1. FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23
Past, Present
and
Future
Amir R Razavi, Reijo Jämsä
Dept. of Biomedical Engineering
FoKurs – Tekniska System Inom Kirurgin, 2007
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery

2. FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23
Overview
Introduction
Working Applications
Strengths and Limitations
Ethical and Safety Considerations
Challenges, Future and Conclusion
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery

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

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

5. FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23
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]
Surgical procedure that may include preoperative planning, intraoperative registration to presurgical plans, use of a combination of robotic assist and manually controlled tools for carrying out the plan, and postoperative verification and follow-up.
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery

6. FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23
Introduction
Motivation
Started 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

7. FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23
Introduction
History
Puma 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

8. FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23
Working Applications
Robotics in Surgery
Autonomous robots
Master-Slave robots
Computer assisted
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery

9. FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23
Working Applications
Available systems
da Vinci robotic system.
Zeus Robotic xyxtem
...
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery

10. FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23
Working Applications
Surgery domains
Cardiology
Gynaecology
General surgery
Urology
Orthopaedics
Paediatrics
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery

11. FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23
Working Applications
Robot-assisted surgery in Sweden
Karolinska university hospital
Lund University hospital
University hospital in Malmö
Linköping university hospital (not installed yet)
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery

12. Strengths and Limitations
Physical separation
Wrist action
Tremor elimination
Optional motion scaling
Three-dimensional stereoscopic image
Electronic information transfer (Telesurgery)
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery

13. Strengths and Limitations
Sensation
Confined operative field
Anesthesia complications
Break down
Increased operation time
Cost of equipment
Sterlization
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery

14. Strengths and 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, € per hour
Hospital stay cost, €432 per day
Time away from work, €83 per day
Ref: Jennifer Brooks, University of North Carolina, November 9, 2006
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery

15. Ethical and Safety Considerations
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?
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery

16. FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23
Challenges and Future
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
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery

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

18. Thanks for your attention! Moahahahhaaaaa
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery