Robotics in Surgery Introduction: The Da Vinci Robot The Da Vinci Robot was the first FDA-approved robot-assisted surgery

system. This tool in surgery uses a system with three or four endowrist-instruments being controlled by the surgeon through the control computer, with a 3 dimensional display of the whole surgery for the team or other viewers. Robot-assisted surgery was first introduced in the early 2000s and is slowly becoming a technique that is being used in hospitals today. With the use of robots in surgeries now, surgeons are now performing minimally-invasive surgeries with only 3 to 4 small incisions are needed now to perform many surgeries, simple or complex. Advantages in Surgery Over time, robotic-assisted laparoscopies have started to becoming a more accepted technique in abdominal surgeries. Conventional laparotomies required the surgeon to make a large single incision to create a "site" for the surgeon which lead to increased morbidity whereas in laparoscopies, only a small incision is needed, greatly decreasing the chance for infection. Giuseppe Spinoglio and his team (2011) and Casandra Anderson and her team (2007) have both written similarly about the decreased morbidity rate with the use of robots in surgery. Rodrigo Pedraza and his team (2012) conducted a case study on a patient with a perforation caused by a colonoscopy. A perforation during a colonoscopy is very rare, however, when this does happen, it is very serious. Generally this can be repaired by performing a laparotomy; however, in this case study, the surgeon uses the assistance of the Da Vinci robot to complete the laparoscopy. When performing this procedure with the Da Vinci Robot, it improves the quality of the surgery greatly since the surgeon has a clear visualization of their site. The use of the

instruments almost completely take away the surgeon tremor. With the results of this procedure being successful, it becomes a great example of the advantages of robotic-assisted laparoscopies over conventional laparotomies. Training When robotic-assisted surgery was first introduced in 2000, it was foreseen that if a surgeon was unable to operate the machinery, they themselves became obsolete. When thinking about the concept of such advanced machinery being used within a delicate procedure dealing with the human body, it may bring up fear of the difficulty of operating it; however, Dan Eisenburg and his team (2013) conducted a study on the two different techniques of surgery. To do this, Eisenburg gave 5 surgeons the task to tie a square knot with both techniques. When doing this, the knots made with the assistance of the Da Vinci robot were of much better quality. It was noted that the surgeons did not have any personal experiences before this study with the robot; they were given some formal training before the start of the study. With the comparison of the two techniques in this study, it is shown that the surgeons were able to perform better with the Da Vinci robot with little training compared to the conventional methods they usually practice. Increased Skills In the previous passage, the results made between the two different types of techniques were compared. From this, it was shown that robotic-assisted surgeries had better results. The simplistic use of the robot was not the only factor that produced better results; it was also the increased skills brought by using the Da Vinci robot. Starvros A. Antoniou and his team(2011), A. P. Advincula(2006), Casandra Anderson and her team(2007), and Chang Moo Kang and

her team(2010) are all researchers that similarly find that the Da Vinci robot provides many extremely beneficial attributes to the surgeon. With the assistance of the Da Vinci robot, the surgeon had advanced degrees of freedom with his tools, a magnifying camera effect, stable camera platform, the elimination of the surgeon tremor, as well as the 3-D imaging. With this, the surgeon's precision is improved greatly, thus decreasing the amount of nerve damage and increasing the quality of the surgery. Conclusion The Da Vinci robot, although relatively new, has already shown that it has the potential to change the way surgeries are performed. Results of using robots in surgery have shown that patients will have better results post op. The use of this minimally-invasive technique results in a more cosmetically-appealing outcome; however, this is only a small result when compared to the other outcomes of using robots in surgery. It will also increase the amount of surgeons able to perform more delicate procedures. Since the use of the robot in surgery is relatively easy, minimal training is needed to operate the machinery adequately. Although the results may be better when compared to the conventional method, patients are still skeptical of this new technique. Although robotic-assisted surgeries are a new method that is growing in operating rooms, many hospitals have yet to adapt to the new technology. What stops many is the amount of people projected to favor the conventional method over the robotic-assisted surgery even with the results favoring robotic-assisted surgery. The cost of a Da Vinci robot is not cheap, of course. With this, many hospitals fear they will lose money on the lack of patients agreeing to this method of surgery. The low demand of robotic surgeries may be the lack of knowledge of the new technique itself. Most people are either completely unaware that we have this type of

technology now, while others may not be adequately informed of it, consequently, it will create skepticism over the decision choosing robot-assisted surgery. Project Proposal Chang Moo Kang and their team (2010) discuss the results of the robotic assisted surgery. What seemed interesting about this study was when they would ask the patients to consent to use of the Da Vinci robot; when asking this, the younger patients preferred the robotic-assisted surgery, whereas the older patients favored the conventional method. With this, it shows that the younger people are willing to try this new method, so it seems that hospitals could be shown the growing demand for this new method with a survey of people. A survey would give the hospital a better understanding of the amount of people actually willing to undergo surgery with the Da Vinci robot. The survey would be designed to find the amount of people willing to undergo surgery with the use of the Da Vinci robot. Although the content within the survey must stay simplistic to be suited for the general public, it will have facts and statistics of the procedure and results of robot-assisted surgeries compared to conventional laparotomies. To obtain an accurate result from the survey, the distribution of age, sex, race, and economic state must be put into account. With these numbers, it would show a much more detailed result for the interest in the Da Vinci Robot. The survey would be informing the public at the same time it would be finding the interest. This would then result in a growing demand for the robot in hospitals.

References Advincula, A. P. "Surgical Techniques: Robot-assisted Laparoscopic Hysterectomy With The Da Vinci Surgical System." The International Journal of Medical Robotics and Computers. Volume 2, Issue 4, 15 December 2006: pg 306-311. Anderson, Casandra. Joshua Ellenhorn, Minia Hellan, Alessio Pigazzi. "Pilot Series of Robot-Assisted Laparoscopic Subtotal Gastrectomy With Extended Lymphadenectomy For Gastric Cancer." Springer Link. 8 March 2007. 18 October 2013. Antoniou, Starvros A. George A. Antuniou, Oliver O. Koch, Rudolf Pointner, Frank A. Granderath. "Robot-assisted Laparoscopic Surgery of the Colon and Rectum." Springer Link. 20 August 2011. 18 October 2013. Eisenberg, Dan. Tamas J. Vidoszky, James Lau, Bernadette Guiroy, Homero Rivas."Comparison of Robotic and Laparoendoscopic Single-site Surgery Systems in a Suturing and Knot Tying Task." Springer Link. 27 February 2013. 18 October 2013. Kang, Chang Moo. Dong Hyun Kim, Woo Jung Lee, Hoon Sang Chi. "Conventional Laparoscopic and Robot-assisted Spleen-Preserving Pancreatectomy: Does Da Vinci Have Clinical Advantages?" Springer Link. 7 December 2010. 19 October 2013 Pedraza, Rodrigo. Madhu Ragupathi, Tara Martinez, Eric M. Haas. "Robotic-assisted Laparoscopic Primary Repair of Acute Iatrogenic Colonic Perforation: Case Report." International Journal of Medical Robotics and Computer Assisted Surgery. Volume 8, Issue 3. 20 June 2012: pg 375-378.

Spinoglio, Giuseppe. Luca Matteo Lenti, Valeria Maglione, Francesco Saverio Lucido, Fabio Priora, Paolo Pietro Bianchi, Federica Grosso, Rual Quarati. "Single-Site Robotic Choecystectomy (SSRC) versus Single-Incision Laparoscopic Cholecystectomy(SILC): Comparison of Learning Curves. First European Experiences." Springer Link. 17 December 2011. 18 October 2013.