Laparoscopic surgery - AbsoluteAstronomy.com

Laparoscopic surgery, also called minimally invasive surgery (MIS), bandaid surgery, or keyhole
Keyhole
A keyhole is where a key is inserted to open a lock. It is more properly known as a keyway.Keyhole has the following meanings:* Gravitational keyhole is a region of an orbit where a small gravitational input could cause a small body to collide with the large body it is orbiting.* Keyhole surgery is...

surgery, is a modern surgical

Surgery

Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

technique in which operations in the abdomen

Abdomen

In vertebrates such as mammals the abdomen constitutes the part of the body between the thorax and pelvis. The region enclosed by the abdomen is termed the abdominal cavity...

are performed through small incisions (usually 0.5–1.5 cm) as opposed to the larger incisions needed in laparotomy

Laparotomy

A laparotomy is a surgical procedure involving a large incision through the abdominal wall to gain access into the abdominal cavity. It is also known as coeliotomy.- Terminology :...

.

Keyhole surgery makes use of images displayed on TV monitors to magnify the surgical elements.

Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic surgery. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy

Endoscopy

Endoscopy means looking inside and typically refers to looking inside the body for medical reasons using an endoscope , an instrument used to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ...

.

There are a number of advantages to the patient with laparoscopic surgery versus an open procedure. These include reduced pain due to smaller incisions and hemorrhaging, and shorter recovery time.

The key element in laparoscopic surgery is the use of a laparoscope. There are two types: (1) a telescopic rod lens

Lens (optics)

A lens is an optical device with perfect or approximate axial symmetry which transmits and refracts light, converging or diverging the beam. A simple lens consists of a single optical element...

system, that is usually connected to a video camera

Video camera

A video camera is a camera used for electronic motion picture acquisition, initially developed by the television industry but now common in other applications as well. The earliest video cameras were those of John Logie Baird, based on the electromechanical Nipkow disk and used by the BBC in...

(single chip

Charge-coupled device

A charge-coupled device is a device for the movement of electrical charge, usually from within the device to an area where the charge can be manipulated, for example conversion into a digital value. This is achieved by "shifting" the signals between stages within the device one at a time...

or three chip), or (2) a digital laparoscope where the charge-coupled device

Charge-coupled device

is placed at the end of the laparoscope, eliminating the rod lens system. Also attached is a fiber optic cable system connected to a 'cold' light source (halogen

Halogen

The halogens or halogen elements are a series of nonmetal elements from Group 17 IUPAC Style of the periodic table, comprising fluorine , chlorine , bromine , iodine , and astatine...

or xenon

Xenon

Xenon is a chemical element with the symbol Xe and atomic number 54. The element name is pronounced or . A colorless, heavy, odorless noble gas, xenon occurs in the Earth's atmosphere in trace amounts...

), to illuminate the operative field, inserted through a 5 mm or 10 mm cannula

Cannula

A cannula or canula is a tube that can be inserted into the body, often for the delivery or removal of fluid or for the gathering of data...

or trocar

Trocar

A trocar is a medical instrument with a sharply pointed end, often three-sided, that is used inside a hollow cylinder to introduce this into blood vessels or body cavities...

to view the operative field. The abdomen

Abdomen

In vertebrates such as mammals the abdomen constitutes the part of the body between the thorax and pelvis. The region enclosed by the abdomen is termed the abdominal cavity...

is usually insufflated

Insufflation (medicine)

Insufflation is the practice of inhaling a substance. Insufflation has limited medical use, but is a common route of administration with many respiratory drugs used to treat conditions in the lungs and paranasal sinus .The technique is common for many recreational drugs and is also used for some...

, or essentially blown up like a balloon, with carbon dioxide

Carbon dioxide

Carbon dioxide is a naturally occurring chemical compound composed of two oxygen atoms covalently bonded to a single carbon atom...

gas. This elevates the abdominal wall above the internal organs like a dome to create a working and viewing space. CO₂ is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures.

History

It is difficult to credit one individual with the pioneering of the laparoscopic approach. In 1902, Georg Kelling

Georg Kelling

Georg Kelling was a German internist and surgeon who was born in Dresden. He studied medicine at the Universities of Leipzig and Berlin. He earned his medical doctorate in 1890, and later worked as a physician at the city hospital in Dresden.Kelling was a specialist concerning gastrointestinal...

