Presentation Robot-assisted Surgery

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

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

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

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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

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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]

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

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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]

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

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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

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

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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.

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

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Working Applications Robotics in Surgery Autonomous robots Master-Slave robots Computer assisted

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

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

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

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Working Applications Surgery domains Cardiology Gynaecology General surgery Urology Orthopaedics Paediatrics

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

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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)

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

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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)

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

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Strengths and Limitations Limitations Sensation Confined operative field Anesthesia complications Break down Increased operation time Cost of equipment Sterlization FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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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

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

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

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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

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

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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

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

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Thanks for your attention! Moahahahhaaaaa FoKurs – Tekniska System Inom Kirurgin, Robotic surgery 2007-02-23

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