Robots are quickly becoming the main source of labor for many growing industries and medicine is no exception. Today we are familiar with robots that can aid surgeons in producing more flawless procedures with lesser margins of error with a higher chance of accuracy. Robots have the ability to perform, and aid in performing, anything from blood draws to major surgery on bodily organs. Robotic surgery has many benefits, including its enhanced accuracy compared to usual surgical procedures and precision that causes these procedures to be minimally invasive.
Robotic surgery has already become a successful option in cardiothoracic, urological, gynecological, neurological, and numerous general surgical procedures.
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The da Vinci system specifically helps produce minimally invasive procedures by having probes inserted into the patient through small incisions that the surgeon has already made. The probes then have small clamps at their ends which can operate the same as the usual surgical tools. One specific probe even has the ability to heat and seal off any parts of organs or blood vessels that may be bleeding, so that the flesh can be bound back together. The robotic surgery reduces the amount and size of incisions needed to do many procedures which ultimately leaves less healing needed for the patient along with a lot less scarring. The surgeon sits at their own console, performing the surgery via the robot with a 3D visual field of the surgical area seen through a camera that has also been inserted through one of the previous incisions. The da Vinci is widely used in gynecology and urology procedures. One that is common is the gastric bypass surgery, where the stomach is stapled to be a fraction of its usual size and the excess of the stomach is severed off by a heated probe to ensure no gastric leakage or bleeding in the abdominal cavity.
Intuitive Surgical, makers of the da Vinci robotic surgery system, have released upgrades in the number of operating arms, eliminating the need for one surgical assistant, which may expand its clinical applications. The da Vinci system is used primarily for cardiology, colorectal, general surgery, gynecology, head and neck procedures, thoracic and urological procedures. On the cardiac side, in the past doctors could only operate on the heart with open-heart surgery, however, with the evolution of the da Vinci system, it only requires surgeons to do small incisions so that they could insert the surgical equipment and camera for viewing. The use of the da Vinci system has not only improved results but it’s also saved time. When it comes to the colorectal side, in the past surgeons would have to make large incisions on the skin and in the muscle so they could see the area of work, however, for the new improvements, surgeons are only putting small incisions due to the use of the inserted cameras. Doctors are also now able to use special long-handled tools to perform surgery while viewing the magnified images on the patient cart. When it comes to general surgery, surgeons are now able to do minimally invasive procedures that only require very small incisions. There has been an increase in the da Vinci system in bariatric surgeries as well since surgeons can now use special long-handled tours to view the magnified images from the camera as patients can either choose sleeve gastrectomy or gastric bypass to produce weight loss. Like this, the da Vinci system has helped with the overall rehabilitation of the body, as it helps assure successful surgeries and speedy recoveries. The da Vinci system has 3 total components: surgeon console, patient cart, and the vision cat. The surgeon console allows the surgeon to sit side by side during the procedure to the console to control the instruments through a much higher magnifying lens. The patient cart is located on the side of the operating table which holds the camera that allows the surgeon to control the instrument and view the anatomy. Lastly, the vision cart ensures proper service and communication between the parts of the system and helps lay a base of the magnified vision.
Another surgical system is the Mako total knee replacement surgery robot. This robotic arm manufactured by the company Stryker helps plan and perform joint replacement surgeries, especially for those suffering from arthritis in any of their joints. This robot can cost around $1 million, while other companies like Navio, a Smith & Nephew’s product, can cost only half that price. Stryker specifically uses its own implants while the Navio is not strict on which implants can be inserted using this device. In addition, the Navio also does lack some features compared to the Mako. The Mako device provides a personalized surgical plan based on the patient’s unique anatomy. A CT scan of the joint that needs replacement is taken first and is then uploaded to the Mako System, where a 3D model of the joint is created. This 3D model is used to pre-plan and assist the surgeon in performing the joint replacement procedure.
Mako provides personalized surgical plans that result in more accuracy during the surgery and the pre-planning aspect of the device lets the surgeons stay within the appropriate boundaries of the operating field. A laboratory study showed that the robot demonstrated accurate placement of the implants within the patient, following their personalized plans, while also demonstrating soft tissue protection to the ligaments around the knee. Depending upon the severity of arthritis in the knee, a partial or total knee replacement may be offered to the patient by a surgeon, in which case the orthopedic surgeon will use the Mako robotic-arm to guide the machine to remove the diseased cartilage. A Mako robotic-arm assisted partial knee replacement is often for adults who have little to no progression of early to mid-stage osteoarthritis. Patients may have a bicompartmental, medial (inside), patellofemoral (top), or a lateral (outside) implant placed in their knee depending on where the arthritis is affecting the knee most. Late-stage osteoarthritis may require a total knee replacement, where a Triathlon total knee implant is put in, as opposed to a regular knee implant that allows less movement usually. Another operation that the Mako can perform is hip replacement surgery, which can be needed for those who suffer from degenerative joint diseases (DJD), such as osteoarthritis, post-traumatic arthritis, rheumatoid arthritis (RA), avascular necrosis (AVN) and hip dysplasia.