, of Dresden, Saxony

Dresden

Dresden is the capital city of the Free State of Saxony in Germany. It is situated in a valley on the River Elbe, near the Czech border. The Dresden conurbation is part of the Saxon Triangle metropolitan area....

, performed the first laparoscopic procedure in dogs and in 1910, Hans Christian Jacobaeus

Hans Christian Jacobaeus

Hans Christian Jacobaeus was a Swedish internist born in Skarhult. In 1916 he became a professor at the Karolinska Institutet in Stockholm. From 1925 until his death in 1937, he was a member of the Nobel Prize Committee....

of Sweden reported the first laparoscopic operation in humans. In the ensuing several decades, numerous individuals refined and popularized the approach further for laparoscopy. The start of computer chip television camera was a seminal event in the field of laparoscopy. This technological innovation provided the means to project a magnified view of the operative field onto a monitor and, at the same time, freed both the operating surgeon's hands, thereby facilitating performance of complex laparoscopic procedures. Prior to its conception, laparoscopy was a surgical approach with very limited application, used mainly for purposes of diagnosis and performance of simple procedures in gynecologic applications.

The first publication on diagnostic laparoscopy by Raoul Palmer appeared in the early 1950s, followed by the publication of Frangenheim and Semm. Hans Lindermann and Kurt Semm practised CO2 hysteroscopy during the mid-1970s.

In 1972, Clarke invented, published, patented, presented, and recorded on film laparoscopic surgery, with instruments marketed by the Ven Instrument Company of Buffalo, New York, USA.

In 1975, Tarasconi, from the Department of Ob-Gyn of the University of Passo Fundo Medical School (Passo Fundo, RS, Brazil), started his experience with organ resection by laparoscopy (Salpingectomy), first reported in the Third AAGL Meeting, Hyatt Regency Atlanta, November 1976 and later published in The Journal of Reproductive Medicine in 1981.
This laparoscopic surgical procedure was the first laparoscopic organ resection reported in medical literature.

In 1981, Semm, from the Universitats Frauenklinik, Kiel, Germany, performed the first laparoscopic appendectomy. Following his lecture on laparoscopic appendectomy, the president of the German Surgical Society wrote to the Board of Directors of the German Gynecological Society suggesting suspension of Semm from medical practice. Subsequently, Semm submitted a paper on laparoscopic appendectomy to the American Journal of Obstetrics and Gynecology, at first rejected as unacceptable for publication on the grounds that the technique reported on was 'unethical,' but finally published in the journal Endoscopy.
The abstract of his paper on endoscopic appendectomy can be found at here.
Semm established several standard procedures that were regularly performed, such as ovarian cyst enucleation, myomectomy, treatment of ectopic pregnancy and finally laparoscopic-assisted vaginal hysterectomy (nowadays termed as cervical intra-fascial Semm hysterectomy). He also developed a medical instrument company Wisap in Munich, Germany, which still produces various endoscopic instruments of high quality. In 1985, he constructed the pelvi-trainer = laparo-trainer, a practical surgical model whereby colleagues could practice laparoscopic techniques. Semm published over 1000 papers in various journals.[4] He also produced over 30 endoscopic films and more than 20,000 colored slides to teach and inform interested colleagues about his technique. His first atlas, More Details on Pelviscopy and Hysteroscopy was published in 1976, a slide atlas on pelviscopy, hysteroscopy, and fetoscopy in 1979, and his books on gynecological endoscopic surgery in German, English, and many other languages in 1984, 1987, and 2002.

Prior to 1990, the only specialty performing laparoscopy on a widespread basis was gynecology, mostly for relatively short, simple procedures such as a diagnostic laparoscopy or tubal ligation. The introduction in 1990 of a laparoscopic clip applier with twenty automatically advancing clips (rather than a single load clip applier that would have to be taken out, reloaded and reintroduced for each clip application) made general surgeons more comfortable with making the leap to laparoscopic cholecystectomies (gall bladder removal). On the other hand, some surgeons continue to use the single clip appliers as they save as much as $200 per case for the patient, detract nothing from the quality of the clip ligation, and add only seconds to case lengths.

