Robotic surgery
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[[Image:Laproscopic Surgery Robot.jpg|thumb|Patient-side cart of the [[Da_Vinci_Surgical_System|da Vinci surgical system]].]]
'''Robotic surgery''' is the use of [[robot]]s in performing [[surgery]]. Three major advances aided by surgical robots have been [[remote surgery]], [[minimally invasive surgery]] and unmanned surgery. Major potential advantages of robotic surgery are precision and miniaturization. Further advantages are articulation beyond normal manipulation and three-dimensional magnification.
==History==
In '''1985''' a robot, the [[PUMA 560]], was used to place a needle for a brain biopsy using CT guidance. In 1988, the PROBOT, developed at [[Imperial College London]], was used to perform prostatic 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]].
The [[Da_Vinci_Surgical_System|da Vinci Surgical System]] comprises three components: a surgeon’s console, a patient-side robotic cart with 4 arms manipulated by the surgeon (one to control the camera and three to manipulate instruments), and a high-definition 3D vision system. Articulating surgical instruments are mounted on the robotic arms which are introduced into the body through [[cannula]]s. The surgeon’s hand movements are scaled and filtered to eliminate hand tremor then translated into micro-movements of the proprietary instruments. The camera used in the system provides a true stereoscopic picture transmitted to a surgeon's console. The da Vinci System is [[Food and Drug Administration|FDA]] cleared for a variety of surgical procedures including surgery for prostate cancer, hysterectomy and mitral valve repair, and is used in more than 800 hospitals in the [[Americas]] and [[Europe]]. The da Vinci System was used in 48,000 procedures in 2006 and sells for about $1.2 million.{{Fact|date=March 2008}}
*In [[1997]] a reconnection of the fallopian tubes operation was performed successfully in Cleveland using ZEUS.<ref>[http://www.howstuffworks.com/framed.htm?parent=robotic-surgery.htm&url=http://www.hoise.com/vmw/99/articles/vmw/LV-VM-11-99-1.html VMW Monthly]</ref>
*In May [[1998]], Dr. Friedrich-Wilhelm Mohr using the ''Da Vinci surgical robot'' performed the first robotically assisted [[heart bypass]] at the [[Leipzig Heart Centre]] in [[Germany]].
*In October [[1999]] the world's first surgical robotics ''beating heart'' coronary artery bypass graft (CABG) was performed in Canada using the ZEUS surgical robot.<ref>[http://findarticles.com/p/articles/mi_m0EIN/is_1999_Oct_6/ai_56012592 BNET]</ref>
*In [[2001]], Prof. Marescaux used the ''Zeus'' robot to perform a [[cholecystectomy]] on a pig in [[Strasbourg]], [[France]] while in [[New York]].<ref>[http://ieeexplore.ieee.org/search/srchabstract.jsp?arnumber=1014815&isnumber=21842&punumber=7916&k2dockey=1014815@ieeecnfs&query=%28transatlantic%29+%3Cin%3E+metadata&pos=2 IEEE]</ref>
*The first unmanned robotic surgery took place in May 2006 in Italy.<ref>[http://www.dlmag.com/1653/robot-successfully-completes-unassisted-heart-surgery.html DLMAG]</ref>
==Applications==
===Cardiac surgery===
[[TECAB|Endoscopic coronary artery bypass]] (TECAB) surgery and [[mitral valve]] replacement have been performed. Totally closed chest, endoscopic mitral valve surgeries are being performed now with the robot.
Irfan mulic was the first person to have this done to him
===Gastrointestinal surgery===
Multiple types of procedures have been performed with either the ''Zeus'' or ''da Vinci robot'' systems, including [[bariatric surgery]].
===Gynecology===
Robotic surgery in gynecology is one of the fastest growing fields of robotic surgery. This includes the use of the da Vinci surgical system in benign gynecology and gynecologic oncology. Robotic surgery can be used to treat fibroids, abnormal periods, endometriosis, ovarian tumors, pelvic prolapse, and female cancers. Using the robotic system, gynecologists can perform hysterectomies, myomectomies, and lymph node biopsies. The need for large abdominal incisions is virtually eliminated.
===Neurosurgery===
Several systems for [[stereotactic surgery|stereotactic intervention]] are currently on the market. MD Robotic's [[NeuroArm]] is the world’s first MRI-compatible surgical robot.
===Orthopedics===
The ROBODOC system was released in 1992 by the Integrated Surgical Systems, Inc<ref>[http://www.robodoc.com/eng/index.html Integrated Surgical Systems<!-- Bot generated title -->]</ref>.
===Pediatrics===
Surgical robotics has been used in many types of pediatric surgical procedures including: [[tracheoesophageal fistula]] repair, [[cholecystectomy]], [[nissen fundoplication]], [[morgagni hernia]] repair, [[kasai portoenterostomy]], [[congenital diaphragmatic hernia]] repair, and others. On January 17, 2002, surgeons at [[Children's Hospital of Michigan]] in [[Detroit]] performed the nation's first advanced computer-assisted robot-enhanced surgical procedure at a children's hospital.
===Radiosurgery===
The [[CyberKnife]] Robotic [[Radiosurgery]] System uses image-guidance and computer controlled robotics to treat tumors throughout the body by delivering multiple beams of high-energy radiation to the tumor from virtually any direction.
