Presentation Transcript

1. Concorde Career College, Department of Surgical Technology ST210

   Biomedical Sciences: Information Technology, Electricity Concepts, Robotics, & The Future of Surgery

2. Information Technology

3. Objectives Define the term computer List and describe the basic components of a computer system Understand basic word processing and the use of graphics
4. Objectives Access the internet to gather information Apply basic computer skills to the educational process and to surgical case management Demonstrate knowledge of terminology related to computer skills verbally and in the written form
5. Utilization of Computer Technology in the Operating Room Scheduling Send/Receive Orders Send/Receive Medical Records Update Pt. Chart Insurance Billing Update Surgeon’s Preference Card Manage and Print Instrument Count Sheets Order Supplies Complete Operative Record Laboratory Requisitions
6. Utilization of Computer Technology in the Operating Room Surgical patient scheduling software
7. Utilization of Computer Technology in the Operating Room Preference Card Applications As opposed to…
8. Utilization of Computer Technology in the Operating Room …Hand written Often illegible Difficult to find Easily lost Can be taken with the surgeon to another facility
9. Utilization of Computer Technology in the Central Sterile Department Order Supplies and Instruments Maintain Inventory Par Levels Save and Manage Sterilization Records Create Instrument Tray Menu Cards Interdepartmental Equipment Transfers Track Equipment Maintenance
10. Utilization of Computer Technology in the Operating Room Supply chain maintenance and ordering software
11. Robotics The use of robotics in the OR is gaining in popularity among many surgical specialties Integrates complex computer science and mechanics STs are often required to maintain, manage, sterilize, and manipulate this equipment Must understand basic computer concepts in order to successfully function in the robotics-integrated OR suite
12. Robotics
13. Computer Hardware
14. Computer Hardware Watch the following basic computer hardware tutorial: http://www.youtube.com/watch?v=-FnnGouYpQQ
15. Computer Software Programs that operate the computer system and its individual hardware components Operating systems Word processing Email Internet
16. Internet Basics Global network connected through millions of servers World Wide Web (www) is the most recent format for the Internet Photo and Article Access Each has address begins http://www. Not all Web addresses contain www Ending of address identifies what type organization publishes the information (.org, .gov, .edu, etc.)
17. Internet Basics Search Engine Popular Search Engines Google, Bing, Yahoo Uses keyword or phrases to search for subject Usually first 20 – 30 articles directly pertain to subject
18. Internet Basics Research for Homework and Projects Avoid using sites like Wikipedia that are not peer reviewed, professional data sources Prefer scholastic search engines to general search engines Google Scholar: http://scholar.google.com/ iSeek: http://education.iseek.com/iseek/home.page Library of Congress: http://www.loc.gov/index.html Google Books: http://books.google.com/ Science.gov: http://www.science.gov/
19. Activity AST Website & Discussion Board http://www.ast.org/ Visit the state assembly http://www.ast.org/state_assemblies/index.aspx