Procedures

Laparoscopic cholecystectomy

Cholecystectomy

Cholecystectomy is the surgical removal of the gallbladder. It is the most common method for treating symptomatic gallstones. Surgical options include the standard procedure, called laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy.-Open surgery:A...

is the most common laparoscopic procedure performed. In this procedure, 5-10mm diameter instruments (graspers, scissors, clip applier) can be introduced by the surgeon

Surgery

into the abdomen through trocar

Trocar

A trocar is a medical instrument with a sharply pointed end, often three-sided, that is used inside a hollow cylinder to introduce this into blood vessels or body cavities...

s (hollow tubes with a seal to keep the CO₂

Carbon dioxide

Carbon dioxide is a naturally occurring chemical compound composed of two oxygen atoms covalently bonded to a single carbon atom...

from leaking). Dr. Eddie Joe Reddick of Nashville, TN was the pioneer of laparoscopic cholecystectomies in the U.S., and was instrumental in teaching other surgeons the procedure and establishing the technique as the standard of care for gall bladder removal. Over one million cholecystectomies are performed in the U.S. annually, with over 96% of those being performed laparoscopically.

There are two different formats for laparoscopic surgery. Multiple incisions are required for technology such as the "Da Vinci" system, which uses a console located away from the patient, with the surgeon controlling a camera, vacuum pump, saline cleansing solution, cutting tools, etc. each located within its own incision site, but oriented toward the surgical objective. The surgeon uses two PlayStation-type controls to manipulate the devices.

In contrast, requiring only a single small incision, the "Bonati system" (invented by Dr. Alfred Bonati), uses a single 5-function control, so that a saline solution and the vacuum pump operate together when the laser cutter is activated. A camera and light provide feedback to the surgeon, who sees the enlarged surgical elements on a TV monitor. The Bonati system was designed for spinal surgery and has been promoted only for that purpose.

Rather than a minimum 20 cm incision as in traditional (open) cholecystectomy

Cholecystectomy

, four incisions of 0.5–1.0 cm will be sufficient to perform a laparoscopic removal of a gallbladder

Gallbladder

In vertebrates the gallbladder is a small organ that aids mainly in fat digestion and concentrates bile produced by the liver. In humans the loss of the gallbladder is usually easily tolerated....

. Since the gall bladder is similar to a small balloon that stores and releases bile, it can usually be removed from the abdomen by suctioning out the bile and then removing the deflated gallbladder through the 1 cm incision at the patient's navel. The length of postoperative stay in the hospital is minimal, and same-day discharges are possible in cases of early morning procedures.

In certain advanced laparoscopic procedures where the size of the specimen being removed would be too large to pull out through a trocar site (as would be done with a gallbladder) an incision larger than 10mm must be made. The most common of these procedures are removal of all or part of the colon (colectomy

Colectomy

Colectomy consists of the surgical resection of any extent of the large intestine .-History:Sir William Arbuthnot-Lane was one of the early proponents of the usefulness of total colectomies, although his overuse of the procedure called the wisdom of the surgery into question.-Indications:Some of...

), or removal of the kidney (nephrectomy

Nephrectomy

Nephrectomy is the surgical removal of a kidney.-History:The first successful nephrectomy was performed by the German surgeon Gustav Simon on August 2, 1869 in Heidelberg. Simon practiced the operation beforehand in animal experiments...

). Some surgeons perform these procedures completely laparoscopically, making the larger incision toward the end of the procedure for specimen removal, or, in the case of a colectomy, to also prepare the remaining healthy bowel to be reconnected (create an anastomosis). Many other surgeons feel that since they will have to make a larger incision for specimen removal anyway, they might as well use this incision to have their hand in the operative field during the procedure to aid as a retractor, dissector, and to be able to feel differing tissue densities (palpate), as they would in open surgery. This technique is called hand-assist laparoscopy. Since they will still be working with scopes and other laparoscopic instruments, CO2 will have to be maintained in the patient's abdomen, so a device known as a hand access port (a sleeve with a seal that allows passage of the hand) must be used. Surgeons that choose this hand-assist technique feel it reduces operative time significantly versus the straight laparoscopic approach. It also gives them more options in dealing with unexpected adverse events (i.e. uncontrolled bleeding) that may otherwise require creating a much larger incision and converting to a fully open surgical procedure.

Conceptually, the laparoscopic approach is intended to minimise post-operative pain

Pain

Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...

and speed up recovery times, while maintaining an enhanced visual field for surgeons. Due to improved patient outcomes, in the last two decades, laparoscopic surgery has been adopted by various surgical sub-specialties including gastrointestinal surgery (including bariatric procedures for morbid obesity

Obesity

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...

