instrument arms and the camera arm are mounted (Brown University, 2008)

 VoXim™, IVS Software Engineering software system  NI LabVIEW software (National Instruments Corporation, 2009) (Brown University, 2008)

 Laboratory Virtual Instrumentation Engineering Workbench  programs/subroutines are called virtual instruments (VIs)  used for  data acquisition  instrument control  industrial automation (Wikipedia, 2009)

 No surveys or focus groups given to potential users  Uses discussion forums  No cognitive walkthrough  No heuristic evaluation  No formal usability  No apparent field study (McGonigle & Mastrian, 2009)

 Healthcare Management Systems (HMS)  integrates clinical and financial applications on a single IBM platform  Technology such as:  Pen tablets  Mobile carts  Bar coding  Document imaging (Healthcare Management Systems Inc, 2009)

 Type of information system: Administrative/Clinical  Who can use this system: Any healthcare professional  HMS function: All aspects of hospital  Configuration: Local Area Network  Nursing Practice Standards: NANDA  Recommend: Yes (Healthcare Management Systems Inc, 2009)

 Major advantages of robotic surgery:  precision  miniaturization  smaller incisions  decreased blood loss  less pain  quicker healing time (Holman, 2004)

 New technology  Cost  Size of systems  Lack of compatible instruments and equipment ( Lanfranco, Castellanos, Desai, & Meyers, 2004)

 Ethical Issues  Malfunction of equipment  Replacement of human care by mechanical care  Not a lot of ethical issues  Legal Issues  Methodology for research on effectiveness and safety (Butter, et. al, 2008)

 Ability to interpret information  Basic information about robots  Basic information about software (Kaminski, 2007)

 More patient teaching  Interpret and organize information  Give information to surgeons (Kaminski, 2007)

 Surgery done by robots  Hardware  Types of robots  Da Vinci  Zeus  Software  Robots mostly contain own software  Examples  NI LabVIEW  VoXim  Advantages and disadvantages  Smaller incisions  High cost of robots  Ethical/Legal issues  Not many ethical legal issues because of lack of research on robotic surgery  Nursing competencies  Ability to use software  Basic information about robots

Brown University. (2008). Robotic Surgery. Retrieved February 16, 2009 from e=2&qsrc=0&zoom=Disadvantages+to+%3CKW%3ERobotic+Surgery%3C%2FKW %3E%7CInformation+%3CKW%3ERobotic+Surgery%3C%2FKW%3E%7C%3CKW %3ERobotic%3C%2FKW%3E+Heart+%3CKW%3ESurgery%3C%2FKW%3E&ab=0& u=http%3A%2F%2Fbiomed.brown.edu%2FCourses%2FBI108%2FBI108_2008_Grou ps%2Fgroup12%2FRoboticsurgery.html Butter, M., Rensma, A. and Boxyl, J. (2008). Robotics for Healthcare. Retrieved February 23, 2009 from Cao, C. & Rogers, G. (Ed.) (2006). Handbook of Human Factors and Ergonomics in Healthcare and Patient Safety. Mahwah: Lawrence Erlbaum. Healthcare Management Systems Inc Retrieved February 23, 2009 from Kaminski, J. (2007). Nursing Informatics Competencies: Self – Assessment. Retrieved February 25, 2009 from informatics.com/niassess/competencies.html

Krummel, T., Holman, E., & Ford, S. (2004). Surgical Robotics in Children’s Surgery [PowerPoint slides]. Retrieved from Lanfranco, A., Castellanos, A., Desai, J., & Meyers W. (2004). Robotic Surgery, A Current Perspective. Annals of Surgery, 239, McGonigle, D. & Mastrian, K. (2009). Nursing Informatics and the Foundation of Knowledge. Massachusetts: Jones and Bartlett Publishers. National Instruments Corporation. (2009). Robotic Surgery Moves from Science Fiction to Reality. Retrieved February 16, 2009 from &zoom=Disadvantages+to+%3CKW%3ERobotic+Surgery%3C%2FKW%3E%7 CInformation+%3CKW%3ERobotic+Surgery%3C%2FKW%3E%7C%3CKW%3 ERobotic%3C%2FKW%3E+Heart+%3CKW%3ESurgery%3C%2FKW%3E&ab=0 &u=http%3A%2F%2Fzone.ni.com%2Fdevzone%2Fcda%2Fpub%2Fp%2Fid%2 F257 Wikipedia Robotic Surgery. Retrieved January 26, 2009 from