RobotAssistedSurgery+Plan

This is where we will add all of our information for our group

High Level Overview
High Level Overview
 * Introduction - Robotic assistance useful in surgical procedures
 * Background
 * Factors Involved
 * Doctors
 * Patients
 * Manufactures
 * Engineers
 * Specific Tools
 * Focus on certain surgery (Da Vinci Model)
 * The da Vinci Surgical System is composed of four components:
 * A surgeon console
 * A computerized control system
 * Two instrument “arms”
 * A camera
 * Pros of Robot Assisted Surgery (RAS)
 * Cons of Robot Assisted Surgery (RAS)
 * How RAS helps
 * Conclusion

Researched Information

 * Robotic heart surgery: []
 * New Technology and Health Care Costs — The Case of Robot-Assisted Surgery: []
 * Da Vincni Official Website - []
 * Da Vinchi Robotic Surgery Pros and Cons - [|http://www.steadyhealth.com/articles]
 * Pros and Cons of Robot Assisted Surgery - []
 * [|/Da_Vinci_Robotic_Surgery__Pros_and_Cons_a1259.html]


 * Surgical Robots:**

//Page1// http://allaboutroboticsurgery.com/surgicalrobots.html

//Page 2// http://allaboutroboticsurgery.com/surgicalrobots/surgicalrobotspage2.html

//Page 3// //http://allaboutroboticsurgery.com/surgicalrobots/surgicalrobotspage3.html//

Link: http://www.springerlink.com/content/t886367474221h83/fulltext.pdf · **Robotic Surgery: A Current Prospective** o [] · **E-Skin For Robots Can Lead to Touch-Feely Prosthetics for Humans** o []
 * Robotic Knee Replacement Surgery**


 * Elsa:**

@http://www.tmh.org/body.cfm?id=396 About the da Vinci® Surgical System Tallahassee Memorial is the first hospital in the Florida Big Bend and Southwest Georgia regions to acquire the da Vinci™ Surgical System, a state-of-art robotic surgery system that offers the benefits of a more precise surgery with reduced pain for the patient and a faster recovery. The daVinci™ Surgical System is being used by urologists from Southeast Urological Center for radical prostatectomy, a common treatment for prostate cancer that involves removal of the prostate gland. Recent studies suggest that da Vinci™ Prostatetectomy may improve cancer control and reduce the risk of urinary incontinence and impotence following surgery. The da Vinci™ Surgical System allows the surgeon’s hand movements to be scaled, filtered and translated into extremely precise movements within the operative site. The magnified 3-dimensional view and small robotic instruments enhance the surgeon’s ability to perform complex procedures through small incisions. To perform a procedure, the surgeon uses the console’s master controls to maneuver the patient-side cart’s four robotic arms, which securely hold the patented EndoWrist instruments and high-magnification endoscopic camera. The EndoWrist instruments’ jointed-wrist design exceeds the natural range of motion of the human hand; motion scaling and tremor reduction further interpret and refine the surgeon’s hand movements. A final hallmark of the da Vinci System is its fail-safe design, incorporating multiple, redundant safety features designed to minimize opportunities for human error when compared with traditional approaches. With conventional laparoscopy, the surgeon must look up and away from the instruments, to a nearby 2D video monitor to see an image of the target anatomy. The surgeon must also rely on his/her patient-side assistant to position the camera correctly. In contrast, the da Vinci System’s ergonomic design allows the surgeon to operate from a seated position at the console, with eyes and hands positioned in line with the instruments. To move the instruments or to reposition the camera, the surgeon simply moves his/her hands. For the patient, a da Vinci procedure can offer all the potential benefits of a minimally invasive procedure, including less pain, less blood loss and need for blood transfusions, shorter hospital stay, a quicker recovery and faster return to normal daily activities. Clinical studies also suggest that the da Vinci System may help surgeons provide better clinical outcomes than conventional technologies allow — for example, better cancer control and a lower incidence of impotence and incontinence with da Vinci Prostatectomy.* While clinical studies support the use of the da Vinci® System as an effective tool for minimally invasive surgery, individual results may vary.
 * Cancer control is defined in part by margin rates and PSA test scores. The following studies provide support for these claims: Ahlering TE, Woo D, Eichel L, Lee DI, Edwards R, Skarecky DW. Robot-assisted versus open radical prostatectomy: a comparison of one surgeon's outcomes. Urology. 2004 May;63(5):819-22. Menon M, Tewari A, Peabody JO, Shrivastava A, Kaul S, Bhandari A, Hemal AK. Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases. Urol Clin North Am. 2004 Nov;31(4):701-17. Tewari A, Srivasatava A,