), gynecologic surgery and urology. Based on numerous prospective randomized controlled trial

Randomized controlled trial

A randomized controlled trial is a type of scientific experiment - a form of clinical trial - most commonly used in testing the safety and efficacy or effectiveness of healthcare services or health technologies A randomized controlled trial (RCT) is a type of scientific experiment - a form of...

s, the approach has proven to be beneficial in reducing post-operative morbidities such as wound infections and incisional hernia

Hernia

A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. A hiatal hernia occurs when the stomach protrudes into the mediastinum through the esophageal opening in the diaphragm....

s (especially in morbidly obese patients), and is now deemed safe when applied to surgery for cancers such as cancer of colon.
The restricted vision, the difficulty in handling of the instruments (new hand-eye coordination skills are needed), the lack of tactile perception and the limited working area are factors which add to the technical complexity of this surgical approach. For these reasons, minimally invasive surgery has emerged as a highly competitive new sub-specialty within various fields of surgery. Surgical residents who wish to focus on this area of surgery gain additional laparoscopic surgery training during one or two years of fellowship after completing their basic surgical residency. In OBGYN residency programs, the average laparoscopy-to-laparotomy quotient (LPQ) is 0.55.

The first transatlantic surgery (Lindbergh Operation)

Lindbergh Operation

The Lindbergh Operation was a complete tele-surgical operation carried out by a team of French surgeons located in New York on a patient in Strasbourg, France using telecommunications solutions based on high-speed services and sophisticated surgical robotics...

ever performed was a laparoscopic gallbladder

Gallbladder

In vertebrates the gallbladder is a small organ that aids mainly in fat digestion and concentrates bile produced by the liver. In humans the loss of the gallbladder is usually easily tolerated....

removal.

Laparoscopic techniques have also been developed in the field of veterinary medicine

Veterinary medicine

Veterinary Medicine is the branch of science that deals with the prevention, diagnosis and treatment of disease, disorder and injury in non-human animals...

. Due to the relative high cost of the equiment required, however, it has not become commonplace in most traditional practices today but rather limited to specialty-type practices. Many of the same surgeries performed in humans can be applied to animal cases - everything from an egg-bound tortoise to a German Shepherd can benefit from MIS. A paper published in JAVMA (Journal of the American Veterinary Medical Association) in 2005 showed that dogs spayed laparoscopically experienced significantly less pain (65%)than those that were spayed with traditional 'open' methods. Arthroscopy

Arthroscopy

Arthroscopy is a minimally invasive surgical procedure in which an examination and sometimes treatment of damage of the interior of a joint is performed using an arthroscope, a type of endoscope that is inserted into the joint through a small incision...

, thoracoscopy, cystoscopy are all performed in veterinary medicine today. The University of Georgia School of Veterinary Medicine and Colorado State University's School of Veterinary Medicine are two of the main centers where veterinary laparoscopy got started and have excellent training programs for veterinarians interested in getting started in MIS.

Advantages

There are a number of advantages to the patient with laparoscopic surgery versus an open procedure. These include:

Reduced hemorrhaging, which reduces the chance of needing a blood transfusion
Blood transfusion
Blood transfusion is the process of receiving blood products into one's circulation intravenously. Transfusions are used in a variety of medical conditions to replace lost components of the blood...

.
Smaller incision, which reduces pain and shortens recovery time, as well as resulting in less post-operative scarring.
Less pain, leading to less pain medication
Analgesic
An analgesic is any member of the group of drugs used to relieve pain . The word analgesic derives from Greek an- and algos ....

needed.
Although procedure times are usually slightly longer, hospital stay is less, and often with a same day discharge which leads to a faster return to everyday living.
Reduced exposure of internal organs to possible external contaminants thereby reduced risk of acquiring infections.

Although laparoscopy in adult age group is widely accepted, its advantages in pediatric age group is questioned. Benefits of laparoscopy appears to recede with younger age. Efficacy of laparoscopy is inferior to open surgery in certain conditions such as pyloromyotomy for Infantile hypertrophic pyloric stenosis. Although laparoscopic appendiectomy has lesser wound problems than open surgery, the former is associated with more intra-abdominal abscesses.

