Robotics in Surgical Techniques: Present and Future Trends

Robotics in Surgical Techniques: Present and Future Trends

Vassilia Costarides (National Technical University of Athens, Greece), Apollon Zygomalas (University of Patras, Greece & University Hospital of Patras, Greece), Kostas Giokas (National Technical University of Athens, Greece) and Dimitris Koutsouris (National Technical University of Athens, Greece)
DOI: 10.4018/978-1-5225-1724-5.ch005
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Healthcare robotic applications are a growing trend due to rapid demographic changes that affect healthcare systems, professionals and quality of life indicators, for the elderly, the injured and the disabled. Current technological advances in robotic systems offer an exciting field for medical research, as the interdisciplinary approach of robotics in healthcare and specifically in surgery is continuously gaining ground. This chapter features a review of current applications, from external large scale robotic devices to nanoscale swarm robots programmed to interact on a cellular level.
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In the delicate balance between minimally invasive surgery and high-cost state of the art technology, lies robot-assisted surgery, a field rapidly evolving in conjunction with other disciplines, such as micro and nano machines, wireless communications, bioengineering and information technology.

Minimally invasive procedures refer to techniques that target at limiting the incision site, so that wound healing times, pain and infection risk are controlled and minimized. It is widely used by interventional radiologists, employing imaging techniques and catheters, used as interventional instruments directed at the targeted vessel or organ, but also by general surgeons with laparoscopic procedures.

There are several techniques that surgeons use to perform minimally invasive surgery with the patient under general or local anesthesia, depending on the procedure. Usually, laparoscopic instruments either have a telescopic rod lens system that is connected to a camera, or the laparoscope is digital and the charged – couple device is placed at the end of it (Swanstrom, 2013).

The demand of robots in healthcare and specifically in surgery comes from the finite human capability to perform certain actions with adequate efficiency. As described above, latest trends in healthcare align towards automatization, robot – assisted surgery and minimization and therefore efficiency must be maximized along with patient safety, security and sensitivity. The manipulation of robotic instruments via a console, directly or indirectly that translate the surgeon movements to precision actions, was first introduced in 1983 with the Arthrobot (Paul, 1992), a bone mountable hip arthroplasty surgery robot and in 1985 the PUMA 560 (Piltan, 2012) was introduced, for a needle brain biopsy, under CT guidance. In 1988 it was used to perform a transurethral resection and a year earlier for the first laparoscopic cholecystectomy. In 1992 the Robodoc was introduced to mill out precise fittings in the femur for hip replacement (Schulz, 2007).

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