1. Robotic surgery Atefeh Jannatbabaee
Department of Biomedical Engineering
Amirkabir University of Technology
April 2008
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2. Open Surgery: Advantages Disadvantages 3D vision Tactile sensing
Short instruments
Disadvantages
More blood loss
More pain
Long recovery time
Damage to the side tissues
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3. Endoscopic Surgery: Advantages: Disadvantages: Less blood loss
Less pain
Shorter recovery time
Less damage
Disadvantages:
2D vision
tactile feedback
Long instruments
Human cameraholder
Long training course for staff
Not efficient to all surgeries
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4. Robotic features: Doing routine tasks efficiently in shorter time
Doing jobs that human cannot do!
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5. History :
US military began a top secret project in order to use robo surgeons in the battlefields cause of the shortage of surgeons during wars
Dr Fred Moll established the Intuitive Surgical Inc. in 1995
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6. Common robotic systems on the market:
AESOP
ZEUS
Da Vinci
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7. AESOP (Automated Endoscopic System for Optimal Positioning)
A robotic arm used as a camera holder; product of Computer Motion Inc.
AESOP1000 : 6DOF ,hand and foot switch control
AESOP2000: Voice controlled
AESOP3000: an additional joint as an elbow; 7 DOF
AESOP HR (HERMES READY):Voice control of AESOP, prepheral devices such as room light
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8. ZEUS: Product of Computer Motion Inc. First surgery in 1998
FDA approval in 2001
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9. Components:
Surgeon_side :
Console:
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10. 2 robotic arms for manipulation of instruments 1 camera arm
Patient_side :
2 robotic arms for manipulation of instruments
1 camera arm
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11. Features: 3D vision of Storz system
Note: the surgeon wears special glasses
Tremor abolition
Motion scaling in the range of 2:1 & 10:1
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12. Da Vinci: Product of Intuitive Surgical Inc. in 1997
First Surgery by Himpens et al. in 1997
FDA approval in July, 2000
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14. Features: 7 DOF Surgeon at a console Stereoscopic vision
Tremor elimination
Motion scaling
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15. Components:
Robotic Cart
The Console
Endoscopic stack
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16. Robotic cart: 2 meters high , 1 meter long and 1 meter wide
Approximately 544kg weight
Manual movement on wheels
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17. Robotic Cart The Arms: A central arm to hold camera
Two lateral arms to hold instruments
The arms are not sterile and are draped with sterile bags.
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18. Robotic cart Camera system: There are two cameras with 0 and 30 angles
The camera system has a dual lens
system with two three-chip cameras
Projection of two images provides real 3D image in binocular viewer
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19. Robotic cart Instruments: They have an 8 mm diameter
Endo-wrist instruments
6DOF of the tips and 1DOF within instrument activity
They can be resterilized up to 10 times
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21. The Console: Binocular viewer of the Insite vision system:
The 3D image is viewed by binocular viewer
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22. The Console Instrument Controllers:
The surgeon put his thumb and forefinger in the loops of master controller
Approximate motion of fingers operate the instruments
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23. The Console Foot Pedals: Central pedal: adjusts the camera focus
Camera pedal : engages the camera arm & disengages instrument arms
Clutch pedal: disengages instrument arms
Third pedal: activates diathermy
Fourth pedal: usually inactive
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24. The console Control Panels:
First panel :adjustments of camera, endoscope and motion scaling
Second panel: Start control system, emergency stop button & standby buttons.
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25. Endoscopic stack: 2D monitor CO2 insufflator Light source Camera unit
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26. Ergonomics:
Ergonomic chair
Ergonomic controller
Head rest
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27. Operation Room:
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28. Clinical Impact: Robotic surgery used in:
Cardiothoracic surgery
Gastrointestinal surgery
urological surgery
Gynecological surgery
Areas of surgery have been improved:
Radical prostatectomy
Areas of surgery in which MIS became possible:
Coronary artery bypass grafting
Other thoracic procedures
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29. Good for: Bad for: Precise tissue manipulation Large areas
Improved visualization
Magnification
Tremor elimination
Surgeon ergonomics
Bad for:
Large areas
Tactile feedback
Speed
Team ergonomics
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30. Two important issues about Da Vinci:
Cumbersome at bedside
Resident teaching issues
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31. Barriers: Size Cost Culture within the operating room Ease of use
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32. The Future of Robotic Surgery:
Will make more difficult operations possible
Will allow more surgeons to perform advanced laparoscopic surgery
The systems will be smaller and much easier to use and have semiautonomous control
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33. Need of Robots in telemedicine:
Robots will be an integral part of health care delivery in wars, explorations or in far distant locations
Intelligent robots will reduce the need for a physician
Rapid delivery of care
Independent of distance or environment
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34. THE END
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