Robotic Assisted Minimally Invasive Surgery

Minimally invasive surgery has impacted the outcomes of surgery more than any technology since the development of sterile technique. The hard science has demonstrated that decrease in wound complications and recovery time has created the biggest gap with open approaches to surgery. The total economic benefit may be unfathomable when looked at comprehensively. Integral to the rise of minimal access and therapeutic techniques in surgery has been the growth of technological improvements over time. Beginning with insufflators, videoscopy, and energy devices, that evolution has continued into the development of tele-surgical devices that feature full articulation of instruments, high-resolution 3-D optics, and computer assisted movement. This has come with controversy – as the dominant manufacturer of robotic assisted devices, Intuitive Surgical, and their generations of da Vinci surgical platforms, holds enough market share to spur cries of monopoly and financial excess. However, with over 3000 world-wide systems in use, and over 6000 peer-reviewed research articles, the impact of robotic surgery cannot be ignored. The current state of data suggests equivalency in most procedures with regard to traditional outcome measures, equal or somewhat elevated costs, with specific areas of superiority. The first section of this textbook, Surgical Robots, covers the history, economics, training, and medico-legal aspects of robotic surgery that will be of interest to students, residents, fellows, surgical staff, and administrators or public health specialists who seek to gain a comprehensive background on robotic surgery, or justification for purchasing a robotic system for their institution. Surgeons will also find this background valuable to their practice, to give context to their procedures so they can better counsel their patients, help with advocating for robotic platform purchases, and proactively prepare themselves for medico-legal issues. The chapter on legal issues will have specific instances of robotic surgery-related lawsuits and their outcomes, a first for robotic surgery texts. The second section of this textbook, Robotic Procedures, will contain a comprehensive catalogue of procedures that have been performed robotically in general surgery, gynecology, urology, plastic surgery, cardiothoracic, and otolaryngology. Each author will cover the existing literature, preoperative planning, room and patient setup, steps of the procedure, and postoperative care. Standardized room maps and port placement will help the student, resident, fellow, surgeon or OR Staff to quickly reference these before cases. Each chapter will also cover the specific equipment needs and expected complexity of the procedures, allowing administrators to better gauge how to prepare for, or ration, use or their robotic resources. The final section, Future of Robotics, will give the entire scope of audience a look into what exciting advancements in the field are on the horizon. This textbook is a complete resource for robotic-assisted minimally invasive surgery, covering the history, current state, technical and clinical aspects, and future considerations that may be of interest to any who has a role, stake, or curiosity regarding robotic surgery.

Advances in research have led to the use of robotics in a range of surgical applications. Medical robotics: Minimally invasive surgery provides authoritative coverage of the core principles, applications and future potential of this enabling technology. Beginning with an introduction to robot-assisted minimally invasive surgery (MIS), the core technologies of the field are discussed, including localization and tracking technologies for medical robotics. Key applications of robotics in laparoscopy, neurology, cardiovascular interventions, urology and orthopaedics are considered, as well as applications for ear, nose and throat (ENT) surgery, vitreoretinal surgery and natural orifice transluminal endoscopic surgery (NOTES). Microscale mobile robots for the circulatory system and mesoscale robots for the gastrointestinal tract are investigated, as is MRI-based navigation for in vivo magnetic microrobots. Finally, the book concludes with a discussion of ethical issues related to the use of robotics in surgery. With its distinguished editor and international team of expert contributors, Medical robotics: Minimally invasive surgery is a comprehensive guide for all those working in the research, design, development and application of medical robotics for surgery. It also provides an authoritative introduction for academics and medical practitioners working in this field. Provides authoritative coverage of the core principles, applications and future potential of medical robotics Introduces robot-assisted minimally invasive surgery (MIS), including the core technologies of the field and localization and tracking technologies for medical robotics Considers key applications of robotics in laparoscopy, neurology, cardiovascular interventions, urology and orthopaedics