@http://www.tmh.org/surgery.cfm?id=488 Robotic Surgery for Gynecological Cancer John McBroom, MD, the Big Bend region’s only gynecological oncologist, is now using the da Vinci™ robotic system at Tallahassee Memorial Hospital for gynecological cancer surgery. For complex hysterectomies and other gynecologic procedures, robot assisted surgery with the da Vinci Surgical System may be the most effective, least invasive treatment option because the surgeon can operate with greater precision and control through tiny 1 to 2 centimeter incisions. For the patient, this increases the likelihood of a faster recovery. Other potential benefits include reduced trauma to the body, reduced blood loss and need for transfusions, less post-operative pain and discomfort, less risk of infection, and a shorter hospital stays. TMH was the first hospital in the Big Bend region to acquire the da Vinci robotic surgery system in 2005. It is also being used at THM for gynecologists Shawn Ramsey, DO (Doctor of Osteopathic Medicine), and Jana Bures-Forsthoefel, MD, of and for prostate cancer surgery by Urologists David Burday, MD, Daniell Rackley, MD, and Jean-Paul Tran, MD.


 * Andre -- Pros and cons of da Vinci robotic system:**

__Citation and Link -__ Journal Article Hubens, G., Coveliers, H., Balliu, L., Ruppert, M., Vaneerdeweg, W. //"A performance study comparing manual and robotically assisted laparoscopic surgery using the da Vinci system"//, 2003 Springer New York Medicine http://dx.doi.org/10.1007/s00464-002-9248-1 [|DaVinciSystemStudy.pdf]

