Remote Surgery - Term Paper Example

? Remote Surgery Introduction Similarly with computers’ revolution, the last half of the 20th century marked massive change in the field of robotics and as we speak, they are making such great impact in advancement of technology and development especially in the 21st century. So far we have witnessed robots carry out critical tasks such as manufacturing of automobiles and other consumer services and goods by speeding and streaming up the design and assembly process. Amazing we have even robots functioning as robots pets and lawn mowers. Additionally robots have been utilized to reach destinations that man has not yet landed, such as depths of the sea and other planets and heavenly bodies (Borzellino 120). With this growing trend, there is no telling what is next. For instance in the coming years, we might witness robots bearing the ability to exercise Artificial Intelligence (AI). As a matter of fact, some as Honda’s ASIMO shall be able to assemble and resemble the human form. It is of no shock that they might finally become conscious and self-aware and most probably function as any man would do. Essentially when we speak about robots taking the roles of human, we usually point to the future, however remote surgery is already with us and it is happening. Doctors around the globe are utilizing advanced robots to do surgical procedures. In a nutshell remote surgery also referred to as telesurgery can be defined as the ability for doctors to carry out surgery even when they are physically absent from the same location. It takes a model of telepresence. Remote surgery merges components of robotics, sophisticated communication technology for example high speed connection to data and elements of Management Information Systems (MIS) (Dasguta 56). Given that the area of robotic surgery is fairly established in many parts, majority of these robots are operated by doctors at the same venue of the surgery. But basically remote surgery is sophisticated telecommunication for surgeons, and whereby the distance physically between the patient and the surgeon is immaterial. It is a great promise to get the expertise of surgery specialists to have the means to reach out to patients without distance limitation, and without the essence for patients to go beyond their respective hospital. Basically not all surgery robots are of equality. There are various types of robotic surgery namely: telesurgical system, supervisory-controlled systems, and shared-control system. The core variance between each of the above is significantly how the surgeon shall be when carrying out this vital procedure (Yogesan 212). On one side of the spectrum, robots achieve surgical techniques without direct involvement of a surgeon. On the other end, surgeons carry out surgery with the involvement of a robot, however given that the doctor does most of the job. Advantages of Robotic Surgery This innovation is generating positive response from the consumers and thus more and more hospitals are buying and investing into this technology. These system promises huge potential to increase the effectiveness and safety of surgeries. Most likely in today’s operating rooms you will find several surgeons, several nurses and an anesthesociologist all performing specific roles in the process. Most surgeries will need nearly ten people in the operation room. And with the automation logic coming to play, surgical robots are slowly but steady eliminating the need for some staff in the operation room. If we could projection in the future, surgery will surely need only one surgeon, one or two nurses and an anesthesiologist. In this almost empty room, the surgeon sits at a computer system, either out or inside the operating room, utilizing the surgical robot to achieve what it took many people to be done(Dasguta 156). The utilization of a computer system to carry out operations from far distance gives way to the idea of telesurgery, which shall include a doctor performing vulnerable surgery distance away from the patient. In cases where the doctor doesn’t have to perform the surgery and can keep on check the robot arms from his or her computer station just as if the doctor was standing next to the patient. For instance if it was possible to use computer stations to move the robotic arms in real-time, then it could be possible for a doctor in California for example to carry out an operation exercise in New York (Borzellino 150). A key hurdle in telesurgery has and still is latency. Latency is defined as the time delayed between moving her or his hands and the robotic arms response to the movements. Currently for instant reaction to occur the doctor ought to be in the room with the patient. Giving doctors the opportunity to carry out operation on a patient over long distance and enabling the possibility of having fewer staff in the operation room shall cut down the expenses of maintaining health care and thus also boosting the quality of health care services. Also to add to the cost efficiency, remote surgery has various other benefits over the conventional surgery that includes advanced precision and decreased trauma to the patient. For example, conventional surgery heart bypass needs that the patient’s chest part of the body to be “cracked” open by incision of about 1-foot. However, with the modern approach such as da vinci system, the surgeons are able to operate on the heart by cutting three or four small slit in the chest, each expanding for about 1 centimeter length. As a result the doctor shall make these minute incisions instead of one long one down the area around the chest, hence forth the patient shall go through less trauma, pain and bleeding and that means faster healing and recovery. Another advantage is