Disadvantages

While laparoscopic surgery is clearly advantageous in terms of patient outcomes, the procedure is more difficult from the surgeon's perspective when compared to traditional, open surgery:

The surgeon has limited range of motion at the surgical site resulting in a loss of dexterity
Poor depth perception
Surgeons must use tools to interact with tissue rather than manipulate it directly with their hands. This results in an inability to accurately judge how much force is being applied to tissue as well as a risk of damaging tissue by applying more force than necessary. This limitation also reduces tactile sensation, making it more difficult for the surgeon to feel tissue (sometimes an important diagnostic tool, such as when palpating for tumors) and making delicate operations such as tying sutures more difficult.
The tool endpoints move in the opposite direction to the surgeon's hands due to the pivot point, making laparoscopic surgery a non-intuitive motor skill that is difficult to learn.

Risks

Some of the risks are briefly described below:

The most significant risks are from trocar
Trocar
A trocar is a medical instrument with a sharply pointed end, often three-sided, that is used inside a hollow cylinder to introduce this into blood vessels or body cavities...

injuries to either blood vessel
Blood vessel
The blood vessels are the part of the circulatory system that transports blood throughout the body. There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and...

s or small or large bowel
Colon (anatomy)
The colon is the last part of the digestive system in most vertebrates; it extracts water and salt from solid wastes before they are eliminated from the body, and is the site in which flora-aided fermentation of unabsorbed material occurs. Unlike the small intestine, the colon does not play a...

. The risk of such injuries is increased in patients who have below average body mass index
Body mass index
The body mass index , or Quetelet index, is a heuristic proxy for human body fat based on an individual's weight and height. BMI does not actually measure the percentage of body fat. It was invented between 1830 and 1850 by the Belgian polymath Adolphe Quetelet during the course of developing...

or have a history of prior abdominal surgery
Abdominal surgery
The term abdominal surgery broadly covers surgical procedures that involve opening the abdomen. Surgery of each abdominal organ is dealt with separately in connection with the description of that organ Diseases affecting the abdominal cavity are dealt with generally under their own names The term...

. The initial trocar
Trocar
A trocar is a medical instrument with a sharply pointed end, often three-sided, that is used inside a hollow cylinder to introduce this into blood vessels or body cavities...

is typically inserted blindly. While these injuries are rare, significant complications can occur. Vascular injuries can result in hemorrhage that may be life threatening. Injuries to the bowel can cause a delayed peritonitis
Peritonitis
Peritonitis is an inflammation of the peritoneum, the serous membrane that lines part of the abdominal cavity and viscera. Peritonitis may be localised or generalised, and may result from infection or from a non-infectious process.-Abdominal pain and tenderness:The main manifestations of...

. It is very important that these injuries be recognized as early as possible.
Some patients have sustained electrical burns unseen by surgeons who are working with electrode
Electrode
An electrode is an electrical conductor used to make contact with a nonmetallic part of a circuit...

s that leak current into surrounding tissue. The resulting injuries can result in perforated organs and can also lead to peritonitis. This risk is eliminated by utilizing active electrode monitoring.
There may be an increased risk of hypothermia
Hypothermia
Hypothermia is a condition in which core temperature drops below the required temperature for normal metabolism and body functions which is defined as . Body temperature is usually maintained near a constant level of through biologic homeostasis or thermoregulation...

and peritoneal trauma due to increased exposure to cold, dry gases during insufflation
Insufflation (medicine)
Insufflation is the practice of inhaling a substance. Insufflation has limited medical use, but is a common route of administration with many respiratory drugs used to treat conditions in the lungs and paranasal sinus .The technique is common for many recreational drugs and is also used for some...

. The use of heated and humidified CO₂ may reduce this risk.
Many patients with existing pulmonary disorders may not tolerate pneumoperitoneum
Pneumoperitoneum
Pneumoperitoneum is air or gas in the abdominal cavity. It is often seen on X-ray, but small amounts are often missed, and CT is nowadays regarded as a criterion standard in the assessment of a pneumoperitoneum. CT can visualize quantities as small as 5 cm³ of air or gas...

(gas in the abdominal cavity
Abdominal cavity
The abdominal cavity is the body cavity of the human body that holds the bulk of the viscera. It is located below the thoracic cavity, and above the pelvic cavity. Its dome-shaped roof is the thoracic diaphragm , and its oblique floor is the pelvic inlet...

