I, Doctor: An Exploration of Robotic Assisted Surgery
by Anamiguel Pomales
I see long mechanical arms clamped to a patient’s abdomen, imitating human hand gestures. My first thought: Dr. Octopus. But what I am actually looking at is the da Vinci Robot, a robotic surgical system. Its similarities to Dr. Octopus are merely physical.
In the medical field, robots are used to perform repetitive tasks during surgeries and are entirely controlled by physicians who sit three feet from the device. Depending on the surgery, three to five tiny incisions are made into the area being operated on. Cameras and probes carrying various traditional surgical instruments such as forces and bovies are slipped through the incisions. The surgeon then directs each probe to pull tissue, cut away tumors, and stitch the body back together as if the probes were his own hands.
Robots made their first debut in the medical field in 1985 with the invention of the PUMA 560, a robotic device designed to help perform brain biopsies. The robot had only one mechanical arm, which wielded a needle. A CT scan was used to see where the needle was being inserted.
Three decades later there are over half a dozen types of robots being used worldwide for brain, heart, abdominal, and orthopedic surgery. In the United States, the most common robotic technology used is the da Vinci robot. This technology was originally developed for the United States Army to protect surgeons operating during combat. As combat-related injuries are often complex, surgeons needed a type of robot that could do more than brain surgery. Surgeons and researchers who helped develop the technology for the military saw its potential application to many other fields. Slight modifications to the original design of the robot create a tool that can be used in cardiology, gynecology, urology, and otolaryngology.
Aside from being minimally invasive, the da Vinci robot also increases the amount of instruments available simultaneously, enhances wrist mobility, provides tremor control, and takes pictures throughout the procedure for post-op education, monitoring, and diagnosis. Robotic assisted surgery also reduces post-op recuperation time, decreases blood loss, minimizes damage to adjacent tissues and leaves only small scars. The advantages of robotic surgery caused a 26 percent increase in their use from 2011 to 2012, and the technology has continued to become more prevalent in medical facilities across the country.
While the use of robotics has already enhanced surgery, much more improvement will come in the next few years. The increased use of these technologies in the medical field has given researchers a better insight on ways of improving current robots and ideas for creating new devices. One recent development is software called Phantom, which uses a combination of X-ray and MRI technology to mimic a surgeon’s sense of touch. Dr. Howie Choset, Dr. Alon Wolf and Dr. Marco Zenati, former professor at University of Pittsburgh Medical School, created a snake like device called the Flex System. It mimics a snake’s flexibility and allows surgeons to reach previously inaccessible areas.
While each new device facilitates surgery for both the patient and the doctor, it also brings with it a new learning curve, new complications to fix and new angles to visualize. In order for robotics to be an effective tool in the medical field, doctors have to master each new technology. Currently, a surgeon needs to have worked on at least 50 cases to be considered competent with the technology in a specific field. Many medical schools now incorporate robotics training in rotations. Other schools, such as the University of Pittsburgh School of Medicine, are offering M.D./Ph.D. programs to students who want to dedicate their careers to the use and development of robotic assisted surgery.
My initial hesitant reaction to robotics in the medical field is not uncommon. Many let their imaginations run wild and believe that robotics in the medical field are copied from a science fiction film. But the reality is that robotic assisted surgery has made a strong, positive impact on the medical field. It has enabled surgeons to perform operations that were once considered impossible and has reduced the amount of discomfort a patient endures during operations. Yet, the use of robotics in the medical field is only in its initial stages. Forthcoming developments assure that robotic assisted surgery will continue to revolutionize modern medicine.