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Health, Medicine, Nursing
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Robotic Surgery: The Need To Handle Complex Tasks In Dangerous And Unhealthy Environments (Research Paper Sample)


The assignment required the writer to compile a research paper on robotic surgery.

Robotic Surgery Name Institution Robotic Surgery The growth of robotic surgery was fuelled by the need to perform minimally invasive surgeries. The term telerobotic surgery originates from telepresence which a description of the sensation that a person is at two places at the same time (Soper et al., 2015). The need to handle complex tasks in dangerous and unhealthy environments fuelled robotics. In the 1940's, robotic arms were developed inspired by Robert Heilein’s scientific fiction novel. The mechanical glove assisted Waldo harness items by moving his arms and fingers. The arm was later improved by Raymond Goertz and used to handle radioactive material during research. However, significant progress in robotics and telepresence was achieved in 1982 owning to advancements in computing and electronics. In 1987, Dr. Philipe Mouret conducted the first minimally invasive laparoscopic cholecystectomy surgery using robotics. The emergence of charge coupled devices necessary for digital imaging made the surgery possible (Wall, Chandra and Krummel, 2013). Thereafter, application of technology into laparoscopic procedures continued to gain traction in the medical field. However, the technology was only applicable to simple procedures such as tissue removal and closure. Advances were made in developing staplers and other devices for tissue closure but still were relatively less sophisticated. Robotics was still underdeveloped at this level. The technology used was semi- autonomous and required the presence of surgeons for direction. Medics recognized the dire need to have autonomous robots conduct complex and computerized minimally invasive surgeries. In 1983, Arthrobot conducted the first documented robot aided surgery in Canada (Graur et al., 2016). The robot assisted in carrying orthopedic procedures. In later years, the Programmable Universal machine for Assembly (PUMA), and the Surgeon Assistant Robot for Prostatectomy (SARP) conducted a transurethral resection of the prostrate. Advancements in prostatectomy led to the development of prostrate robots, urology robots and a programmable urology device. In 1993, the Food and Drug Administration (FDA) of The USA approved the use of Automated Endoscopic System for Optimal Positioning (AESOP) for use in surgery. Developed by a research grant from The National Aeronautics and Space Administration (NASA), a surgeon operated AESOP was used to control camera movements during surgery (Spinoglio et al., 2016). In later advancements, a laparoscopic robotic arm was incorporated into AESOP. Initially, AESOP was operated using hand and foot controls, however, in later years, AESOP takes voice commands. Surgeons attach AESOP to the side of surgical tables and use it to hold any rigid laparoscopic devices. The year 2001 saw the introduction of ZEUS Robotic Surgical System (ZRSS). The development allowed surgeons remotely operate a robotic device docked to a patient. The voice controlled ZRSS holds a camera, and has two arms (Soper et al., 2015). The independent attachment of ZRSS on the surgery table allowed free movement and could hold several tele-manipulated instruments using joysticks. In the ZRSS, the computer monitored the 3-D positioning of the camera. Before this, the surgeon used handles to operate the laparoscopic devices. The advanced ZRSS used a computer to synchronize the movement of arms. More recent versions of the ZRSS make use of more ergonomic modules between the robots and the surgeon. As such, the ZRSS allows the surgeon comfortably sit in front of the monitor while the system articulates the surgical instruments. The computer reduces incidences of hand tremors thereby precisely scaling the surgeon’s hand movements (Taylor et al., 2016). The 3-D camera of ZRSS allows the surgeon observe operation on two separate screens as the surgeon voice operates the robotic arm. The two cameras focus on the operative field with each one broadcasting at a rate of thirty frames per second. The frames are then combined by a computer making the rate of broadcast per second at sixty. Broadcasting is interchanged between the left and right camera with a matrix in the monitor further alternating them between a clockwise and anticlockwise filter to match the images (Hussein et al., 2014). The surgeon wears 3-D glasses to view the monitor. The ZRSS performed a complete fallopian tube anastomosis laparoscopic procedure in 1998. Further, through telepresence, the ZRSS performed a robot aided cholecystectomy in France while the surgeon in charge was in New York in 2001. More recently, with developments in robotics, engineers have developed the Da Vinci Surgical System. The Da Vinci consists of a 3-D imaging system, a hands interface and robotic arms. The system provides the surgeon with an ergonomic seat where the surgeon can