Robotic assisted minimally invasive surgery

Abstract

The term "robot" was coined by the Czech playright Karel Capek in 1921 in his play Rossom's Universal Robots. The word "robot" is from the check word robota which means forced labor. The era of robots in surgery commenced in 1994 when the first AESOP (voice controlled camera holder) prototype robot was used clinically in 1993 and then marketed as the first surgical robot ever in 1994 by the US FDA. Since then many robot prototypes like the Endoassist (Armstrong Healthcare Ltd., High Wycombe, Buck, UK), FIPS endoarm (Karlsruhe Research Center, Karlsruhe, Germany) have been developed to add to the functions of the robot and try and increase its utility. Integrated Surgical Systems (now Intuitive Surgery, Inc.) redesigned the SRI Green Telepresence Surgery system and created the daVinci Surgical System((R)) classified as a master-slave surgical system. It uses true 3-D visualization and EndoWrist((R)). It was approved by FDA in July 2000 for general laparoscopic surgery, in November 2002 for mitral valve repair surgery. The da Vinci robot is currently being used in various fields such as urology, general surgery, gynecology, cardio-thoracic, pediatric and ENT surgery. It provides several advantages to conventional laparoscopy such as 3D vision, motion scaling, intuitive movements, visual immersion and tremor filtration. The advent of robotics has increased the use of minimally invasive surgery among laparoscopically naïve surgeons and expanded the repertoire of experienced surgeons to include more advanced and complex reconstructions.

Keywords: Robotic surgery; da Vinci surgery.

Figure 1

da Vinci S-Type (Intuitive Surgicals Inc., Sunnyvale, CA)

Figure 2

Instruments

Figure 3

A. Endowrist instrument, B. Endowrist Instrument ergonomics

Figure 4

Surgeon console

Figure 5

Binocular viewer

Figure 6

Masters

Figure 7

Foot control

Figure 8

Endoscopic stack