===Urology===
The da Vinci robot is commonly used to remove the prostate gland for cancer, repair obstructed kidneys, repair bladder abnormalities and remove diseased kidneys. New minimally invasive robotic devices using steerable flexible needles are currently being developed<ref>[http://automation.berkeley.edu/projects/needlesteering UC Berkeley: Needle Steering]</ref><ref>[http://lcsr.jhu.edu/NeedleSteering Johns Hopkins University: Needle Steering]</ref> for use in [[prostate brachytherapy]].
==Limitations==
Current equipment is expensive to obtain, maintain and operate. If one of the older model non-autonomous robots is being used, surgeons and staff need special training. Data collection of procedures and their outcomes remains limited. Data are emerging to suggest that [http://prostatecancerinfolink.net/2008/07/08/satisfaction-and-regret-after-two-types-of-radical-prostatectomy/ robotic surgery can be associated with patient regret and dissatisfaction].
==Miniature robotics==
As scientists seek to improve the versatility and utility of robotics in surgery, some are attempting to miniaturize the robots. For example, the [[University of Nebraska Medical Center]] has led a multi-campus effort to provide collaborative research on mini-robotics among surgeons, engineers and computer scientists.<ref>[http://www.newscientist.com/article.ns?id=mg18925366.400 New Scientist Magazine, January 2006]</ref> Scientists at [[Hebrew University]] have also developed a miniature robot to navigate through the bloodstream. {{Fact|date=March 2008}}
==See also==
* [[Telemedicine]]
* [[NeuroArm]]
* [[CyberKnife]]
* [[Da Vinci Surgical System]]
* [[Remote Magnetic Navigation]]
* [[Zeus Surgical System]]
* [[Robot-assisted heart surgery]]
==References==
{{reflist}}
==Sources==
* Monkman. G.J., S. Hesse, R. Steinmann & H. Schunk – Robot Grippers - Wiley, Berlin 2007.
* Füchtmeier. B., S. Egersdoerfer, R. Mai, R. Hente, D. Dragoi, G.J. Monkman & M. Nerlich - Reduction of femoral shaft fractures in vitro by a new developed reduction robot system "RepoRobo" - Injury - 35 ppSA113-119, Elsevier 2004.
* [[Daniel Ichbiah]]. ''Robots : From Science Fiction to Technological Revolution''.
* Dharia SP, Falcone T. Robotics in reproductive medicine. Fertil Steril 84:1-11,2005.
* Pott PP, Scharf H-P, Schwarz MLR, Today’s State of the Art of surgical Robotics, Journal of Computer Aided Surgery, 10,2, 101-132, 2005.
*Lorincz A, Langenburg S, Klein MD. Robotics and the pediatric surgeon. Curr Opin Pediatr. 2003 Jun;15(3):262-6.
==External links==
* [http://www.intuitivesurgical.com/products/robotic/index.aspx The Development of Robotic-Assisted Surgery]
* [http://www.mira2008.com/uff/default.htm Minimally Invasive Robotic Association website]
* [http://www.intuitivesurgical.com/products/davinci_surgicalsystem/index.aspx da Vinci Surgical System]
* [http://www.robodoc.com/home.html ROBODOC]
* [http://www.prosurgics.com/prosurgics_pathfinder.htm PathFinder neurosurgical robot]
* [http://news.nationalgeographic.com/news/2001/09/0919_robotsurgery.html National Georgaphic, September Article about remote surgery]
* [http://www.indianjurol.com/showBackIssue.asp?issn=0970-1591;year=2005;volume=21;issue=2;month=July-December Robotics in Urology]
* [http://www.haivision.com/downloads/CSCmas.pdf High Performance Network Video in support of Remote Surgery]
* [http://www.cisst.org/ NSF Engineering Research Center for Computer-Integrated Surgical Systems and Technology] -- [[Johns Hopkins University]], [[Carnegie Mellon University]], [[Massachusetts Institute of Technology]]
* [http://english.pravda.ru/news/science/10-06-2006/81824-robots-0 Robotic doctor with sense of touch]
* [http://www.mechatronics.org REPOROBO project]
* [http://www.usatoday.com/tech/news/robotics/2007-04-17-robot-brain-surgeon_N.htm Canadian robot does better brain surgery], USA Today, April 17, 2007
* [http://www.ahfmr.ab.ca/publications/newsletter/Winter05/www.files/inside/neuroarm.htm neuroArm project] at [[University of Calgary]], [[Alberta, Canada]]
* [http://www.ucalgary.ca/oncampus/online/march-06/neuroarm.html Surgical Robot Out of This World]
* [http://www.sciencedaily.com/releases/2007/04/070417114732.htm World's First Image-guided Surgical Robot To Enhance Accuracy And Safety Of Brain Surgery at University of Calgary]
* [http://www.lhsc.on.ca/About_Us/LHSC/Media_Room/Media_Releases/1999/october6_2.htm World's First Closed-Chest Beating Heart Bypass]
* [http://www.nytimes.com/2008/02/12/business/12place.html?em&ex=1202965200&en=3e61f3904b0aa746&ei=5087%0A A Medical Robot Makes Headway], New York Times, February 12, 2008
* [http://electronics.howstuffworks.com/robotic-surgery.htm overview of how robotic surgery works (article from 2000)]
* [http://www.enotalone.com/article/8839.html overview of robotic surgery field]
* [http://www.davinciprostatectomy.com/davinci_prostatectomy/index.aspx animated video of robotic prostate surgery]
[[Category:Surgery]]
[[Category:Computer assisted surgery]]
[[Category:Surgical robots]]
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[[fr:Endoscopie chirurgicale]]
[[it:Chirurgia robotica]]
[[hu:Robotsebészet]]
[[ru:Роботизированная хирургия]]