20. Electricity Concepts

21. Objectives Define the term electricity. Understand the basic principles of electricity. List and describe the types of electrical current.
22. Objectives List and describe the basic components of an electrical receptacle. Analyze the relationship between magnetism and electricity. Identify basic electrical equipment utilized in the surgical environment.
23. Objectives Apply knowledge of electricity to safe practice in the surgical environment. Demonstrate knowledge of terminology related to electricity verbally and in the written form.
24. Electricity – Uses in the OR Electrosurgery X-ray Endoscopes Lasers Robotics
25. Atoms, Electrons, and Matter Matter is anything that has mass and occupies space All matter consists of atoms Volume is the amount of space occupied by an object. Protons – Inside nucleus and positively charged Neutrons – Inside nucleus; neutral particles Electrons – Revolve around the nucleus; negatively charged particles Atoms are composed of small particles: Protons Neutrons Electrons
26. Electron Theory Electrons revolve around the nucleus in paths called shells or orbits Electrons that are located closer to the nucleus demonstrate a stronger attraction the nucleus; electrons moving in the outer orbits are less attracted. In certain atoms, if these outer electrons are exposed to light, heat, or electric energy, they will speed up and leave the atom
27. Electricity These outer electrons are known as free electrons The movement of free electrons creates electric current The term electricity describes the free electrons moving or flowing from the ring of one atom to another
28. Conductors Materials that allow the flow of free electrons Examples: silver, iron, saltwater, copper Copper is the commonly used because it’s the most economical Examples of OR devices that use copper: OR lights, power drills, ESU
29. Conductors Because water is a conductor of electricity, the amount of humidity in the air is important High humidity often results in static charge leakage Low humidity results in the formation of sparks Relative humidity in the OR is maintained between 20% and 60%
30. Insulators Materials that inhibit the flow of free electrons Insulators are simply poor conductors Conductors are wrapped in insulation to prevent leakage of electrons while the current flows to the device that will use it. Examples of insulators in the OR are the plastic and rubber casings that cover the ESU cords
31. Electrical Charge Can be either negative or positive. Like charges repel each other, unlike charges attract each other. 2 negative charges or 2 positive charges will repel each other. ***Opposites attract*** (magnets)
32. Electrical Current Electric current is movement of the electrical charge The electrical current travels through conductors by movement of the free electrons that migrate from atom to atom inside the conductor
33. Volts Electrical potential Voltage: The force or push that moves free electrons from one atom to another.
34. Resistance Restricting the flow of the current Measured in ohms Opposing or counteracting force
35. Power, Load , and Switch Power – the rate at which work is done (ex- battery) Power is measured in watts (W) Load – the device that uses the energy (ex- flashlight bulb) Switch – device that opens or closes a circuit and controls the flow of electricity (ex- between the battery and flashlight)
36. Hot Wire and Neutral Wire Hot Wire: supplies electrical current in a circuit TO a device. Neutral Wire: AKA ground wire, carries electrical current in a circuit AWAY from a device.
37. Wall Outlets Plugs used in surgery have 3 prongs. Components: First prong (positive) Second prong (negative) Third prong (ground) If electrical short occurs, the electrical current will flow through the grounded plug to reduce the risk of current passing through surgical team or patient. Must never be removed to fit in a 2 prong plug.
38. Direct and Alternating Current Direct (DC): electrical current that flows in one direction. Batteries Alternating (AC): electrical current that reverses direction periodically. A complete cycle moves in one direction and then reverses its course. Electrosurgery
39. Direct Current
40. Alternating Current
41. Electrosurgical Unit (ESU) Circuit Generator (power source) Active electrode (electrosurgical pencil) Delivers the electric current to the surgical site through the tissue, the energy is converted from electrical to thermal. Patient Dispersive electrode/inactive electrode (grounding pad) Electric current is channeled back to the generator via the grounding pad Placing the grounding pad p 112
42. Monopolar Most common Coagulation or cutting, or blend Large areas Grounding pad needed Bipolar Less frequent Only coagulation Delicate procedures Areas of moisture Grounding pad not needed Monopolar/Bipolar
43. Monopolar ESU
44. Accessories to Electrosurgery Harmonic scalpel Ultrasonic energy Cut and coagulate Surrounding tissue suffers less thermal damage (charring) A grounding pad is not necessary No electricity
45. Advantages of Electrosurgery Reduced blood loss Saves time Cutting current also burns tissue reducing the need to stop and control bleeding Cutting current seals small spaces in the tissue and lymphatic vessels
46. Dangers of ESU Electrical burns Patient and surgical team Resonant frequency (RF) capacitive coupling: AC travels from active electrode, across insulation and into skin. EX: surgeon clamps hemostat to bleeding vessel Dielectric Breakdown: occurs when high voltage breaks down insulating material (gloves) causing a hole and possibly burning the individual.
47. Laser Light Different from ordinary light Monochromatic Coherent Collimated Its color will decide how it will react with various tissues Red laser light is absorbed by red-pigmented tissue Photon: a particle of LASER light energy
48. Laser Fluence Spot size, watts, time Four interactions of laser with tissue Absorption, transmission. reflection, or scattering
49. Parts of a Laser System Energy pump (excitation source) responsible for delivering the energy to the laser head to produce laser light - can be from any energy form (media) Laser head – active medium that produces the laser energy. Lasers are named according to active medium. Mirrors are positioned at both ends of laser head. Laser energy is reflected off mirrors. Ancillary components – includes the console, cooling system and vacuum pump Control panel – controls for operating the system; includes wattage, duration, and mode Delivery system – transports the laser energy from the laser head to the tissue. Ex – articulated arm, fiber, fixed optical array
50. Parts of a Laser System
51. Lasers Carbon Dioxide Argon Nd:YAG Holmium: YAG **YAG=pulsed beam
52. CO2 Most frequently used Invisible beam Helium-neon laser beam is transmitted with the Co2 laser to aid in aiming (red color) Permits precise cutting and coagulating Absorbed by cellular water content (not dependent on tissue color or consistency) Not effective for use where the laser light needs to be transmitted through clear fluids. Delivered through an articulated arm w/ mirrors positioned at the articulations.
53. CO2 Laser Bronchoscopy Dermatologic Pigmented lesions Shallow Tumors GYN HPV BX for abnormal PAP
54. Argon Produces a blue or green light Plasma tube that contains argon $$$ Laser energy is converted to heat when absorbed, produces coagulation and vaporization. Can travel through clear fluids and tissues, absorbed in tissue by hemoglobin or melanin. Used in treatment for the eye
55. Argon Eyes Bleeding vessels
56. Nd: YAG Consists of crystal laced with neodymium. Invisible beam: requires helium-neon laser aiming beam Absorbed by darker tissue Can be transmitted through clear fluids. Used to vaporize bladder tumors Delivered through non contact or contract fiber delivery system.
57. Nd:YAG TURP Urethral Strictures Bladder Tumors Hysteroscopy Uterine polyps fibroids
58. Holium: YAG Discharges a pulsed beam Travels through flexible fiber Can be transmitted through clear fluids Used in arthroscopic procedures
59. Holmium: YAG LASIK Lithotripsy -Tripsy: crushing Lith/o:stone
60. Active Media Gas: Co2 , Helium Neon, Krypton, Argon and Excimer Solid: KTP and Nd:YAG. (Most power output)

