Computer-assisted surgery, and robotically-assisted surgery are terms for technological developments that use robotic systems to aid in surgical procedures. Robotically-assisted surgery was developed to overcome the limitations of minimally-invasive surgery and to enhance the capabilities of surgeons performing open surgery.
In the case of robotically-assisted minimally-invasive surgery, instead of directly moving the instruments, the surgeon uses one of five methods to control the instruments; either a direct tele-manipulator or through computer control.
A tele-manipulator is a remote manipulator that allows the surgeon to perform the normal movements associated with the surgery whilst the robotic arms carry out those movements using end-effectors and manipulators to perform the actual surgery on the patient. In computer-controlled systems the surgeon uses a computer to control the robotic arms and its end-effectors, though these systems can also still use tele-manipulators for their input. One advantage of using the computerized method is that the surgeon does not have to be present, but can be anywhere in the world, leading to the possibility for remote surgery.
In the case of enhanced open surgery, autonomous instruments (in familiar configurations) replace traditional steel tools, performing certain actions (such as rib spreading) with much smoother, feedback-controlled motions than could be achieved by a human hand. The main object of such smart instruments is to reduce or eliminate the tissue trauma traditionally associated with open surgery without requiring more than a few minutes' training on the part of surgeons. This approach seeks to improve open surgeries, particularly cardio-thoracic, that have so far not benefited from minimally-invasive techniques.
Robotic surgery in the field of urology is becoming popular. It has been most extensively applied for excision of prostate cancer because of difficult anatomical access. It is also utilized for kidney cancer surgeries and to lesser extent surgeries of the bladder. New minimally invasive robotic devices include ultrasound probes for selective excisions of kidney tumors, steerable flexible needles for use in prostatebracho therapy. In 2000, the first robot-assisted laparoscopic radical prostatectomy was performed.
Surgeons at the University of Illinois at Chicago College of Medicine were the first to offer robotic kidney transplantation to morbidly obese patients- having BMIs (body mass indexes) over 50- and since then advancement in Robotic Surgery has reduced to fewer complications among this high-risk population (wound infections go from 15 percent in open surgery to 0 percent, length of hospitalization is reduced from 8.5 days to 5 days).
