Wednesday, November 16, 2005

The Evolution of Robotic Surgery--Success and Possibility

by Hannah Shakartzi (Class of '05)

Who ever thought that surgeons would be able to perform surgery from around the world? Developments and the evolution of robotic surgery over the last five years have improved medicine and have made telesurgery possible.

Robotic surgery first made its debut as part of the da Vinci Surgical System. The da Vinci System first enabled surgeons to perform endoscopic- minimally invasive surgery, without physically maneuvering surgical tools.

It did so with the use of a viewing and control console along with a surgical robotic arm unit which performed the surgery.

A surgeon was able to look at the viewfinder to see magnified 3D images of the surgical site and control the surgery, while sitting at the console. The 3D images were provided by an endoscope, a small surgical camera in the patient controlled by one robotic arm. The surgeon used foot pedals to control the camera, and used hand movements to adjust and reposition the remaining two, robotic arms, performing the surgery. Electrical signals enabled the robotic arms to mimic the surgeons hand movements.

The Zeus Robotic Surgical System is another surgical aid that has also contributed to the advancement in medicine and the idea of telesurgery. It was cleared in October 2001.

The Zeus Robotic Surgical System consists of three robotic arms that are mounted on an operating table. It has a computer work station, video display, and hand controls which move the three robotic arms that maneuver the surgical instruments. One of the robotic arms is called the Automated Endoscopic System for Optimal Positioning, or otherwise known as the AESOP. The AESOP, like in the da Vinci System, maneuvers the endoscope. However, unlike the da Vinci System, the AESOP and the robotic system itself is voice-activated. The two systems are similar in the way that they function.

The two systems have improved medicine in a variety of ways. Both of the robotic surgery systems provide greater precision and control when dealing with surgical tools. The system provides a greater depth perception and viewing of the surgical site than a human eye could see due to the magnifying lens of the camera. The robots enable smaller scale work which conventional surgery permits, and also eliminate tremors from fatigued surgeons. Fewer surgeons are also needed in the operating room because of the robots assistance. Another benefit is that robotic surgery requires less incision, lowering blood loss, reducing trauma, ultimately resulting in a quicker recovery.

The da Vinci Surgical System, the Zeus Robotic Surgical System and the AESOP, have most importantly led to the development of telesurgery.

Scientists soon began to realize that if surgery could occur from meters away, than it was also possible from miles and even continents away. With the use of the Zeus Robotic Surgical System, and high speed fibre optic networking, a surgeon in the United States removed a gall bladder of a sixty-eight year old woman from over 7,000 miles away, in Strasbourg France, on September 17, 2001. Operation Lindberg was the first telesurgery operation in the world.

Operation Lindberg was a medical success. It showed that people would be able to receive surgery from surgeons around the world. Telesurgery could serve beneficial to people living in impoverished nations, and could lower the price of healthcare due to minimizing travel. It could also serve as a model to provide astronauts with surgery on long missions, along with aiding wounded soldiers in battle.

The da Vinci Robotic System and the Zeus Robotic System served as the basis for the advancement of surgery around the world and has provided science and medicine with endless possibility.

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