The Encyclopedia of Medical Robotics combines contributions in four distinct areas of Medical robotics, namely: Minimally Invasive Surgical Robotics, Micro and Nano Robotics in Medicine, Image-guided Surgical Procedures and Interventions, and Rehabilitation Robotics. The volume on Minimally Invasive Surgical Robotics focuses on robotic technologies geared towards challenges and opportunities in minimally invasive surgery and the research, design, implementation and clinical use of minimally invasive robotic systems. The volume on Micro and Nano robotics in Medicine is dedicated to research activities in an area of emerging interdisciplinary technology that is raising new scientific challenges and promising revolutionary advancement in applications such as medicine and biology. The size and range of these systems are at or below the micrometer scale and comprise assemblies of micro and nanoscale components. The volume on Image-guided Surgical Procedures and Interventions focuses primarily on the use of image guidance during surgical procedures and the challenges posed by various imaging environments and how they related to the design and development of robotic systems as well as their clinical applications. This volume also has significant contributions from the clinical viewpoint on some of the challenges in the domain of image-guided interventions. Finally, the volume on Rehabilitation Robotics is dedicated to the state-of-the-art of an emerging interdisciplinary field where robotics, sensors, and feedback are used in novel ways to re-learn, improve, or restore functional movements in humans.Volume 1, Minimally Invasive Surgical Robotics, focuses on an area of robotic applications that was established in the late 1990s, after the first robotics-assisted minimally invasive surgical procedure. This area has since received significant attention from industry and researchers. The teleoperated and ergonomic features of these robotic systems for minimally invasive surgery (MIS) have been able to reduce or eliminate most of the drawbacks of conventional (laparoscopic) MIS. Robotics-assisted MIS procedures have been conducted on over 3 million patients to date — primarily in the areas of urology, gynecology and general surgery using the FDA approved da Vinci® surgical system. The significant commercial and clinical success of the da Vinci® system has resulted in substantial research activity in recent years to reduce invasiveness, increase dexterity, provide additional features such as image guidance and haptic feedback, reduce size and cost, increase portability, and address specific clinical procedures. The area of robotic MIS is therefore in a state of rapid growth fueled by new developments in technologies such as continuum robotics, smart materials, sensing and actuation, and haptics and teleoperation. An important need arising from the incorporation of robotic technology for surgery is that of training in the appropriate use of the technology, and in the assessment of acquired skills. This volume covers the topics mentioned above in four sections. The first section gives an overview of the evolution and current state the da Vinci® system and clinical perspectives from three groups who use it on a regular basis. The second focuses on the research, and describes a number of new developments in surgical robotics that are likely to be the basis for the next generation of robotic MIS systems. The third deals with two important aspects of surgical robotic systems — teleoperation and haptics (the sense of touch). Technology for implementing the latter in a clinical setting is still very much at the research stage. The fourth section focuses on surgical training and skills assessment necessitated by the novelty and complexity of the technologies involved and the need to provide reliable and efficient training and objective assessment in the use of robotic MIS systems.In Volume 2, Micro and Nano Robotics in Medicine, a brief historical overview of the field of medical nanorobotics as well as the state-of-the-art in the field is presented in the introductory chapter. It covers the various types of nanorobotic systems, their applications and future directions in this field. The volume is divided into three themes related to medical applications. The first theme describes the main challenges of microrobotic design for propulsion in vascular media. Such nanoscale robotic agents are envisioned to revolutionize medicine by enabling minimally invasive diagnostic and therapeutic procedures. To be useful, nanorobots must be operated in complex biological fluids and tissues, which are often difficult to penetrate. In this section, a collection of four papers review the potential medical applications of motile nanorobots, catalytic-based propelling agents, biologically-inspired microrobots and nanoscale bacteria-enabled autonomous drug delivery systems. The second theme relates to the use of micro and nanorobots inside the body for drug-delivery and surgical applications. A collection of six chapters is presented in this segment. The first chapter reviews the different robot structures for three different types of surgery, namely laparoscopy, catheterization, and ophthalmic surgery. It highlights the progress of surgical microrobotics toward intracorporeally navigated mechanisms for ultra-minimally invasive interventions. Then, the design of different magnetic actuation platforms used in micro and nanorobotics are described. An overview of magnetic actuation-based control methods for microrobots, with eventually biomedical applications, is also covered in this segment. The third theme discusses the various nanomanipulation strategies that are currently used in biomedicine for cell characterization, injection, fusion and engineering. In-vitro (3D) cell culture has received increasing attention since it has been discovered to provide a better simulation environment of in-vivo cell growth. Nowadays, the rapid progress of robotic technology paves a new path for the highly controllable and flexible 3D cell assembly. One chapter in this segment discusses the applications of micro-nano robotic techniques for 3D cell culture using engineering approaches. Because cell fusion is important in numerous biological events and applications, such as tissue regeneration and cell reprogramming, a chapter on robotic-tweezers cell manipulation system to achieve precise laser-induced cell fusion using optical trapping has been included in this volume. Finally, the segment ends with a chapter on the use of novel MEMS-based characterization of micro-scale tissues instead of mechanical characterization for cell lines studies.Volume 3, Image-guided Surgical Procedures and Interventions, focuses on several aspects ranging from understanding the challenges and opportunities in this domain, to imaging technologies, to image-guided robotic systems for clinical applications. The volume includes several contributions in the area of imaging in the areas of X-Ray fluoroscopy, CT, PET, MR Imaging, Ultrasound imaging, and optical coherence tomography. Ultrasound-based diagnostics and therapeutics as well as ultrasound-guided planning and navigation are also included in this volume in addition to multi-modal imaging techniques and its applications to surgery and various interventions. The application of multi-modal imaging and fusion in the area of prostate biopsy is also covered. Imaging modality compatible robotic systems, sensors and actuator technologies for use in the MRI environment are also included in this work., as is the development of the framework incorporating image-guided modeling for surgery and intervention. Finally, there are several chapters in the clinical applications domain covering cochlear implant surgery, neurosurgery, breast biopsy, prostate cancer treatment, endovascular interventions, neurovascular interventions, robotic capsule endoscopy, and MRI-guided neurosurgical procedures and interventions.Volume 4, Rehabilitation Robotics, is dedicated to the state-of-the-art of an emerging interdisciplinary field where robotics, sensors, and feedback are used in novel ways to relearn, improve, or restore functional movements in humans. This volume attempts to cover a number of topics relevant to the field. The first section addresses an important activity in our daily lives: walking, where the neuromuscular system orchestrates the gait, posture, and balance. Conditions such as stroke, vestibular deficits, or old age impair this important activity. Three chapters on robotic training, gait rehabilitation, and cooperative orthoses describe the current works in the field to address this issue. The second section covers the significant advances in and novel designs of soft actuators and wearable systems that have emerged in the area of prosthetic lower limbs and ankles in recent years, which offer potential for both rehabilitation and human augmentation. These are described in two chapters. The next section addresses an important emphasis in the field of medicine today that strives to bring rehabilitation out from the clinic into the home environment, so that these medical aids are more readily available to users. The current state-of-the-art in this field is described in a chapter. The last section focuses on rehab devices for the pediatric population. Their impairments are life-long and rehabilitation robotics can have an even bigger impact during their lifespan. In recent years, a number of new developments have been made to promote mobility, socialization, and rehabilitation among the very young: the infants and toddlers. These aspects are summarized in two chapters of this volume.