robotic assistants can also reduce the fatigue that surgeons during the surgeries that takes long duration of time. Doctor can become tired and exhausted over the long surgeries, and can even suffer hand tremors as a consequence. Comparatively even the steadiest of human hands cannot beat those of a surgical robot. From the design and production engineers program robotic surgery to recompense for tremors, hence if the surgeon’s handshakes the computer disregard it and keeps the mechanical arm stable. Fig 1. A typical operation room Supervisory-controlled Robotic Surgery System Of the three kinds of robotic surgery, the most automated are the supervisory-controlled systems. However, this does not mean these robots can execute surgery without any human control. The fact remains that surgeons ought to expansive preparation work with the patients before even using the robot to do the operation. This is because supervisory-controlled systems trail a particular set of directions when performing a surgery. Thereby the human effort is still critical as they is need for data input data into the robot system and this can only be done via human effort. Essentially this initiates a string of controlled completes and motions the surgery. Although they say man is to error, there is no provision for error as the robots cannot adjust accordingly in real time if anything goes wrong. Surgeons need to be vigilant over the robot’s response and be in readiness to intervene if it happens something goes amiss contrary to the initial plan (Kumar 200). One of the motivations why surgeons opt to use this kind of a system is because they are precise, and subsequently this means decreased trauma and shorter recovery duration for the patient. This robot is recurrently used in procedures such as knee and hip. In this procedure the job of the robot is to drill the bone part so that an implant fits comfy into the new joint. It is not possible to have a standard plan for the robot to follow; this is because there are no two people having the same body structure (Borzellino 220). This has the implication that surgeons ought to map the patient’s body very carefully so that the robot can move in the correct direction. This is rightly achieved by following a three step process namely registration, planning and navigation. In the initial stage which is planning, the doctor captures the image of the patient body with sole purpose to determine the most appropriate surgical approach. The commonly used methods for imaging include magnetic resonance imaging (MRI), Computer Tomography (CT), X-ray and Fluoroscopy scans. For some instances, the surgeons are forced to place pins through the bones of the patient to function as markers for the computer. After the surgeon has done the imaging, he or she ought to decide the surgical pathway the robot shall undertake. It is the responsibility of the doctor to tell the robot what the surgical pathway to follow. The robot does not have the ability to make such a decision. The robot shall only be able to function well if it is programmed well by the doctor. The step that follows is registration. In this part, the doctor searches the point on the body of the patient that match to the images made during the precious phase. The surgeon must match points exactly so that the robot can finish the surgery without a fault. The last but not the least phase is navigation. This stage entails the actual surgery. The surgeon needs to first set the robot and the patient in such a way that every movement the robot moves match with the information in its program. Once all this is done, the surgeon starts the robot, which performs the instructions. Fig 2: A surgeon demonstrates a robot surgery system The da Vinci Surgical System This is a product of the company called Intuitive Surgical, and apparently it is one of the most famous robotic apparatus in the surgery world today. It is classified under the telesurgical apparatus, having the implication of human directs the movement of the robot. In one way or the other, the devices making up the robot are very expensive as they are of high-tech nature. Generally the da vinci system comprises of the two basic components: the control and viewing console and the surgical arm that includes three to four arms, depending on the make (Borzellino 320). When using da Vinci system, the surgeon makes three or four slit depending on the number of arms of the make, but not larger than the size of the pencil in the patient abdomen, that permits the surgeon to insert three or four rods of stainless steel. One of the stainless steel rods has two endoscopic cameras that provide a stereoscopic image inside, and the other rod consists of surgical instrument that have the ability to suture and dissect the tissue. Contrary to the traditional surgery, the surgeon does not control these surgical apparatus directly. Fig 3: Types of instruments used by the da Vinci Surgical System Shared-control Robotic Surgery Systems In this kind of system the human does the bulk of the work, and of course with the aid of the robotic system. Contrary to the other robotic types the surgeon is entirely in control of the system and therefore must operate the instruments. On the other hand the robot monitors the performance of the surgeon and also provides support and stability through active constraint. An active constraint is an idea that tries to define region on a patient as one of the following; close, safe, forbidden and boundary. According to the surgeons safe parts are the key focus of a surgery. For example, the safe region in orthopedic surgery might be a particular part on the patient’s hip. It is also define that safe regions are not near the soft tissues. Of the three types of robot surgical