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Robotic surgery

Robotic surgery. Atefeh Jannatbabaee Department of Biomedical Engineering Amirkabir University of Technology April 2008. Advantages 3D vision Tactile sensing Short instruments. Disadvantages More blood loss More pain Long recovery time Damage to the side tissues. Open Surgery :.

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Robotic surgery

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  1. Robotic surgery Atefeh Jannatbabaee Department of Biomedical Engineering Amirkabir University of Technology April 2008

  2. Advantages 3D vision Tactile sensing Short instruments Disadvantages More blood loss More pain Long recovery time Damage to the side tissues Open Surgery:

  3. Advantages: Less blood loss Less pain Shorter recovery time Less damage Disadvantages: 2D vision tactile feedback Long instruments Human cameraholder Long training course for staff Not efficient to all surgeries Endoscopic Surgery:

  4. Robotic features: • Doing routine tasks efficiently in shorter time • Doing jobs that human cannot do!

  5. History : • US military began a top secret project in order to use robo surgeons in the battlefields cause of the shortage of surgeons during wars • Dr Fred Moll established the Intuitive Surgical Inc. in 1995

  6. Common robotic systems on the market: AESOP ZEUS Da Vinci

  7. AESOP (Automated Endoscopic System for Optimal Positioning) • A robotic arm used as a camera holder; product of Computer Motion Inc. • AESOP1000 : 6DOF ,hand and foot switch control • AESOP2000:Voice controlled • AESOP3000: an additional joint asan elbow; 7 DOF • AESOP HR (HERMES READY):Voice control of AESOP, prepheral devices such as room light

  8. ZEUS: • Product of Computer Motion Inc. • First surgery in 1998 • FDA approval in 2001

  9. Components: • Surgeon_side : Console:

  10. Patient_side : 2 robotic arms for manipulation of instruments 1 camera arm

  11. Features: • 3D vision of Storz system Note: the surgeon wears special glasses • Tremor abolition • Motion scaling in the range of 2:1 & 10:1

  12. Da Vinci: • Product of Intuitive Surgical Inc. in 1997 • First Surgery by Himpens et al. in 1997 • FDA approval in July, 2000

  13. Features: • 7 DOF • Surgeon at a console • Stereoscopic vision • Tremor elimination • Motion scaling

  14. Components: • Robotic Cart • The Console • Endoscopic stack

  15. Robotic cart: • 2 meters high , 1 meter long and 1 meter wide • Approximately 544kg weight • Manual movement on wheels

  16. Robotic Cart • The Arms: • A central arm to hold camera • Two lateral arms to hold instruments • The arms are not sterile and are draped with sterile bags.

  17. Robotic cart • Camera system: • There are two cameras with 0 and 30 angles • The camera system has a dual lens system with two three-chip cameras • Projection of two images provides real 3D image in binocular viewer

  18. Robotic cart • Instruments: • They have an 8 mm diameter • Endo-wrist instruments • 6DOF of the tips and 1DOF within instrument activity • They can be resterilized up to 10 times

  19. The Console: • Binocular viewer of the Insite vision system: The 3D image is viewed by binocular viewer

  20. The Console • Instrument Controllers: • The surgeon put his thumb and forefinger in the loops of master controller • Approximate motion of fingers operate the instruments

  21. The Console • Foot Pedals: • Central pedal: adjusts the camera focus • Camera pedal : engages the camera arm & disengages instrument arms • Clutch pedal: disengages instrument arms • Third pedal: activates diathermy • Fourth pedal: usually inactive

  22. The console • Control Panels: • First panel :adjustments of camera, endoscope and motion scaling • Second panel: Start control system, emergency stop button & standby buttons.

  23. Endoscopic stack: • 2D monitor • CO2 insufflator • Light source • Camera unit

  24. Ergonomics: • Ergonomic chair • Ergonomic controller • Head rest

  25. Operation Room:

  26. Clinical Impact: • Robotic surgery used in: • Cardiothoracic surgery • Gastrointestinal surgery • urological surgery • Gynecological surgery • Areas of surgery have been improved: • Radical prostatectomy • Areas of surgery in which MIS became possible: • Coronary artery bypass grafting • Other thoracic procedures

  27. Good for: Precise tissue manipulation Improved visualization Magnification Tremor elimination Surgeon ergonomics Bad for: Large areas Tactile feedback Speed Team ergonomics

  28. Two important issues about Da Vinci: • Cumbersome at bedside • Resident teaching issues

  29. Barriers: • Size • Cost • Culture within the operating room • Ease of use

  30. The Future of Robotic Surgery: • Will make more difficult operations possible • Will allow more surgeons to perform advanced laparoscopic surgery • The systems will be smaller and much easier to use and have semiautonomous control

  31. Need of Robots in telemedicine: • Robots will be an integral part of health care delivery in wars, explorations or in far distant locations • Intelligent robots will reduce the need for a physician • Rapid delivery of care • Independent of distance or environment

  32. THE END

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