Handbook of Robotic and Image-Guided Surgery provides state-of-the-art systems and methods for robotic and computer-assisted surgeries. In this masterpiece, contributions of 169 researchers from 19 countries have been gathered to provide 38 chapters. This handbook is 744 pages, includes 659 figures and 61 videos. It also provides basic medical knowledge for engineers and basic engineering principles for surgeons. A key strength of this text is the fusion of engineering, radiology, and surgical principles into one book. A thorough and in-depth handbook on surgical robotics and image-guided surgery which includes both fundamentals and advances in the field A comprehensive reference on robot-assisted laparoscopic, orthopedic, and head-and-neck surgeries Chapters are contributed by worldwide experts from both engineering and surgical backgrounds

Operative urology has evolved in recent years to include laparoscopic and robot-assisted surgical procedures, which have resulted in significant improvements in quality of life-related outcome. Nevertheless, training methods in urologic laparoscopy and robot-assisted surgery vary considerably, and a structured training scheme is required to enable the modern urologist to adapt to and make optimal use of these techniques. Accordingly, the main goal of this surgical atlas is to guide the urologist carefully through all the standard laparoscopic and robot-assisted procedures. Each procedure is presented in detail with numerous supporting endoscopic images and diagrams. The reader is thereby acquainted with the different surgical steps and will acquire the knowledge necessary for reliable reproduction of the techniques in clinical practice.

This thesis lays the groundwork for the automatic supervision of the laser incision process, which aims to complement surgeons’ perception of the state of tissues and enhance their control over laser incisions. The research problem is formulated as the estimation of variables that are representative of the state of tissues during laser cutting. Prior research in this area leveraged numerical computation methods that bear a high computational cost and are not straightforward to use in a surgical setting. This book proposes a novel solution to this problem, using models inspired by the ability of experienced surgeons to perform precise and clean laser cutting. It shows that these new models, which were extracted from experimental data using statistical learning techniques, are straightforward to use in a surgical setup, allowing greater precision in laser-based surgical procedures.

This book provides a data-driven analysis of robotic assisted, laparoscopic, and endoscopic urological procedures in children, including renal surgery, ureteral surgery, oncology, and bladder surgery. Introductory chapters outline and describe the logistics of establishing a dedicated minimally invasive program at your institution, as well as the basics of anatomy, instrumentation, access, and trocar placement. Subsequent chapters are organized by anatomic compartment (upper tract and lower tract) and organ system. Each chapter also addresses advanced techniques and future directions, as well as common complications and case-based challenges. The final chapters review oncology and special considerations in infants. Minimally Invasive and Robotic-Assisted Surgery in Pediatric Urology provides a comprehensive, evidence-based text on pediatric urology robotic and minimally invasive surgery, allowing readers to implement the material presented for the improvement of their own practices and patient outcomes.

Robotics began as a science fiction creation which has become quite real, first in assembly line operations such as automobile manufacturing, airplane construction etc. They have now reached such areas as the ever-multiplying - medical field. Robotic surgery is now becoming highly practised in open heart, lung, and other forms of surgery. This book covers the developing stages of robotic surgery and its expectations in the medical field.