system, the telesurgical method has yielded the most attention. While it is evident the great impact that the surgical robots are bringing forth compared to human being performance, we still have a long way to go given that the aim and objective is to realize autonomous robots that shall be able independently without human control. However, with the dynamic advancement in technology and development, the future looks brighter (Patel 300). The challenge now lies with the software developers, hardware manufacturer and the medical fraternity to work towards common goal of achieving this mission. As we speak the probability of witnessing scientists design and develop a robot that has the ability to locate abnormalities in the human anatomy, analyzing and operating to correct the defects without human intervention are pretty high. Fig 4: Shared-control Robotic Surgery System Conclusion In a nutshell remote surgery also referred to as telesurgery can be defined as the ability for doctors to carry out surgery even when they are physically absent from the same location. It takes a model of telepresence. Remote surgery merges components of robotics, sophisticated communication technology for example high speed connection to data and elements of Management Information Systems (MIS). So far we have witnessed robots carry out critical tasks such as manufacturing of automobiles and other consumer services and goods by speeding and streaming up the design and assembly process. Amazing we have even robots functioning as robots pets and lawn mowers. Additionally robots have been utilized to reach destinations that man has not yet landed, such as depths of the sea and other planets and heavenly bodies. With this growing trend, there is no telling what is next. This innovation is generating positive response from the consumers and thus more and more hospitals are buying and investing into this technology. These system promises huge potential to increase the effectiveness and safety of surgeries. The utilization of a computer system to carry out operations from far distance gives way to the idea of telesurgery, which shall include a doctor performing vulnerable surgery distance away from the patient. For instance if it was possible to use computer stations to move the robotic arms in real-time, then it could be possible for a doctor in California for example to carry out an operation exercise in New York. A key hurdle in telesurgery has and still is latency. Giving doctors the opportunity to carry out operation on a patient over long distance and enabling the possibility of having fewer staff in the operation room shall cut down the expenses of maintaining health care and thus also boosting the quality of health care services (Borzellino 20). Also to add to the cost efficiency, remote surgery has various other benefits over the conventional surgery that includes advanced precision and decreased trauma to the patient. Another advantage is robotic assistants can also reduce the fatigue that surgeons during the surgeries that takes long duration of time. Doctor can become tired and exhausted over the long surgeries, and can even suffer hand tremors as a consequence. Of the three kinds of robotic surgery, the most automated are the supervisory-controlled systems. However, this does not mean these robots can execute surgery without any human control. Thereby the human effort is still critical as they are in need of data input in the robot system and this can only be done via human effort. Essentially this initiates a string of controlled completes and motions the surgery. Although they say man is to error, there is no provision for error as the robots cannot adjust accordingly in real time if anything goes wrong. Da Vinci is a product of the company called Intuitive Surgical, and apparently it is one of the most famous robotic apparatus in the surgery world today. It is classified under the telesurgical apparatus, having the implication of human directs the movement of the robot. When using da Vinci system, the surgeon makes three or four slit depending on the number of arms of the make, but not larger than the size of the pencil in the patient abdomen, that permits the surgeon to insert three or four rods of stainless steel. Shared-control Robotic Surgery Systems are the kind of system the human does the bulk of the work, and of course with the aid of the robotic system. Contrary to the other robotic types the surgeon is entirely in control of the system and therefore must operate the instruments. On the other hand the robots monitor the performance of the surgeon and also provide support and stability through active constraint (Yogesan 12). An active constraint is an idea that tries to define region on a patient as one of the following; close, safe, forbidden and boundary. According to the surgeons safe parts are the key focus of a surgery. While it is evident the great impact that the surgical robots are bringing forth compared to human being performance, we still have a long way to go given that the aim and objective is to realize autonomous robots that shall be able independently without human control. The challenge now lies with the software developers, hardware manufacturer and the medical fraternity to work towards common goal of achieving this mission. Works Cited Borzellino, Giuseppe. Biliary Lithiasis: Basic Science. New Jersey, NJ: Prentice Hall, 2008. Print. Dasguta, Prokar. Urologic Surgery in Clinical Practise. New York, NY: Allyn and Bacon, 2010. Print. Patel, Vipul. Robotic Urologic Surgery. Oxford: Oxford University Press, 2009. Print. Kumar, Sajeesh. Telesurgery. New Jersey, NJ: Prentice Hall, 2008. Print. Yogesan, Kanagasingam. Telephthalmology. New York, NY: Allyn and Bacon, 2010. Print. Read More