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Presented By -Sayyan .N Shaikh 4SN11MAR10

Introduction History Types of Robotic surgery Robotic System Requirements Steeps involved in conducting surgery Robotic surgery unit Advantages Robotic Surgery under zero gravity Conclusion

The use of computer integration in surgery or simply the use of robots in surgery is termed as robotic surgery. The surgeons view the patient via a terminal and manipulates robotic surgical instructions via a control panel. A surgical robot is a self-powered, computer controlled device that can be programmed to aid in the positioning and manipulation of surgical instruments, enabling the surgeon to carry out more complex tasks.

History of Robotic Surgery

puma560 in 1985, a robot used to perform neurosurgical biopsies with greater precision. PROBOT in 1988, developed at Imperial College London, was used to perform prostatic surgery. The ROBODOC from Integrated Surgical Systems was introduced in 1992. Later US army developed a Mobile Advanced Surgical Hospital (MASH) with surgical equipment's and operated on remotely by a surgeon. Further development of robotic systems was carried out by Intuitive Surgical with the introduction of the da Vinci Surgical System and Computer Motion with the AESOP(Automated Endoscopic System for Optimal Positioning)and the ZEUS robotic surgical system.

Types of Robotic Surgery

The Robotic Surgery divided into 3 subcategories depending on the degree of interaction of surgeon during the procedure.

1. Supervisory control system 2. Telesurgical system 3. Shared control system

Supervisory controlled system

Procedure is executed solely by the robot, which acts according to the computer program that the surgeon inputs into it prior to the procedure. Surgeon does not take part directly. It does require a significant amount of preparation to set up to perform each surgery. Just prior to the surgery, mapping of the body using three-dimensional medical imaging is done. Then system is registered to match the patient's body to the mapping in the surgical system. Finally, the surgery begins and robotic system will automatically execute the procedure

Telesurgical System
It is also known as Remote surgery. It gives ability to a doctor to perform surgery on a patient even though they are not physically in the same location. Requires the surgeons to manipulate the robotic arms during the procedure rather than allowing the robotic arms to work from a predetermined program. Uses real-time image feedback. Remote surgery combines elements of robotics, cutting edge communication technology such as high-speed data connections and elements of management information systems. e.g. davinci surgical system.

daVinci Robotic System

Shared Control System

The human surgeon will perform most of the work, actually operating the surgical tools by hand. The system will monitor the activities of the surgeon and assists to stabilize and support the surgeon's movements using a technique called active constraint. In this technique, areas of the surgical field are identified as forbidden, boundary, close and safe. Through forced feedback in the surgical tools, the system will limit their use within the appropriate area.

Robotic System Requirements

Bandwidth -usually requires relatively low bandwidth. -transmission of real-time motion images at VMS tape quality (about 75 Mbits/second). Latency -latency of the control system should be under 10 msec. Security -require a high level of transmission security to be sure that they cannot be viewed or altered during transmission.

Reliability -The network must be as close to 100% reliable. -Lack of reliability could result in life threatening situations. Scalability -The bandwidth available on the network should be scalable so that the capacity can be increased in the future in response to potential increases in demand

Steeps involved in conducting surgery

1. Data acquisition and subsequent planning
It is a pre-operative phase in which a patient dependent model is created. For this, several medical imagery techniques, MRI, Scanner, Ultrasonic, etc. are used. In the same time, the mechanical model of the robotic system is fused in an overall geometric model. This model will be used to describe and simulate the different potential problems that may occur during the intervention.

2. Intra-operative assistance The results obtained in the planning phase are calibrated and put in correspondence with patient in intra-operative situation. As a consequence, the robotic system is able to provide interactive assistance/guidance, and to constrain the movements of the surgeon in order to perform, with the predefined, desired procedure with precision. e.g. neuro-surgical biopsy

Robotic surgery unit

Surgeon console -It has high definition 3-dimensional image of the area to be operated upon is projected on to a screen and a mechanical control for operating the robotic. Image processing equipment -This consists of optical sensors and a Digital signal processor for getting enhanced images. Surgical arm cart: -This acts as a platform for the entire Robotic arm and is used for controlling the linear movements of the arm. Hi-resolution 3-D Endoscope -This consists of an optical fibre and a reflector arrangement, it is an optical instrument used for visual inspection or photography of internal parts of the human body.

Advantages robotic surgery

Less pain, Less scarring Less blood loss and transfusions. It will bring down the cost of the operation. Risk of infection or complications decreases. Physiological stresses of surgeons are reduced. Robotic arms do not suffer fatigue or tremors as do the human hand. By using cameras and enhanced visual effects, doctors can make the tinniest of incisions. Due to small and precise cuttings, patients hospital stay is greatly reduced and recovered faster.

Robotic Surgery under zero gravity

SRI International and the University of Cincinnati will soon conduct the first robotic surgery in zero gravity aboard a NASA C-9 aircraft over the Gulf of Mexico. SRI developed software will also assist robot surgeons to compensate for errors in movement that is a very real possibility while flying through space. A surgeon controls a multi-armed robots which will be controlled remotely from a distant location using a telecommunication network. Provides emergency medical & surgical care to astronauts during space flights.

Robotic surgery will soon replace conventional surgical procedures. It brings surgery to the digital age. Further research must evaluate cost effectiveness or a true benefit over conventional therapy for robotic surgery to take full root.

Riccardo Muradore, Davide Bresolin, Luca Geretti, Paolo Fiorini, and Tiziano Villa Robotic Surgery- formal verification of plans IEEE- Sep- 2011. Y.V.K.D. Bhavani, Y. Vijaya Background of Surgical Robos and Robotics in Different Surgeries IJCST Vol. 3, Issue 1, Jan. - March 2012 J. Desai and N. Ayache, Editorial special issue on medical robotics, Int. J. Robot.Res., vol. 28, no. 9, pp. 10991100, 2009. J. Craig, Introduction to Robotics Mechanics and Control. Upper Saddle River, NJ:Pearson Prentice Hall, 2005. A. Rovetta, A. Bejczy, et al., A New Telerobotic Application: Remote Laparoscopic Surgery Using Satellites and Optical Fibre Networks for Data Exchange, The International Journal of Robotics Research, Vol.15, N.3, June 1996. Damiano R. Next up: surgery by remote control. New York Times. April 4, 2000.


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