), resulting in a need for conversion to open surgery after the initial attempt at laparoscopic approach.
Not all of the CO₂ introduced into the abdominal cavity is removed through the incisions during surgery. Gas tends to rise, and when a pocket of CO₂ rises in the abdomen, it pushes against the diaphragm (the muscle that separates the abdominal from the thoracic cavities and facilitates breathing), and can exert pressure on the phrenic nerve
Phrenic nerve
The phrenic nerve originates mainly from the 4th cervical nerve, but also receives contributions from the 5th and 3rd cervical nerves in humans....

. This produces a sensation of pain that may extend to the patient's shoulders. For an appendectomy, the right shoulder can be particularly painful. In some cases this can also cause considerable pain when breathing. In all cases, however, the pain is transient, as the body tissues will absorb the CO₂ and eliminate it through respiration.
Coagulation
Coagulation
Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis, the cessation of blood loss from a damaged vessel, wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop bleeding and begin repair of the damaged vessel...

disorders and dense adhesions (scar tissue
Scar tissue
Scar tissue can refer to:*Granulation tissue, a product of healing in major wounds*The tissue of a scar*"Scar Tissue", a Red Hot Chili Peppers song*Scar Tissue , the autobiography of Anthony Kiedis, lead singer of the Red Hot Chili Peppers...

) from previous abdominal surgery may pose added risk for laparoscopic surgery and are considered relative contra-indications for this approach.

Robotics and technology

The process of minimally invasive surgery

Surgery

has been augmented by specialized tools for decades. For example, TransEnterix of Durham, North Carolina

Durham, North Carolina

Durham is a city in the U.S. state of North Carolina. It is the county seat of Durham County and also extends into Wake County. It is the fifth-largest city in the state, and the 85th-largest in the United States by population, with 228,330 residents as of the 2010 United States census...

received U.S. Food and Drug Administration approval in October 2009 for its SPIDER Surgical System using flexible instruments and one incision in the navel

Navel

The navel is a scar on the abdomen caused when the umbilical cord is removed from a newborn baby...

area instead of several, allowing quicker healing for patients. Dr. Richard Stac of Duke University

Duke University

Duke University is a private research university located in Durham, North Carolina, United States. Founded by Methodists and Quakers in the present day town of Trinity in 1838, the school moved to Durham in 1892. In 1924, tobacco industrialist James B...

developed the process.

In recent years, electronic tools have been developed to aid surgeons.
Some of the features include:

Visual magnification — use of a large viewing screen improves visibility
Stabilization — Electromechanical damping of vibrations, due to machinery or shaky human hands
Simulators — use of specialized virtual reality
Virtual reality
Virtual reality , also known as virtuality, is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds...

training tools to improve physicians' proficiency in surgery
Reduced number of incisions

Robotic surgery has been touted as a solution to underdeveloped nations

Developing country

A developing country, also known as a less-developed country, is a nation with a low level of material well-being. Since no single definition of the term developing country is recognized internationally, the levels of development may vary widely within so-called developing countries...

, whereby a single central hospital can operate several remote machines at distant locations. The potential for robotic surgery

Robotic surgery

Robotic surgery, computer-assisted surgery, and robotically-assisted surgery are terms for technological developments that use robotic systems to aid in surgical procedures....

has had strong military interest as well, with the intention of providing mobile medical care

Health care

Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...

while keeping trained doctors safe from battle.

Non-robotic hand guided assistance systems

There are also user-friendly non robotic assistance systems that are single hand guided devices with a high potential to save time and money. These assistance devices are not bound by the restrictions of common medical robotic systems. The systems enhance the manual possibilities of the surgeon and his team, regarding the need of replacing static holding force during the intervention.

Some of the features are:

The stabilisation of the camera picture because the whole static workload is conveyed by the assistance system.

Some systems enable a fast repositioning and very short time for fixation of less than 0.02 seconds at the desired position. Some systems are lightweight constructions (18 kg) and can withstand a force of 20 N in any position and direction.

The benefit – a physically relaxed intervention team can work concentrated on the main goals during the intervention.

The potentials of these systems enhance the possibilities of the mobile medical care with those lightweight assistance systems. These assistance systems meet the demands of true solo surgery assistance systems and are robust, versatile, and easy to use.

External links

Feder, Barnaby J., "Surgical Device Poses a Rare but Serious Peril" The New York Times, March 17, 2006
Laparoscopic surgeries

The source of this article is wikipedia, the free encyclopedia. The text of this article is licensed under the GFDL.

History

Procedures

Advantages

Disadvantages

Risks

Robotics and technology

Non-robotic hand guided assistance systems

See also

External links