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Robotic Surgery
Submitted in partial fulfillment of the requirement for the award of degree
of Computer Science
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Preface
I have made this report file on the topic Robotic Surgery, I have tried
my best to elucidate all the relevant detail to the topic to be included in
the report. While in the beginning I have tried to give a general view about
this topic.
My efforts and wholehearted co-corporation of each and everyone has
ended on a successful note. I express my sincere gratitude to
..who assisting me throughout the prepration of this topic. I thank
him for providing me the reinforcement, confidence and most importantly
the track for the topic whenever I needed it.
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Introduction
A robot is a virtual or mechanical artificial agent. In practice, it is usually
an electro-mechanical system which, by its appearance or movements,
conveys a sense that it has intent or agency of its own. There is no
consensus on which machines qualify as robots, but there is general
agreement among experts and the public that robots tend to do some or
all of the following: move around, operate a mechanical limb, sense and
manipulate their environment, and exhibit intelligent behavior, especially
behavior which mimics humans or other animals. Today, commercial and
industrial robots are in widespread use performing jobs more cheaply or
with greater accuracy and reliability than humans. They are also
employed for jobs which are too dirty, dangerous or dull to be suitable for
humans. Robots are widely used in manufacturing, assembly and packing,
transport, earth and space exploration, surgery, weaponry, laboratory
research, and mass production of consumer and industrial goods. [2]
In 2006, there were an estimated 3,540,000 service robots in use, and an
estimated 950,000 industrial robots. [35] A different estimate counted more
than one million robots in operation worldwide in the first half of 2008,
with roughly half in Asia, 32% in Europe, 16% in North America, 1% in
Australasia and 1% in Africa.
Robotic surgery
Robotic surgery is the use of robots in performing surgery. Three major
advances aided by surgical robots have been remote surgery, minimally
invasive surgery and unmanned surgery. There are three different kinds of
robotic surgery systems: supervisory-controlled systems,
telesurgical systems and shared-control systems. The main
difference between each system is how involved a human surgeon must
be when performing a surgical procedure. The military is responsible for
many of the advances in robotic surgery. That's because military officials
hoped that robotic surgery would provide a way for doctors to help
patients on the front lines of combat zones without putting themselves in
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The surgeon must tell the robot what the proper surgical pathway is. The
robot can't make these decisions on its own. Once the surgeon programs
the robot, it can follow instructions exactly.
The next step is registration. In this phase, the surgeon finds the points on
the patient's body that correspond to the images created during the
planning phase. The surgeon must match the points exactly in order for
the robot to complete the surgery without error.
The final phase is navigation. This involves the actual surgery. The
surgeon must first position the robot and the patient so that every
movement the robot makes corresponds with the information in its
programmed path. Once everyone is ready, the surgeon activates the
robot, which carries out its instructions.
Telesurgical systems
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Shared control
Shared-control robotic systems aid surgeons during surgery, but the
human does most of the work. Unlike the other robotic systems, the
surgeons must operate the surgical instruments themselves. The robotic
system monitors the surgeon's performance and provides stability and
support through active constraint.
Active constraint is a concept that relies on defining regions on a patient
as one of four possibilities: safe, close, boundary or forbidden.
Surgeons define safe regions as the main focus of a surgery. For example,
in orthopedic surgery, the safe region might be a specific site on the
patient's hip. Safe regions don't border soft tissues.
In orthopedic surgery, a close region is one that borders soft tissue. Since
orthopedic surgical tools can do a lot of damage to soft tissue, the robot
constrains the area the surgeon can operate within. It does this by
providing haptic responses, also known as force feedback. As the surgeon
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approaches the soft tissue, the robot pushes back against the surgeon's
hand.
As the surgeon gets closer to soft tissue, the instrument enters the
boundary region. At this point, the robot will offer more resistance,
indicating the surgeon should move away from that area. If the surgeon
continues cutting toward the soft tissue, the robot locks into place.
Anything from that point on is the forbidden region.
Like the other robots we've looked at, shared-control system robots don't
automatically know the difference between a safe region versus a
forbidden region. The surgeons must first go through the planning,
registration and navigation phases with a patient. Only after inputting that
information into the robot's system can the robot offer guidance.
