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by Joan Trombetti

This article originally appeared in the December 2008 issue of DOTmed Business News



It is no longer relegated to the pages of science fiction and doesn't have a name like R2-D2, but it is innovative and brings important and enabling technology to operating rooms around the world. Robotic surgery employs four to six arms and a 3D high-definition vision system allowing a surgeon to sit at a console and guide instruments smoothly and precisely in sensitive operations. Surgeons aren't using the apparatus just because they're fans of hi-tech gadgets. There's a practical side as well, robotic procedures readily lend themselves to minimally invasive surgery resulting in less trauma, reduced pain and morbidity, reduced hospital stay and quicker return to normal activity.

How robotic surgery evolved

Today's technique has transitioned as technology has improved. Starting with traditional open surgery, moving to laproscopic surgery, which in turn gave rise to the relatively new robotic surgery option. Since the 1990s, surgeons have favored the advantages of minimally invasive surgery, but did not enjoy some of its limitations including the unsteadiness of a video camera held by an assistant and its two-dimensional field of vision, as well as the awkward positions a surgeon had to maintain in order to maneuver the laproscopic instruments.

Therefore, there has been a growing appreciation for robotic surgery and the potential advantages it holds for surgeons. At this time, the field is relatively wide-open with only a handful of companies producing equipment used for the technique. One of the most widely used robotic devices is the da Vinci System - a self-powered, computer-controlled device programmed to aid in the positioning and manipulation of surgical instruments. It allows the surgeon to carry out more complex tasks but does not act independently. Instead it acts as a remote extension completely controlled by the surgeon. When the surgeon moves the control to the right, the robot's instruments move to the right, giving the surgeon natural hand-eye coordination. The patented Insite Vision System of da Vinci gives the surgeon a three-dimensional, 10x magnified view of the operating field, providing an excellent view of delicate tissue and organs.

Applications

Originally, applications for robotic surgery were applied to endoscopic coronary artery bypass and mitral valve repairs and replacements. Since the first robotic cardiac procedure performed in the United States in 1999, a growing number of surgical procedures using the robotic system have been performed including general surgical, gastrointestinal, gynecological, neurosurgical orthopedic, pediatric, radiosurgical and urologic.

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