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  • Writer's pictureDr Ankita Mishra

Scope of robotics in Laparoscopic surgery

In the operation theater (OT), surgeons must always be precise while making incisions or performing other surgical procedures. The repetitive tasks are tiring and challenging. Advancements in AI and collaborative robotics are applied in the medical field to assist surgeons in the OR.

Image source: Flickr.com

What is Robotic Surgery used for?

Robotic surgery is similar to laparoscopic surgery in that they both use small incisions, a camera, and surgical instruments. However, instead of holding and manipulating the surgical instruments during robotic surgery, the surgeon will sit at a computer console and use controls to manipulate the robot. The console allows the surgeon to view high-definition, magnified 3D images with increased accuracy and vision inside the body.


Is Robotic Surgery better than Regular Surgery?

Image source: Medical device

Compared to traditional surgery, robotic surgery provides the surgeon with a greater range of motion and precision, which may lead to less bleeding and post-operative pain. Robotic surgery allows all laparoscopists to perform advanced laparoscopic procedures with greater ease. The potential advantages of surgical robotic systems include making advanced laparoscopic surgical procedures accessible to surgeons who do not have advanced video endoscopic training and broadening the scope of surgical procedures that can be performed using the laparoscopic method. Robotic surgery is using small robots to do the surgery using smaller incisions on the body than normally would be used in open surgery. Robotic surgery is one of the tools available today to do Minimal Access Surgery otherwise known as MAS.


Types of surgical robots for laparoscopic surgery

Surgical robots for laparoscopic surgery can be classified into

Master-slave type

The master controller device is manipulated by a surgeon to control a robotic arm. Using a system like this, a surgeon can sit or stand at a console, rather than hunch over the patient, reducing strain on the back and shoulders. The robot has a 4-DOF (Degree Of Freedom) arm outside the abdominal cavity and a 2-DOF wrist joint at the tip. The robots enable telesurgery via network and microsurgery by changing the motion scale between the master and the slave. Open consoles, lighter instruments, less invasiveness, and greater portability are a few of the important features. However, this has a few drawbacks like lack of haptic (touch) technology, consuming large space for consoler, and high operating and maintenance cost.

Image source: MDPI

Examples of master-slave surgical robots:

  • Intuitive Surgical da Vinci Xi- USA

  • Zeus- USA

  • Meere Revo- Korea

  • RiverField- Japan (Under development)

  • EndoMaster- Singapore (Clinical trial)

Hand-held robotic forceps


Future challenges for surgical robots:

  1. Compact and inexpensive

  2. Haptic feedback to the operator

  3. Single-Port Access surgery (SPA)

  4. Natural Orifice Transluminal Endoscopic Surgery (NOTES)

  5. Telesurgery

  6. Applications of augmented reality

  7. Automation of surgical tasks

  8. Cyber-physical systems coupled with robots

Benefits of the robotic laparoscopic approach:

  1. Easier access to inaccessible surgical sites

  2. Improves precision

  3. Shorter hospital stays

  4. Decreased postoperative pain

  5. Rapid return to preoperative activity

  6. Decreased postoperative ileus

 

References

  1. Medical Device Network [Website]

  2. A Amodeo, Linares Q, et al; Robotic laparoscopic surgery: cost and training, Minerva Urol Nefrol, 2009 Jun;61(2):121-8. [PubMed]

  3. Association for Advancing Robotics [Website]

  4. Kawashima, K., Kanno, T. & Tadano, K. Robots in laparoscopic surgery: current and future status. BMC Biomed eng 1, 12 (2019). DOI: 10.1186/s42490-019-0012-1

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