[Automation in surgery: a systematical approach]

Abstract

Surgical assistance systems permit a misalignment from the purely manual to an assisted activity of the surgeon (automation). Automation defines a system, that partly or totally fulfils function, those was carried out before totally or partly by the user. The organization of surgical assistance systems following application (planning, simulation, intraoperative navigation and visualization) or technical configuration of the system (manipulator, robot) is not suitable for a description of the interaction between user (surgeon) and the system. The available work has the goal of providing a classification for the degree of the automation of surgical interventions and describing by examples. The presented classification orients itself at pre-working from the Human-Factors-Sciences. As a condition for an automation of a surgical intervention applies that an assumption of a task, which was alone assigned so far to the surgeon takes place via the system. For both reference objects (humans and machine) the condition passively or actively comes into consideration. Besides can be classified according to which functions are taken over during a selected function division by humans and/or the surgical assistance system. Three functional areas were differentiated: "information acquisition and -analysis", "decision making and action planning" as well as "execution of the surgical action". From this results a classification of pre- and intraoperative surgical assist systems in six categories, which represent different automation degrees. The classification pattern is described and illustrated on the basis of surgical of examples.