Robotic Surgery

Robotic surgery, as a current aspect of the medical arena, fundamentally relies on the utility of computer-based or assisted procedures, where current robotics, as advanced through scientific and technological breakthroughs, enable the performance of technical medical procedures. The utility of robotic systems in aiding the medical fraternity to perform complex surgical procedures (robotic surgery), has come to revolutionize the medical field with the creation of complex imaging and robotic devices minimizing the existent aspects of minimally invasive surgical procedures. The latter pertains broadly to the myriads of medical procedures existent prior to the advent of robotic surgery. Initially, the procedures, such as gallbladder excisions and laparoscopic cholecystectomy amongst others, were often performed, but without avoiding long cuts that led to large scarring. With current contexts, however, the procedure instead has surgical entry into the body through small (1cm) entry incisions that are enough for tissue manipulation and handling.

Surgeons generally utilize various long-handled instruments in their operations on the human tissue within the body, with such procedures being guided by the viewing equipment, such as endoscopes. The procedure is being widely used in almost all surgical sub-specialties including the brain, head / Otolaryngology, neck, heart, and spine surgery, displaying its great potential in the future mass application. There are numerous reasons behind the major acclaim of robotic surgery; this does not specifically mean that debate does not exist as to its positive utility. It is the driving force behind the successful application in the various medical specialties. It is the various advantages of robotic devices/machinery, and current complex imaging/scanning medium that have resulted in the revolutionizing process of surgical procedures.

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Introduction

In the contemporary arena, robotic surgery has witnessed tremendous utility, portending to its influential aspect in current medical surgery. This, as such, entails the larger inclusion of robotic systems towards aiding various surgical procedures that are both delicate and limiting in terms of space, maneuvering, and time. As such, these limitations are adequately overcome with the help of minimally invasive surgery, allowing surgeons to perform various open surgeries. A wide range of delicate procedures are performed, as exemplified in the cases, where robotically-assisted minimally-invasive surgeries entail utility of either computer control or telemanipulator control.

Consequently, in case contexts of the current field of open surgery, traditional steel tools are replaced with the autonomous instruments (based on mathematical configurations), which perform specific actions equitable to human hand manipulation. The main objectivity in such cases, with reference to the utility of these smart / artificially intelligent mechanizations, is the reduction or ultimate elimination of tissue trauma, as traditionally associated with various pre-robotic surgery procedures. Through this, better control is given to the surgeon, as compared to other existent traditional surgery techniques/approaches, by enhancing both the surgeon's surgical site view, as well as the better manipulation/control of various instruments pertinent in the operation.

 

Various procedures have with time witnessed increased success rates, as a direct result of utilizing these specialized machineries and instruments in robotic surgery. An example of a positive aspect of robotic surgery is the utility of the Da Vinci Surgical System, where traditional procedures, symbolized by large incisions, have currently been replaced by minimal invasive endoscopic surgical procedures. This, as such, has resulted in positive and quick recovery with the shortened hospital stay, because of the reduced recovery times, converting to saved resources, manpower, and energy resources, which may be effectively expended elsewhere within the greater community (Jones & Jones, 2001).

Problem with Robotic Surgery

Though robotic surgery as a new technology continues showcasing huge potential/promise, often heralded as this century's revolutionary new frontier, it is still in its infancy, with its niche not being yet well defined. Thus, the current practical utility is limited to small surgical procedures, with these systems seemingly having more of "marketing than practical role-play". As such, the above may be blamed on the lacking crossover between the medical and industrial robotics arena, and, in particular, the field of medical surgery. While greater/large-scale utility of such systems is still a long way of paradigm shift or not, their origin is rooted in the existent weaknesses and strengths of its predecessors.

As such, amongst the former weaknesses/problems/disadvantages are the interrelated aspects of cost expenditure efficiency, compatibility with existent systems, and time-frame/duration taken during an operational procedure. The paper will delve on the two interrelated aspects of compatibility and efficiency, both of which majorly influence surgical procedures. With reference to the above, the system's large size, especially in an overcrowded operating theatre, is a problem, as the robotic arms are both bulky and awkward. Adding to that is the need for the ility of varying instruments in minimal spaces and not suitable for complex and little-spaced procedures (Fuchs, 2002).