61. Robotics

62. Robotic Surgery
63. Objectives Define the term robot. Provide a timeline of the events leading up to the use of robots in the surgical environment. List the advantages and disadvantages to the use of robots in the surgical environment.
64. Objectives Describe the principles of geometry that relate to robotics. Identify the basic components of the surgical robot and describe the function of each.
65. Objectives Describe the mechanisms by which the surgical robot operates. Apply knowledge of robotics to safe practice in the surgical environment. Demonstrate knowledge of terminology related to robotics verbally and in the written form.
66. Definition A robot is a machine designed to operate in a seemingly human way, with speed and precision. There are as many different types of robots as there are tasks for them to perform.
67. Definition Robotics is a branch of engineering that involves the conception, design, manufacture, and operation of robots. This field overlaps with electronics, computer science, artificial intelligence, mechatronics, nanotechnology, and bioengineering.
68. Why Robotic Surgery? Improve surgical patient care Overcome human limitations Reliable Complex
69. History First generation robots are simple machines capable of performing precise repetitive motions at high speeds.
70. History First Generation Robot No artificial intelligence (AI) Require constant oversight
71. History Second generation robots incorporate a level of artificial intelligence.
72. History Second Generation Robot Requires occasional monitoring AI (computer chip) Tactile sensors Auditory capabilities Visual abilities
73. History Third generation robots are autonomous.
74. History Third generation robot Mars Rover Spirit Works independently (without supervision) Controlled by a central computer
75. History Fourth generation robots are not yet developed.
76. History Fourth generation robot Predicted to have ability to: Learn Reproduce Evolve
77. Robotics Delta (Berlin, Germany) Robotic Surgical Microscope
78. Advantages Decreased hospital stay/reduced overall cost Reduced tremor Expert surgeon available even if not in geographic area Reduced risk of transfer of disease Disadvantages Initial cost of equipment is great Actual operating time may be increased especially during learning curve Technical difficulties Advantages Vs. Disadvantages
79. Geometry Study of figures in a space of a given number of dimensions and of a given type.
80. Cartesian Geometry René Descartes (1637) introduced the use of coordinates for describing plane curves, the axes were omitted, and only positive values of the x- and the y-coordinates were considered, since they were defined as distances between points. For an ellipse this meant that, instead of the full picture which we would plot nowadays, Descartes drew only the upper half.
81. Geometrical Terms Point Ray or plane X axis or plane (horizontal) Y axis or plane (vertical) Origin (intersection) Angle Z axis or plane (third dimension) Slope Curvilinear
82. Robotic Components Five Basic Components of the Surgical Robot Controller (Hermes) Arm (AESOP – voice controlled) Drive (Zeus – Motor) End Effector (Instruments) Sensor (AI) Socrates – Telecommunication system
83. Robotic Arm
84. End Effector
85. DA VINCI ROBOT SYSTEM
86. DA VINCI ROBOT SYSTEM
87. Coming Technologies NOTES Anesthesia Robots
88. NOTES Natural Orifice Transluminal Endoscopic Surgery
89. NOTES
90. Anesthesia Robots Closed-loop anesthesia systems McSleepy
91. Fully Robotic Surgery McSleepy meets DaVinci
92. What are your responsibilities? Surgical technologists will be responsible for: Setting up the robot Running the computer programs Operating equipment during the surgical procedure