Abby Somebody
One potential future application of shared-control systems is
neurosurgery. In a 2005 volume of Neurosurgery, doctors suggest a
robotic system for brain surgery. The robot would have a single arm with
multiple pivot points. The surgeon could rest his or her elbow on the
robot's arm. The robot arm would also steady the surgical instrument.
While the surgeon controls the motion of the instrument, the robot arm
provides tremor control, stabilizing each movement .
like handles which translate the surgeon's hand movements into precise
micro-movements inside the patient. For example a 1-cm movement by a
surgeon's hand is translated into a .1 cm movement of the surgical tip
held by a robotic arm. Zeus also has the unique capability of reducing
human hand tremor and greatly increasing the dexterity of the surgeon.
Zeus allows surgeons to go beyond the limits of MIS enabling a new class
of delicate procedures currently impossible to perform. The main
disadvantage is high machine cost. It is around 1 million dollars. Its FDA
approval is pending.
Hermes
Unlike Aesop and Zeus, Hermes does not use robot arms to make the
Operating Room more efficient. Rather Hermes is platform designed to
network the OR, integrating surgical devices, which can be controlled by
simple voice commands. Many pieces of surgical equipment are outside
the range of sterility for the surgeon and must be manipulated by a
surgical staff while Hermes enables all needed equipment to be directly
under the surgeon's control. Hermes can integrate tables, lights, video
cameras and surgical equipment decreasing the time and cost of surgery.
Ultimately Hermes decreases the need for a large surgical staff and
facilitates the establishment of a networked, highly organized OR.
Ultimately Computer Motion is working to bring Hermes into 84,000
operating rooms worldwide
FUTURE DEVELOPMENTS
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ADVANTAGES
Major advantages of robotic surgery are precision, miniaturization, smaller
incisions, decreased blood loss, less pain, and quicker healing time.
Further advantages are articulation beyond normal manipulation and
three-dimensional magnification .
Having fewer personnel in the operating room and allowing doctors the
ability to operate on a patient long-distance could lower the cost of health
care in the long term. In addition to cost efficiency, robotic surgery has
several other advantages over conventional surgery, including enhanced
precision and reduced trauma to the patient. For instance, traditional
heart bypass surgery requires that the patient's chest be "cracked" open
by way of a 1-foot (30.48-cm) long incision. However, with the da Vinci
system, it's possible to operate on the heart by making three or four small
incisions in the chest, each only about 1 centimeter in length. Because the
surgeon would make these smaller incisions instead of one long one down
the length of the chest, the patient would experience less pain, trauma
and bleeding, which means a faster recovery. Robotic assistants can also
decrease the fatigue that doctors experience during surgeries that can
last several hours. Surgeons can become exhausted during those long
surgeries, and can experience hand tremors as a result. Even the
steadiest of human hands cannot match those of a surgical robot.
Engineers program robotic surgery systems to compensate for tremors, so
if the doctor's hand shakes the computer ignores it and keeps the
mechanical arm steady.
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DISADVANTAGES
Some robotic surgery systems cost more than $1 million to purchase and
more than $100,000 a year to maintain. While hospitals can save on costs
by decreasing the length of a patient's stay due to a shorter recovery
period, they might not save enough to justify the expense of the
system.Critics have pointed out that hospitals have a hard time recovering
the cost and that most clinical data does not support the claim of
improved patient outcomes.[3]
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LIMITATIONS
Current equipment is expensive to obtain, maintain, and operate.
Surgeons and staff need special training.
Data collection of procedures and their outcomes remains limited.
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CONCLUSION
Robotic surgery is an emerging technology in the medical field. It gives us
even greater vision, dexterity and precision than possible with standard
minimally invasive surgery, so we can now use minimally invasive
techniques for a wider range of procedures. But it's main drawback is high
cost. Besides the cost, Robotic System still has many obstacles that it
must overcome before it can be fully integrated into the existing
healthcare system. More improvements in size, tactile sensation, cost, and
are expected for the future.
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REFERENCE
http://www.stronghealth.com
http://www.computermotion.coin
http://www.intuitivesurgical.com http://www.ctsuse.edu com
http://www.cn.wikipedia.org
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