relax whist his hands placed in a console interface (Hoeckelmann et al., 2015). The main arm of the robot holds the camera, and surgical equipments. The arm then moves around freely at defined degrees allowing for a smooth articulation of instruments. The computer monitors the movement of the arms edge to allow for precision. Further, as the surgical instruments are reusable, the robot notes the number of times an instrument is reused and ceases to use it on reaching the reuse limit. Some shortcomings associated with the use of Single Incision Laparoscopic Surgery ended with the development of Da Vinci Single-Site platform in 2011. Such include the parallel positioning of surgical instruments which creates a conflict between the robots arms and the surgeon’s hands (Spinoglio et al., 2015). The Da Vinci Single Site Platform also solved poor triangulation resulting to limited surgical exposure. Good surgical exposure is essential as it facilitates fine and precise laparoscopic surgery management. The single site is made of silicone and thus flexible enabling insertion into a patient’s abdomen efficiently. Further, triangulation is easier as the target arrow accurately positions the port thereby achieving a clear surgical field. The Fire-Fly imaging system incorporated in the Da Vinci system emits laser lights in real time hence allowing for florescence-led surgery. Further, the development of the EndoWrist One device has allowed sealing of single use surgery equipments (Diana, 2015). The EndoWrist device also comes with a sealer that facilitates efficient closure of incisions. The Advanced Robotic Ultrasound Technology (ART) allows real time 3-D imaging using a portable digital video interface. Hence, a surgeon can view the operative field from two more perspectives. There are many differences between robotic surgery and laparoscopic surgery. Notably, robotic surgery has introduced hitherto unprecedented advancements. Such include telerobotic surgery, telepresence and telementoring. Telerobotic surgery refers to a surgeon’s ability to operate on patients from remote geographical areas (Graur et al., 2016). Through a camera platform, a telerobot operates surgical instruments on a surgeon’s instructions. The telerobot replicates a surgeon’s simulated hand movements using 3-D imaging to conduct complex laparoscopic operations while sited in a different location. Such was as in the case in the French operation of 2001. Telepresence on the other hand allows a surgeon operate on a patient while the images are projected on a virtual monitor. The surgeon simulates hand movements and the same are telecast to the robots arm for mimicking. As such, the surgeon operates on a patient without necessarily meeting them face to face (Wall, Chandra and Krummel, 2013). Telepresence was developed to facilitate surgeons to operate on injured soldiers at the battle field. As most soldiers die before reaching a medical service provider, telepresence was necessary to immediately treat soldiers without exposing surgeons to danger. In this case, wounded soldiers are placed in vehicles fitted with telepresence and telerobotic devices (Hussein et al., 2014). 3-D images of the soldier are then projected to the surgeon who then undertakes the operation. Telepresence technology is suitable for conducting surgery in remote areas as well as in situations where skilled labor is short in supply With telementoring, an experienced surgeon or instructor can instruct students while in a remote location by creating a virtual classroom. Thus, the surgeon can demonstrate and conduct an operation devoid of physical presence. Teleconferencing spurred the development of telementoring owing to its cost effectiveness (Truong et al., 2016). Some notable recorded telementoring cases are such as in 1997 when Rosser performed laparoscopic colectomies through telementoring to novice surgeons. Telementoring can be used across hospitals to improve services as well as across universities to share knowledge. Before the robotics technology, telepresence, telementoring and robotic surgery were not possible through the traditional laparoscopic methods. As such, surgeons had to travel long distances to perform surgeries, expert surgeons had to attend classes to physically demonstrate operations while the use of robots was impossible (Truong et al., 2016). In laparoscopic surgery, surgeons have to make large incisions for surgery. Surgeons in this scenario make smaller incisions on the body where they can insert cameras and small surgical tools. The surgeon then has to manually operate the devices while conducting the procedure. Laparoscopic surgery utilizes two dimensional images and equipments that limit the surgeon’s movement. In contrast, robotic surgery also makes use of small incisions to facilitate insertion of small surgical instruments and the camera. However, in this case, the surgeon does not manually manipulate the camera and instruments but instead uses a computerized console to achieve this (Soper et al., 2015). The computerized console relays high quality and magnified thre...
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