From Laparoscopy to Robotic and Digital Surgery

Current Urology Reports, 2003

With the advent of laparoscopic surgery, a method characterized by a surgeon’s lack of direct contact with the patient’s organs and tissue and the availability of magnified video images, it has become possible to incorporate computer and robotic technologies into surgical procedures. Computer technology has the ability to enhance, compress, and transmit video signals and other information over long distances. These technical advances have had a profound effect on surgical procedures and on the surgeons themselves because they are changing the way surgery is taught and learned. This article provides an overview of the most important advances and issues developing from the use of computer and robotic technologies in surgery.

Journal of Robotic Surgery, 2008

Laparoscopy has found a role in standard urologic practice, and with training programs continuing to increase emphasis on its use, the division between skill sets of established non-laparoscopic urologic practitioners and urology trainees continues to widen. At the other end of the spectrum, as technology progresses apace, advanced laparoscopists continue to question the role of surgical robotics in urologic practice, citing a lack of signiWcant advantage to this modality over conventional laparoscopy. We seek to compare two robotic systems (Zeus and DaVinci) versus conventional laparoscopy in surgical training modules in the drylab environment in the context of varying levels of surgical expertise. A total of 12 volunteers were recruited to the study: four staV, four postgraduate trainees, and four medical student interns. Each volunteer performed repeated time trials of standardized tasks consisting of suturing and knot tying using each of the three platforms: DaVinci, Zeus and conventional laparoscopy. Task times and numbers of errors were recorded for each task. Following each platform trial, a standardized subjective ten-point Likert score questionnaire was distributed to the volunteer regarding various operating parameters experienced including: visualization, Xuidity, eYcacy, precision, dexterity, tremor, tactile feedback, and coordination. Task translation from laparoscopy to Zeus robotics appeared to be diYcult as both suture times and knot-tying times increased in pairwise comparisons across skill levels.

2020

The evolution of robotic platforms has brought up ethical, economic, educational, and clinical applicability issues that refer to the early 1990s, when laparoscopy began its dissemination as a technology that would revolutionize surgery. Introduced in Brazil since 1990, laparoscopy has received a lot of resistance from different sectors, including the medical academy itself. The technique was considered expensive, complex, poorly available and with limited clinical applications. However, in a short time, it was established as the gold standard for the treatment of most diseases in different organ systems and surgical specialties. At this time, similarly to laparoscopy, robotic surgery is expressed as a disruptive technology, determining an important breakdown of paradigms, and moving the wheel of history forward. The author draws a parallel in relation to the use of both technologies in the surgeon's armamentarium. The fear of the "new technology", seen when laparoscop...

Current Opinion in Urology, 2001

In urology, at the end of the last millennium, there was an increasing use of computerized technology, extracorporeal shock wave lithotripsy, microwave therapy and high-energy focused ultrasound. However, experience with manipulating robots in urological surgery is still very limited. Laparoscopic surgery is handicapped by a reduction of the range of motion because of the fixed trocar position. The da Vinci system is the first surgical system to address all these problems adequately. The system consists of two main components: the surgeon's viewing and control console with three-dimensional imaging and the surgical arm unit that positions and manoeuvres detachable surgical instruments. The surgeon performs the procedure seated at the console holding specially designed instruments. Telerobotic laparoscopic radical prostatectomy provides advantages such as stereovision, dexterity and tremor filtering, but there is a learning curve with the device, mainly because of the magnification, the three-dimensional image and the lack of tactile feedback. However, after only a short period of time, the experienced surgeon is able to become familiar with the device. The impact of robotics in urological surgery is therefore very promising, and we are convinced that it will totally change the future of urological surgery. Curr Opin Urol 11:309±320. # 2001

2019

Laparoscopic surgery is minimally invasive, providing various benefits for patients. On the other hand, it is technically demanding for physicians due to limited dexterity of tools, limited vision. In order to cope with those limitations, recent various engineering technologies are trying to help surgeon. Robotics is one of the major technologies in this field. Until today, da Vinci has been only one such robot. But recently, many other robotic systems are under development. Those new robots are introduced in this chapter first. Other than robotics, or in conjunction with robotics, navigation technologies are getting popularity in clinical use. Navigation is a technology that provides useful information such as preoperative images or distance between tool and lesion, etc. to surgeon. Our experience in clinical use of navigation system in robotic surgery is introduced. Finally, technologies applied for the training of surgeon are introduced and described.