Robots have already come so far and soon a lot of the procedures will be done via robots it seems. The benefits of faster recovery times, more outpatient surgeries, few scarring, and incisions, are immense and will ultimately lead to more robotic surgery. It is also plausible that other things such as surgical prep work be done fully by robots to ensure sterility in the operating room. It is even possible that the surgeon’s console is taken farther away from the patient, to almost be in a separate room so that the patient is in a more sterile environment and reducing the risks of intraoperative infections. Advancements in surgical robots can also be made to give surgeons a more tactile feeling of doing the procedure on a patient physically. This would ensure that surgeons are maintaining their skills of having to do more invasive surgeries, while also providing the minimal scarring wanted by the patient. Another advantage of robots in healthcare, especially in surgery, is The da Vinci system, which allows patients to have specific advantages in many different types of procedures, as its purpose was to allow the surgeon a 360-degree view of the operative field by a camera while dime-sized surgical instruments are placed inside the patient through tiny incisions. These robots have made certain surgical procedures a lot easier and drastically reduced the stress involved.
One disadvantage of the use of robotics in healthcare is the idea of it being unethical. A fear that is common in healthcare is that the replacement with robotics could harmfully replace the care of a doctor or any healthcare professional, as humans have various emotions and various social skills which cannot be reciprocated by a robot. This type of ‘robotic care’ can especially be scary for elderly patients who tend to seek the comfort of human contact and conversation more than any other type of patient. Another disadvantage of the use of robotics in healthcare is the increase in costs. Due to recessions coming up, there could be an increase in the loss of jobs further impacting people with their financial situations. As the price of robots increases, many people may not be able to afford healthcare, let alone robotic procedures.
Another robot that is seen in healthcare is the Veebot, which was created back in 2010 by a team of engineers from Princeton and Stanford, as well as a Duke Medical physician. The Veebot is also known as a robotic phlebotomist as it makes drawing blood faster. The overall purpose of the Veebot is to speed up the process of drawing blood or inserting IVs, it occurs by the patient sliding their arm into an inflatable cuff the light from the Veebot as it shines the inner elbow or camera which searches for a vein that could be used to draw blood from. Then an ultrasound confirms the vein has a certain amount of blood flow. Lastly the robotic arm aligns itself with the chosen vein and inserts the needle. The overall process of the Veebot is shown to take about a minute and is correct about 83% of the times which is similar to a human phlebotomist.
Lastly, another robot that is seen in healthcare is the Xenex, which is a robot that is created to reduce HAIs (Health Associated Infections). Xenex was founded by two epidemiologists. Xenex was also first accepted to centers in 2008 and by 2010 Xenex prototype devices were being implemented in many hospitals as the results were life-changing. The Xenex use his pulse eggs on to quickly execute Germany cool ultraviolet light UV light drop patients rooms operating rooms equipment rooms emergency rooms etc. to help reduce the amount of germs which would help overall lower the number of cases seen with HAIs.
Some fun facts about robotics seen in healthcare is that by the end of 2020, surgical robotic sales are expected to almost double to 6.4 billion as does the increasing change of technology that we are currently seeing that can be implemented in robotics. As well as in 2017 minimally invasive surgery so kind of her approximately 86% of the total robotic surgeries performed in the United States, meaning not only have robotic surgeries been accepted to hospitals however it’s taking over 86% of the minimally invasive surgeries. As well as there has been a 70% drop in HAIs due to the Xenex robot which kills the germs in certain locations by shining ultraviolet light. The robotic device Mako has also recorded 76,900 knee and hip replacement procedures. As well as in 2000, when Intuitive Surgical received FDA approval for the da Vinci Surgical System, the company has been able to install bases of over 2,900 systems in the U.S. and over 4,500 worldwide.
The future of robotics in healthcare is anything from better sterility to Virtual reality. In the future there will be rehabilitation robots sent originally virtual reality which can assist people with physical therapy or assist people with basic skills with someone not actually being in front of them. Another thing in the future is fast recovery more outpatient surgery is less scarring and less incisions with the overall effect of robotics and the advancements that are seen in robotics. Along with faster recovery, there is a better sterility and 3-D visual fields for surgeons to get more access to the field and more magnified visions.
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