Robotic Surgery

Past, Present
and
Future
Reijo Jäsmä, Amir R Razavi

Dept. of Biomedical Engineering

FoKurs – Tekniska System Inom Kirurgin, 2007
FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23 1
Overview

Introduction
Working Applications
Strengths and Limitations
Ethical and Safety Considerations
Challenges, Future and Conclusion

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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 2007-02-23 3

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]

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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]

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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

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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.

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Working Applications

Robotics in Surgery
Autonomous robots
Master-Slave robots
Computer assisted

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Working Applications

Available systems
da Vinci robotic system.
Zeus Robotic xyxtem
...

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Working Applications

Surgery domains
Cardiology
Gynaecology
General surgery
Urology
Orthopaedics
Paediatrics

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Working Applications

Robot-assisted surgery in Sweden

Karolinska university hospital
Lund University hospital
University hospital in Malmö
Linköping university hospital (not installed
yet)

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Strengths and Limitations

Strengths
Physical separation
Wrist action
Tremor elimination
Optional motion scaling
Three-dimensional stereoscopic image
Electronic information transfer (Telesurgery)

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Strengths and Limitations

Limitations
Sensation
Confined operative field
Anesthesia complications
Break down
Increased operation time
Cost of equipment
Sterlization

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Strengths and Limitations

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, €100.90 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

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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?

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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

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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

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Thanks for your attention!
Moahahahhaaaaa

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