Journal of Endourology, 2003

Background: Minimally invasive surgery offers many advantages, but its correct practice is associated with a steep learning curve. Telesurgery allows a surgeon at a remote site to guide and teach surgeons at a primary site by utilizing robotic devices, telecommunications, and video technology, thereby reducing complications.

The International Journal of Medical Robotics and Computer Assisted Surgery, 2008

Background Computer-assisted surgery (CAS) systems are currently used in only a few surgical specialties: ear, nose and throat (ENT), neurosurgery and orthopaedics. Almost all of these systems have been developed as dedicated platforms and work on rigid anatomical structures. The development of augmented reality systems for intra-abdominal organs remains problematic because of the anatomical complexity of the human peritoneal cavity and especially because of the deformability of its organs. The aim of the present work was to develop and implement a highly modular platform (targeted for minimally invasive laparoscopic surgery) generally suitable for CAS, and to produce a prototype for demonstration of its potential clinical application and use in laparoscopic surgery.

Hellenic Journal of Surgery, 2010

Telesurgical systems have met with a great degree of acceptance in urology but indications are not yet that clear in the field of general surgery. The surgical robot overcomes certain limitations of conventional laparoscopy by offering three-dimensional, high definition vision, and seven degrees of freedom to the articulating instruments. Newer robots provide image integration, telestration and the dual-console capability for training purposes. According to our experiencs indications for robotic surgery are: the need for intracorporeal suturing, the expectant narrow surgical field, the expectant difficult dissection and/or adhesiolysis, especially in the upper abdomen, near the hiatus or very low in the pelvis. Although the use of robotic systems for simple laparoscopic cases is generally opposed on the basis of its increased operative time and cost, most teams accept that the beginning of the learning curve in robotic surgery must rely upon simple procedures such as cholecystectomies and Nissen fundoplications. Recent studies show more indications for robotic approach of cholecystectomies, such as in the setting of a reoperative, hostile abdomen following gangrenous cholecystitis, or in completion cholecystectomy. Robotic surgery constitutes a revolutionary stage in the evolution of surgery. Current systems aim to overcome certain limitations of laparoscopy. More advanced forms of robotic assistance are expected in the future, incorporating special software for intraoperational navigation and augmented reality guidance, help with the decision-making process, and smart "robotic-assistants" with artificial intelligence and autonomy. Integration of this technology will determine the definite role of robotics in the operating theater.

IEEE Transactions on Biomedical Engineering, 2013

State-of-the-art laparoscopes for minimally invasive abdominal surgery are encumbered by cabling for power, video, and light sources. Although these laparoscopes provide good image quality, they interfere with surgical instruments, occupy a trocar port, require an assistant in the operating room to control the scope, have a very limited field of view, and are expensive. MARVEL is a wireless Miniature Anchored Robotic Videoscope for Expedited Laparoscopy that addresses these limitations by providing an inexpensive in vivo wireless camera module (CM) that eliminates the surgical-tool bottleneck experienced by surgeons in current laparoscopic endoscopic single-site (LESS) procedures. The MARVEL system includes 1) multiple CMs that feature a wirelessly controlled pan/tilt camera platform, which enable a full hemisphere field of view inside the abdominal cavity, wirelessly adjustable focus, and a multiwavelength illumination control system; 2) a master control module that provides a near-zero latency video wireless communications link, independent wireless control for multiple MARVEL CMs, digital zoom; and 3) a wireless human-machine interface that gives the surgeon full control over CM functionality. The research reported in this paper is the first step in developing a suite of semiautonomous wirelessly controlled and networked robotic cyberphysical devices to enable a paradigm shift in minimally invasive surgery and other domains such as wireless body area networks. Index Terms-In vivo wireless networking, minimally invasive surgery (MIS), robotic videoscope. I. INTRODUCTION M INIMALLY invasive surgery (MIS) and particularly laparoscopic endoscopic single-site (LESS) procedures

Advanced Robotics, 2010

The Laparobot is a tele-operated robot designed specifically for training surgeons in advanced laparoscopic techniques. The Laparobot allows a student to practice surgery on a remotely located animal. The system uses standard laparoscopic tools for both the student's control interface and for performing the in vivo surgery, thereby providing a realistic training platform for non-robotic laparoscopic surgery. By allowing students to practice surgery remotely, animal models become more accessible and less expensive, and can replace learning on human patients. The Laparobot addresses problems inherent in designing a low-cost, tele-operated robot.