Introduction
Medical sciences have given people and healthcare professionals newer opportunities to explore the unknown. It has opened new gates and pathways to make medical services easier, convenient, affordable, and time-saving. Everything that medical science and new technologies develop has a common aim to improve human health in every possible way.
Robotic surgery is one such emerging field of advancement that is becoming popular. It has the potential to replace traditional surgery methods. This development is not new. People have witnessed robotic surgery since the 1980s, after which it went through many improvements with time, need, and the emergence of technological advancements. A few standard surgical systems are the Da Vinci system, RoboDoc, and so on, which have made complex surgeries simpler, given greater accessibility to the hard-to-reach or small surgical sites, and improved precision and skills to perform surgeries.
What Is Robotic Surgery?
It is an advanced technology-based surgery performed with robotic devices called surgical robots. Sometimes, it is also called robotic-assisted surgery.
What Are the Types of Robotic Surgery?
There are three types of robotic surgery:
-
Supervisory Controlled Surgery: This surgical robot works on automation, meaning that it automatically performs the surgery. It is used in orthopedic surgeries. For example, RoboDoc performs orthopedic surgery in which the surgeon perfectly positions the bone-cutting tool at the surgery site, and the RoboDoc cuts the bone automatically.
-
Tele Surgical Technique: The Da Vinci System is based on this technique in which the surgeon sits at a console or control panel far from the patient and performs the surgery by controlling the instruments.
-
Shared Controlled Technique: It is a dual performance of the surgeon and the robot in which the robot controls the surgeon's movements that may harm the patient. For example, while performing surgery, if the surgeon accidentally moves the instrument close to the surrounding tissues that may damage them, the robot immediately responds by putting a force or pressure. This acts as a red or danger signal for the surgeon to realign their movement and not cut or damage the healthy tissues. The robot works and responds differently based on location, safety, closeness, and many other factors.
Who Invented Robotic Surgery?
Hap Paul and William Bargar developed a unique system to perform orthopedic surgery called Robodoc in the late 1980s. As a result, RoboDoc performed the first hip replacement surgery.
What Is the History of Robotic Surgery?
The history of robotic surgical systems is long. The significant milestones are given below:
-
The word robot was first coined in 1921 by Karel Capek.
-
Originally, the word robot comes from Czech robota, which means labor work done forcefully, such as slavery.
-
A robot named Puma 560 was the first to be used to perform neurosurgery in 1985.
-
In 1987, telescopes or telesurgical machines were first used to perform cholecystectomy (gallbladder removal).
-
Then, the Puma 560 robot was used to perform prostate surgery. After this successful surgery, a robotic surgical system known as PROBOT was used to perform prostate surgeries. Later on, RoboDoc was developed for hip replacement surgeries. The food and drug administration approved the first-ever surgical robot system RoboDoc.
-
In the 1990s, telesurgery became popular and led to the development of an automated endoscopic system for optimal positioning (AESOP), a robotic arm or hand device that runs on the voice commands of the doctor or surgeon.
-
Later on, this robotic arm underwent several improvements and became the Da Vinci surgical system.
-
Currently, there are various surgical systems available such as RoboDoc, Da Vinci surgical system, Prodoc, a robotic endoscope that works on voice command and Zeus.
Where Is Robotic Surgery Used?
A single robotic system is used to perform a specific surgery. The use of the robotic system is not limited to the following:
-
RoboDoc is used for hip replacement surgery.
-
Da Vinci system and Zeus system are used for cholecystectomy, gastrointestinal surgeries, kidney transplants and many other surgeries.
-
Minimally invasive cardiac or heart surgery.
-
Laparoscopic surgeries in children and infants.
-
Orthopedic surgeries (related to bones and joints).
-
Gynecology surgeries (associated with the female reproductive system).
-
Neurology surgeries (related to the brain).
What Is the Da Vinci System?
Da Vinci system was originally developed for NASA and US army personnel. In this system, there is a robot that works on the surgeon's commands. The robot has multiple arms and is controlled by a panel or console. The console also has a monitor that shows the images and videos directly from the surgery site. It has three elements:
-
Vision Cart: It has lights and cameras.
-
Console or Panel: The surgeon handles it. It has a monitor that processes the three-dimensional images in detail, foot pedals for electrocautery, clutches to control and run the camera, and instrument arms and control grips.
-
Cart: It is moveable and carries instrument or robotic arms and a camera arm. The camera develops three-dimensional images.
What Are the Advantages of Robotic Surgery?
The advantages of robotic surgery are:
-
Improves the surgeon’s hand skills in performing the surgery.
-
Improves ergonomic position. The surgeon's working position is enhanced to reduce posture-related problems such as pain in the neck and back.
-
Improves surgery site visualization by providing three-dimensional and zoomed images.
-
It is now easier to perform complicated surgeries.
-
Improves the precision of the surgery through enhanced skills of the surgeon’s hands.
-
Improves hand-eye coordination.
-
It improves the ability of the surgeon to handle and manipulate the instruments.
-
Improves vision of the surgery site because it provides zoomed or magnified images.
-
Low risk of infection.
-
Quick recovery.
What Are the Disadvantages of Robotic Surgery?
The disadvantages of robotic surgery are:
-
These are not feasible and ultimately cannot be adopted to perform all the surgeries. These are used to perform a limited number of surgeries.
-
These are expensive and thus, every patient cannot afford them.
-
The size of surgical systems is huge if compared to small operating rooms. This requires additional space in the operating room.
-
Limited availability of instruments that are compatible with performing robotic surgery. Due to this, the helpers or surgeons have to perform some surgery manually.
How Is Robotic Surgery Done?
The technique of surgery depends on the robotic surgical system, surgery type, and other factors. In general, all robotic surgeries are performed in an operating room.
-
The surgeon sits or stands near the patient with a console from where they control the instruments.
-
Small incisions or cuts of one to two centimeters are made at the surgery site.
-
A camera and instruments are inserted into the patient’s body.
-
The doctor, from a distance, sitting with a console, performs the surgery.
-
During the surgery, the instrument makes the movement as controlled and manipulated by the surgeon through the console.
Conclusion
With the new advancements in medical sciences and technology, robotic surgery is gaining popularity. It comes with a long list of advantages over traditional surgical procedures. However, it is still undergoing new improvements, and the existing disadvantages make robotic surgery limited. Robotic surgery or robot-assisted surgery is used in wide areas of healthcare, such as orthopedic surgeries, kidney transplants, and pediatric surgeries. Most commonly and widely used in minimally invasive cardiac surgery. Robotic surgery has enabled humans to work beyond their limits and abilities because it improves the hand skills of a surgeon to perform surgery very precisely. However, overcoming the existing limitations and completely replacing the traditional and laparoscopic methods remains a challenge for robotic surgery.