__Direct Copy of Relevant Content:__

Robotically assisted endoscopic surgery has been introduced in cardiac surgery [1, 10, 11], but it is slowly finding its way into other surgical disciplines. Several reports show that it is feasible and safe in urology [9], gynecology [3, 4], and general surgery [2, 7]. Theoretically, many features of laparoscopic surgery make this technique very suitable for robotic technology. Robotic systems should especially improve the limited degrees of freedom with classic laparoscopic instruments and the poor ergonomics for the surgeon, which increase fatigue and pose a heavy burden on the surgeon during longer procedures. Some robotic systems have been evaluated in clinical and experimental settings, mainly for cardiac [10] and gynecologic procedures [4]. These studies made use of camera-holding robots (e.g., the AESOP system; Computer Motion, Goleta, California USA) or prototypes of the ZEUS robotic system (Computer Motion) with a 2D vision. Although procedures could be performed safely, no clear benefit was seen from the assistance of a robot system in either time or performance efficacy. Only two other studies have used an experimental setting to compare manual surgery with robotically assisted laparoscopic surgery in the performance of basic standardized tasks [5, 8]. Both studies made use of the Computer Motion Zeus Surgical Robot system (Computer Motion) with a 2D view only. In this study we evaluated the efficiency and the time needed for certain standardized tasks performed by manually assisted (classic) laparoscopic surgery and with the help of the Intuitive Surgical da Vinci robot system. Both the 3D and 2D view modes were used to evaluate specifically whether this depth perception facilitated the performance of the different exercises. To avoid any bias resulting from previous experience in any of the surgical techniques, only medical students who had no experience at all in open, minimally invasive, or robotically assisted surgery were selected to perform the different tasks. Although the Chamberlain model used for the exercises is used in demonstration programs of the da Vinci robotic system, the tasks performed were standard tasks encountered in any minimally invasive training program with an increasing level of difficulty, especially those designed for robotic surgery. In the first exercise, only one hand was needed to grab the ring and place it over a spike. From a free-hanging suture wire, three equally long pieces had to be cut using both hands against a blank background in exercise 2. In exercise 3, the subject pass a suture traditionally hand over hand while also passing it through four consecutive rings. Finally in exercise 4, a square knot had to be tied. From this experiment it is clear that inexperienced test persons perform standard exercises quicker and more precisely with the aid of the 3D da Vinci robot than by using manually assisted laparoscopic techniques. Especially for the more difficult exercises in this study, this difference was striking, adding to the hypothesis that robots can be especially useful for interventions in which subtle movements and optical magnifications are crucial. No clear time advantage was noted when standardized tasks were performed with the assistance of the Zeus robotic system using a 2D optical system in the two other published experimental studies. In fact, for the simplest exercise (bead dropping) in the study by Nio et al. [8], a significantly longer time was noted when the task was performed with the assistance of the robot. For the other tasks, no time difference was seen. Garcia-Ruiz et al. [5] noted statistically shorter operating times in favor of manually assisted laparoscopic suturing, but this time difference disappeared when smaller sutures (6-0 and 7-0) where used. However, as stated before, their results could be biased as a result of the important expertise in traditional laparoscopic surgery the participants in their study had already acquired. More important than being faster, our inexperienced students performed the different tasks with significantly fewer errors when assisted by the da Vinci robot in the 3D mode. Nio et al. [8] also found a difference in failures favoring the robotically assisted performance for most of their exercises, showing that whatever system is used, control of the instruments is facilitated by the robotic system. Interestingly, working with the aid of the da Vinci system in the 2D mode, the students still performed the tasks significantly more quickly and with fewer errors than when these tasks were performed in the traditional laparoscopic way. The more natural eye hand–surgical ﬁeld uplining, the magnification of the operative ﬁeld, and certainly the use of the articulated instruments of the da Vinci system seem to offer a distinct advantage for the performance of these standardized tasks, as compared with traditional laparoscopic surgery. When the performance of the students aided by the da Vinci system in the 3D mode was compared with that of the students assisted by robot in the 2D mode, time differences in favor of the 3D mode were seen in the more difficult exercises needing both hands for performance of the exercise, but no differences were noted in the accuracy by which the tasks were performed. When asked, however, the students, without exception, claimed to be more at ease with the 3D vision mode. The 3D view of the da Vinci system therefore seems to be more important for performing certain tasks more quickly and more easily, but in this experiment, it offered no additional benefit over the 2D mode in terms of efficacy in performance. The complete loss of tactile sensation often is quoted as one big disadvantage of working with robotic systems. However, in the relatively simple tasks of the current study, this was no cause of major concern. In the knot-tying exercise, no knot broke because of excessive force exerted by the robotic arms. The superior visibility compensated more than enough for the loss of tactile sensation. Nevertheless, from our clinical experience with robotically assisted bowel surgery, we observe that extreme care must be used to avoid involuntary tearing of the bowel wall. In conclusion, from this experimental study, it is clear that people without any surgical experience can learn to perform standardized tasks more easily and more accurately with the aid of the da Vinci robotic system, as compared with traditional manually assisted laparoscopic techniques. These robotic systems are likely to make complex minimally invasive procedures more accessible for more surgeons.


 * RAS Outline**

> >>>> >
 * Introduction
 * Is Robotic Assistance Useful in Surgical Procedures?
 * Background (Courtney Kallemeres section)
 * Robots and the use of robots in surgery
 * Traditional Surgical Procedures
 * Factors Involved in Robotic Assisted Surgery
 * Surgical Robots
 * Da Vinci Surgical System
 * History
 * Components of Da Vinci Surgical System
 * A surgeon console
 * A computerized control system
 * Two instrument “arms”
 * A camera
 * Operation of Da Vinci Surgical System
 * Application
 * Gynecology
 * Required Equipment
 * Procedures
 * Advantages
 * Disadvantages
 * Orthopilot (Krystal Section)
 * History
 * Operation of Orthopilot
 * Application
 * Total Knee Arthoplasty
 * Advantages
 * Disadvantages
 * Robotic Surgery Interview and Observation (Elsa Section)
 * Visit Tallahassee Memorial Hospital
 * Doctor Interview
 * Doctor’s opinion of Robotic Assisted Surgery(RAS)
 * Patient Interview
 * Patient’s apprehension concerning operation (RAS operation)
 * Pre-Interview of Operation
 * Post-Interview of Operation
 * Observe a robotic assisted surgery
 * Evaluation and Analysis
 * Benefits and Disadvantages of Robotic Assisted Surgery
 * Advantages of implementing RAS in other traditional surgeries
 * Solutions for Improving Future RAS
 * Index
 * Reference
 * Interesting Robotic Article:**


 * http://www.engadget.com/2010/10/21/first-all-robot-surgery-performed-at-mcgill-university/**

=Final RAS Paper=