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These being delicate, further require stabilizers, which inevitably add to the overall space occupied by the system alone. It is with the above problem case-scenario that I intend to provide some potential solutions, which may eventually ease the manner and nature of surgical procedures. To be noted is that my opinions are inconclusive, as newer research and data continue being exhibited, and as such, I am welcome to additional views and input. In any surgical operation, both efficiency and surgeon-operating theatre compatibility are vital.

Existing Solutions

With the above scenario portending to a cramped operating theatre/room, surgeons often face some issues, such as the general interference with their dexterity, longer time-durations taken, as well as the need for specialized staff, who may often not be available at all times. Such machinery is delicate and requires specialized care and utility, and it is these limitations that may be aided by some of the following measures/solutions, which, however, are limited by their costly/expensive nature.

Solution 1

Pundits as such, are of the view that the existent social contexts portend to increasing need for the miniaturization of such instruments and robotic arms. With less space being taken due to the bulky nature of the system, the operating surgeon and team's greater maneuverability, as well as dexterity, will be enhanced. This is due to the fact that hand-eye coordination, though somewhat compromised, will be better enhanced. By reducing the overall size, the limited degree of motion (4 degrees) of such instruments may be increased, as well as the human hand and wrist 7 degrees of motion.

However, while miniaturized systems do enhance all the above, the aspect of the creased sense of touch, as well as tremor transmission, are some of the issues that continue affecting overall performance and effectiveness. The motivation behind robotic surgery is founded in men's desire of overcoming various limitations exhibited in current forms of laparoscopic technologies. Due to the continued evolution process of machinery and general mechanizations, smaller and smaller parts are replacing more bulky components, with the overall output and efficiency being enhanced conversely (Satava, 2003).

Solution 2

With reference to the aforementioned problem, another solution that is much more practical as the aforementioned miniaturization revolution is still way off would be to expand the size/space of operating theatres. With larger operating space, both the system's robotic arms, in their current bulky form, extra utilities and the requisite staff will have enough space for better maneuvering/flexibility, as well as enhanced efficiency. This, as such, will be a costly affair, just as is the aforementioned solution 1, because it will entail building bigger compartments in future medical facilities, or the general revamping of existent space within current contexts.

The latter, however, portends to some difficulty, as current theatre / operating room instruments and machinery are not essentially compatible with the novel robotic systems, which continue being manufactured. This, therefore, necessitates specialized operating rooms and other facilities, as well as specialized staff, capable of maintaining them. This is because in such a setting, without the requisite compatible instruments/equipment, there is a need for specialized tableside assistance, which may negate the overall need and utility of such systems (Van Haasteren, 2009).

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Solution 3

Finally, yet importantly, would be the greater consideration and acknowledgment of the aforementioned limitations, the huge potential advantages notwithstanding, and consideration of the limited application of robotic surgery until such a time/era, when the miniaturization revolution is advanced. Consequently, very delicate procedures, necessitating the uttermost skill and accuracy, as well as being constrained by the time-limiting factor, should be performed majorly by the normal/traditional methods. This has happened in the past, and currently continues being performed effectively and portends to no immediate problems from the lack of computer-guided and enabled surgery.

The existent limitation on requisite haptic feedback that is crucial in mitigating the breakage of sutures, especially during tissue clumping or knot tying, is one of the major reasons, why I provide the last solution. This is because in the very delicate surgeries, the above is crucial towards the surgeon's better handling of equipment. Overall, questions do arise, as pertaining to the future replacement of conventional surgical procedures with robotic surgery initiating a generational shift in medical ideas and perspectives (Mohyuddin, 2012).

Conclusion

In conclusion, the replacement of conventional surgical procedures with the robot-based ones is still way off, with expenses/costs, efficiency, and compatibility amongst others being a major contributory factor. As such, it is best reserved for the specialized treatments, which, being delicate, require both accuracy and speed, both of which are crucial aspects in the conduct of human surgery. As a personal view, I am of the opinion that the future of robotic surgery is ripe, especially in reference to very specialized medical procedures. However, the various pertinent questions arising from various risks/disadvantages do pose a heated debate, as pertaining to the greater utility of these measures, especially in reference to the general surgical procedures.

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