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INTRODUCTION
Robotic Surgery 
is a
 
microsurgery in which the surgeonperforms surgery by manipulating the hands of a robot .
 
Roboticsurgery is the use of robotsin performingsurgery. Three major advances aided by surgical robots have beenremote surgery,minimally invasive surgeryand unmanned surgery. Majoradvantages of robotic surgery are precision, miniaturization, smallerincisions, decreased blood loss, less pain, and quicker healing time.Further advantages are articulation beyond normal manipulation andthree-dimensional magnificationRobots are being used in increasingly complex surgicalprocedures. However these robots are not autonomous machinesthat carry out simple, pre-programmed instructions.Operating theatre robots are designed to supplement asurgeon's abilities, translating human movements into incrediblysteady and accurate robotic movements, which, in turn, manipulateinstruments to aid delicate operations. But minimally invasiveprocedures, using instruments controlled by humans, have theirlimitations. For one, instruments are not in the surgeon's directcontrol, being manipulated by assistants. And the instrument'spositioning within the body is subject to human tremors and fatigue,which makes working on minute structures difficult and dangerous.By handing control of the surgical instruments over to a robot-and positioning the surgeon at a comfortable console with a
3
D orand high- resolution display at 10 to
20
times magnification - surgeryis easier and more accurate . Rather than stopping the heart andperforming a sternotomy or a
 
thoracotomy, just three 8 to
10
mm-long incisions are required for two robotic arms with tiny instrumentsand a third for a camera.Patients of conventional open heart surgery need, on average,two weeks recovery in hospital, followed by two to three months restbefore they can resume normal physical exercise- this is how longthe sternum takes A robotic wrist provides articulated motions with afull
7
degrees of freedom inside the abdominal or thoracic cavities(EndoWrist™ technology)Computer interfacing allows for remote control surgery
 
(telesurgery), for more precise manipulations by downscaling thesurgeon’s motions and by allowing surgeon’s good ergonomicposition .Human robotic surgery was introduced by Cadiere’s team (St.Pierre Hospital, Surgical robotics is a new technology that holdssignificant promise. Robotic surgery is often heralded as the newrevolution, and it is one of the most talked about subjects in surgerytoday. Up to this point in time, however, the drive to develop andobtain robotic devices has been largely driven by the market. Thereis no doubt that they will become an important tool in the surgicalarmamentarium, but the extent of their use is still evolving.Several centers are currently using surgical robots andpublishing data. Most of these early studies report that roboticsurgery is feasible. There is, however, a paucity of data regardingcosts and benefits of robotics versus conventional techniques.
 
Background and History of Surgical Robots
 
Since
1921
when Czech playwright Karel Capek introduced thenotion and coined the term robot in his play
Rossom’s UniversalRobots
, robots have taken on increasingly more importance both inimagination and reality. Robot, taken from the Czech
robota
,meaning forced labor, has evolved in meaning from dumb machinesthat perform menial, repetitive tasks to the highly intelligentanthropomorphic robots of popular culture. Although today’s robotsare still unintelligent machines, great strides have been made inexpanding their utility. Today robots are used to perform highlyspecific, highly precise, and dangerous tasks in industry andresearch previously not possible with a human work force. Robotsare routinely used to manufacture microprocessors used incomputers, explore the deep sea, and work in hazardousenvironment to name a few. Robotics, however, has been slow toenter the field of medicine.The lack of crossover between industrial robotics and medicine,particularly surgery, is at an end. Surgical robots have entered thefield in force. Robotic telesurgical machines have already been usedto perform transcontinental cholecystectomy.
3,4
Voice-activatedrobotic arms routinely maneuver endoscopic cameras, and complexmaster slave robotic systems are currently FDA approved, marketed,and used for a variety of procedures. It remains to be seen,however, if history will look on the development of robotic surgeryas a profound paradigm shift or as a bump in the road on the way tosomething even more important.Paradigm shift or not, the origin of surgical robotics is rooted inthe strengths and weaknesses of its predecessors. Minimallyinvasive surgery began in
1987
with the first laparoscopiccholecystectomy. Since then, the list of procedures performedlaparoscopically has grown at a pace consistent with improvementsin technology and the technical skill of surgeons. The advantages of minimally invasive surgery are very popular among surgeons,patients, and insurance companies. Incisions are smaller, the risk of infection is less, hospital stays are shorter, if necessary at all, andconvalescence is significantly reduced. Many studies have shown
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02 / 11 / 2010This doucment made it onto the Rising List!
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