M. Kumari
A surgical robot is a robot that allows
surgeons greater access to areas under operation using more precise and less
invasive methods. They are in most telemanipulators, which use the surgeon's
actions on one side to control the "effector" on the other side.
Basically they are computer-assisted
surgery. Robotically-assisted
surgery was developed to overcome the limitations of pre-existing minimally-invasive
surgical procedures and to enhance the capabilities of surgeons performing
open surgery. The first robot to assist in surgery was the Arthrobot, which was developed
and used for the first time in Vancouver in 1983. Intimately
involved were biomedical
engineer, Dr. James
McEwen, Geof Auchinleck, a UBC engineering
physics grad, and Dr. Brian Day as well as a team of engineering students.
The robot was used in an orthopaedic surgical procedure on 12 March 1984, at the UBC Hospital in Vancouver. Over 60 arthroscopic surgical procedures were performed in the
first 12 months, and a 1985 National
Geographic video on industrial robots, The
Robotics Revolution, featured the device. Other related robotic devices
developed at the same time included a surgical scrub nurse robot, which handed operative instruments on
voice command, and a medical laboratory robotic arm.
In 1985 a robot, the Unimation Puma
200, was used to place a needle for a brain biopsy using CT
guidance.[45] In 1992, the PROBOT, developed at Imperial College London, was used to perform prostatic surgery by Dr.
Senthil Nathan at Guy's and St Thomas' Hospital, London. This was the first
pure robotic surgery in the world. Also the Robot Puma 560, a robot developed
in 1985 by Kwoh et al. Puma 560 was used to perform neurosurgical biopsies with
greater precision. Just like with any other technological innovation, this
system led to the development of new and improved surgical robot called PROBOT.
The PROBOT was specifically designed for transurethral resection of the
prostate. Meanwhile, when PROBOT was being developed, ROBODOC, a robotic system
designed to assist hip replacement surgeries was the first surgical robot that
was approved by the FDA.[46] The ROBODOC from Integrated Surgical Systems
(working closely with IBM) was introduced in 1992 to mill out precise
fittings in the femur for hip replacement. The purpose of the
ROBODOC was to replace the previous method of carving out a femur for an
implant, the use of a mallet and broach/rasp.Further development of robotic
systems was carried out by SRI
International and Intuitive Surgical with the introduction of the da Vinci Surgical System and Computer
Motion with the AESOP and the ZEUS robotic surgical system. The first robotic surgery took place atThe Ohio State University
Medical Center in Columbus,
Ohio under the
direction of Robert
E. Michler. Examples of using ZEUS include a
fallopian tube reconnection in July 1998, a beating heart coronary artery bypass graft in
October 1999,[51] and the Lindbergh Operation, which was a cholecystectomy performed
remotely in September 2001.The original telesurgery robotic system that the da
Vinci was based on was developed at SRI International in Menlo Park with grant
support from DARPA and NASA.[53] Although the telesurgical robot was
originally intended to facilitate remotely performed surgery in battlefield and
other remote environments, it turned out to be more useful for minimally
invasive on-site surgery. The patents for the early prototype were sold to
Intuitive Surgical in Mountain View, California. The da Vinci senses the
surgeon's hand movements and translates them electronically into scaled-down
micro-movements to manipulate the tiny proprietary instruments. It also detects
and filters out any tremors in the surgeon's hand movements, so that they are
not duplicated robotically. The camera used in the system provides a true
stereoscopic picture transmitted to a surgeon's console. Examples of using the
da Vinci system include the first robotically assisted heart
bypass (performed
in Germany) in May 1998, and the first performed in the United States in
September 1999;and the first all-robotic-assisted kidney
transplant, performed in January
2009.[54] The da Vinci Si was released in April 2009,
and initially sold for $1.75 million. In May 2006 the first artificial intelligence doctor-conducted unassisted robotic surgery
on a 34-year-old male to correct heart arythmia. The results were rated as better than an
above-average human surgeon. The machine had a database of 10,000 similar operations, and so, in the
words of its designers, was "more than qualified to operate on any
patient". In August
2007, Dr. Sijo Parekattil of the Robotics Institute and Center for Urology
(Winter Haven Hospital and University of Florida) performed the first robotic
assisted microsurgery procedure denervation of the spermatic cord for chronic
testicular pain. In February 2008, Dr. Mohan S. Gundeti of theUniversity of
Chicago Comer Children's Hospital performed the first robotic pediatric neurogenic bladder
reconstruction. On 12 May
2008, the first image-guided MR-compatible robotic neurosurgical procedure was
performed at University of Calgary by Dr. Garnette Sutherland using the NeuroArm.
In June
2008, the German Aerospace Centre (DLR) presented a robotic system for
minimally invasive surgery, the MiroSurge. In
September 2010, the Eindhoven University of
Technology announced the development of the Sofie surgical system, the first surgical
robot to employ force
feedback.[62] In September 2010, the first robotic
operation at thefemoral vasculature was performed at the University Medical Centre
Ljubljana by a team led by Borut Geršak.
Even various reports and inventions revealed
that there are sound development was noticed in Surgical Robot although need
much work in Neurosurgery. Several systems for stereotactic
intervention are
currently on the market for Neurogergery. The NeuroMate was the first
neurosurgical robot, commercially available in 1997. Originally developed in Grenoble by
Alim-Louis_Benabid's team, it is now owned by Renishaw.
With installations in the United States, Europe and Japan, the system has been
used in 8000 stereotactic brain surgeries by 2009. IMRIS Inc.'s
SYMBIS(TM) Surgical System will
be the version of NeuroArm,
the world's first MRI-compatible surgical robot, developed for world-wide
commercialization. Medtech's Rosa is being used by several institutions,
including the Cleveland Clinic in the U.S, and in Canada at Sherbrooke
University and the Montreal
Neurological Institute and Hospital in Montreal (MNI/H).
Between June 2011 and September 2012, over 150 neurosurgical procedures at the
MNI/H have been completed robotized stereotaxy, including in the placement of
depth electrodes in the treatment of epilepsy, selective resections, and
stereotaxic biopsies.
All these instruments and techniques are not enough
in the line of Neurosurgery. I think; we need sound software with proper
mechanical devices for the surgery and working function of neurons.
Applications should be designed for wide spectrum which has ability to
understand the automatic nano mechanisms. It should be cost effective for all
the levels of community of all continents.
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