I’ve only ever had on surgery in my life and it was minor; nothing to write home about. It took quite a while to completely recover but it may be because I’m not very good with pain. But I’ve also seen the aftermath of major surgery and it makes me feel like there must a better way and the person who sent this week’s question obviously feels the same way.<\/p>\n
The reality is, surgery for many years was quite barbaric. Doctors used to use the same knives that they used in the kitchen without washing them and the same saws that were used to cut wood were used to cut off limbs. We have of course come a long way since then. Doctors have learned how to cut with more precision and greater care. Tests before surgery can help map out the location of problems minimizing incisions and we know the benefits of having a sterile room to perform surgeries. And now, the medical field has taken another leap forward with the use of robots in the operating room.<\/p>\n
There are two major components to robotic surgery. The robot itself and the computer program that controls it. The amount of automation (or reliance on the computer program) varies based on the type of robotic surgery.<\/p>\n
Supervisory-controlled systems require the robot to be programmed before performing surgery. Since all patients are different, there can never be one program. Extensive planning on the part of the surgeon is crucial and the patient must go through a variety of tests (X-Rays, MRIs, PET-scans, etc) to develop the program that is unique to him\/her. There is no room for error as the computer is not able to stray from the program on it’s own. But, there is a fall back plan. The surgeon is able to intervene and take control of the robot if something goes wrong.<\/p>\n
The da Vinci surgical system is probably the most well known. It has three to four arms to hold various instruments. One arm always holds the camera. The others hold tools that are used during the surgery. The number of incisions made is equal to the number of arms the system has. Then, stainless-steel rods are inserted into the incisions by the robotic arm which holds the various instruments. On a computer screen, the surgeon can see 3-D images from the camera and using controls that look a lot like those of a video game, they are able to instruct the robot’s hands. The fields of gynecology and urology have been using the da Vinci system for many surgeries that could also be done laparoscopically (surgery that requires very small incisions and uses smaller versions of traditional tools).<\/p>\n
One down side is that using the da Vinci system costs about a third more than traditional surgeries. The additional cost is contributed to, among other things, the cost of the technology and the increase in surgery time. On the flip side, it will decrease the number of people needed to perform surgery, reduce the amount of time patients need to spend in the hospital and there is less care needed after the surgery. Whether this will offset the increased cost of the surgery is still up for debate. Some critics say that laparoscopic surgery is less expensive and nearly as minimally invasive. Also, robotics surgery has not reduced the number of people who suffer from complications (about five percent of people for both procedures).<\/p>\n
Those who developed the da Vinci system would say it is not meant to replace laparoscopic surgery but in some cases it is preferable. Some examples are, surgery on a woman who is morbidly obese, the removable of an exceptionally large uterus or if the surgeon needs to go deep into the pelvis.<\/p>\n
The last type of robotic surgery is called shared-control and there is one major difference from the other two methods. The robot is actually controlled directly by the surgeon not through a computer. The robot’s value here is providing active constraint. Before surgery begins, the doctors defines safe, close, boundary and forbidden areas on the patient. During the surgery, if the surgeon gets outside the safe zones, the robot will push back in various degrees depending on which area type it is approaching.<\/p>\n
It is hoped that researchers will soon be able to develop a single-point incision using robots. It will reduce scarring and decrease recovery time. These systems also reduces stress on the surgeon that can lead to mistakes in the operating room. Normally a surgeon would be on his feet for surgeries that last hours and he\/she can start to become fatigued and lose their ability to keep a steady hand. The robot takes away this danger.<\/p>\n
Traditional surgeries will still be important to teach young surgeons even if they are using robotic surgery on a daily basis. There maybe a case where a robot is not able to be used or may not be available.<\/p>\n
As robotic sugery becomes more commonplace, more surgeons will need to learn how to use the systems. New surgeons from the video game generation pick up this surgery method more quickly and easily than older surgeons for obvious reasons.<\/p>\n
Researchers are working every day to effectively utilize this technology. One exciting idea is the possibility of tele-medicine or long-distance operations. A surgeon who is extremely skilled at one type of surgery would no longer need to travel to the patient. Instead they could control the robot remotely. This saves time which could be the difference between life and death for the patient. Such surgery has already been successfully performed but there is a delay in the time commands reach the robot. This issue will solve itself as the Internet gets faster.<\/p>\n
All surgery comes with some degree of risk and it is so important that patients are informed and communicate with their doctor. Each patient should be evaluated individually and the method used should be decision between the patient and their doctor. But some day in the future, patients may just be having that conversation with a robot.<\/p>\n","protected":false},"excerpt":{"rendered":"
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