ROBOTIC SURGERY

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ROBOTIC SURGERY

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INTRODUCTION

• Robot-assisted surgery is the latest
  development in the larger movement of endoscopy,
  a type of minimally invasive surgery, the idea
  being that less invasive procedures translated
  into less trauma and pain for patients. Surgery
  through smaller incisions typically results in
  less scarring and faster recovery. It's not that
  robots are changing the basics of surgery.
  Surgeons are still cutting and sewing like they
  have been for decades.
• Robots represent a new computer-assisted tool
  that provides another way for surgeons to work.

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HISTORY

• In 1985 a robot ,the PUMA 560,was used to place a
  needle for brain biopsy using CT guidance.
• In 1988,the PROBOT ,developed at Imperial College
  London, was used to perform prostate surgery.
• The ROBODOC from Integrated Surgical Systems was
  introduced in 1992 to mill out precise fittings
  in the femur for hip replacement.
• 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 and the ZEUS
  robotic surgical system.

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CURRENT ROBOTIC SURGICAL SYSTEMS

• Artemis
• da Vinci and Zeus

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ARTEMIS

• Schurr et al at Eberhard Karls universitys
  section for minimally invasive surgery have
  developed a master-slave manipulator system that
  they call ARTEMIS . This system consists of two
  robotic arms that are controlled by a surgeon at
  a control console . Dario et al at the MiTech
  laboratory of Scuola Superior Sant Anna in
  Italy have developed a prototype miniature
  robotic system for computer-enhanced colonoscopy.

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Da Vinci and Zeus

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• They are comprehensive master- slave
  surgical robotic system
• In the da Vinci system, there are essentially 3
  components
• a vision cart that holds a dual light source and
  dual 3chip cameras,
• a master console where the operating surgeon
  sits, and
• a movable cart, where 2 instrument arms and the
  camera arm are mounted .

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i. ZEUS SYSTEM

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• The ZEUS surgical system is made of an
  ergonomic surgeon console and three table-mounted
  robotic arms, which perform surgical tasks and
  provide visualization during endoscope surgery.
  Seated at an ergonomic console with an
  unobstructed view of the OR, the surgeon controls
  the right and left arms of ZEUS, which translate
  to real-time articulation of the surgical
  instruments. A third arm incorporates the AESOP
  endoscope positioner technology, which provides
  the surgeon with magnified, rock-steady
  visualization of the internal operative field.
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• Fig Zeus system

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Surgeon console

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• Touch screen monitor
• Support arms and surgeon handles
• Mounting areas for speakers
• Access to controller front panels
• Mounting shelves for housing control units

• Fig surgeon console

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Features of Zeus system

• Industry standard mechanism-easy sterilization
• Instrument reusability
• Quick instrument changes
• Rapid setup
• Visualization
• Six degrees of freedom
• Seating accommodation

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ii. DA VINCI SYSTEM

• System overview
• . surgeon console
• . patient side cart
• . insite vision camera with endoscope

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Fail safe mechanisms

• Safety concerns remain the centre of focus.
  To start the procedure, the surgeons head must
  be placed in the viewer. Otherwise the system
  will lock and remain motionless until it detects
  the presence of the surgeons head once again.
  Included in the power source is a backup battery
  that allows the system to run for twenty minutes,
  giving the hospital enough time to re-establish
  power . Each instrument has a chip that prevents
  the use of any instrument other than those made
  by Intuitive Surgical. These chips also store
  information about each instrument for more
  precise control and keep track of instrument
  usage to determine when it must be replaced.

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PROS

• Precision.
• Miniaturization.
• Smaller incisions.
• Decreased blood loss.
• Less pain.
• Quicker healing time.
• Articulation beyond normal manipulation.
• Three- dimensional magnification

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CONS

• efficiency has not yet been well established
• High cost(price tag of million dollars)
• Cubersome robotic arms(miniaturization required)
• lack of compatible instruments and equipment

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APPLICATIONS

• General surgery
• Cardiothoracic surgery
• Cardiology and electrophysiology
• Gastrointestinal surgery
• Neurosurgery
• Orthopedics
• Pediatrics

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FUTURE ENHANCEMENTS

• Robotic surgery is in its infancy. Many
  obstacles and disadvantages will be resolved in
  time and no doubt many other questions will
  arise. Many of the current advantages in robotic
  surgery ensure its continued development and
  expansion. Although these systems have greatly
  improved dexterity, they have yet to develop the
  full potential in instrumentation or to
  incorporate the full range of sensory input. More
  standard mechanical tools and more energy
  directed tools need to be developed. Some authors
  also believe that robotic surgery can be extended
  into the realm of advanced diagnostic testing
  with the development and use of improved
  equipment. The possibilities for improvement and
  advancement are only limited by imagination and
  cost.

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CONCLUSION

• Although still in its infancy, robot
  assisted surgery has already proven itself to be
  of great value, particularly in areas
  inaccessible to conventional laparoscopic
  procedures. It remains to be seen, however, if
  robotic systems will replace conventional
  laparoscopic instruments in less technically
  demanding procedures. It has the potential to
  expand surgical treatment beyond the limits of
  human ability. Whether or not the benefit of its
  usage overcomes the cost to implement it remains
  to be seen and much remains to be worked out.
  Further research must evaluate cost effectiveness
  or a true benefit over conventional therapy for
  robotic surgery to take full root.

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• THANK U!!!!