The da Vinci Robot
The human body is a rather untidy place where organs, bones, flesh, muscles, arteries and connective tissue all compete for space and about 30 percent of world’s 232 million tissue surgeries result in complications. This is because surgeons vary greatly in training, dexterity, experience and decision making and sometimes because of fine tremors of hands and uneconomical movements.Complex surgical procedures like circular anastomosis involve stitching together two severed ends of the intestine and require the skill of an experienced surgeon: Stitch them too far apart or too loose and they will bleed. Tie them too tight, they will strangle and kill the tissue.
By embedding the knowledge of the best surgeons in digital systems, autonomous and semi-autonomous robots could deliver universal access to the best surgical techniques and could potentially be a solution to the problems in conventional surgical procedures.Robots in the surgical suite are nothing new. The best known of them, the da Vinci robot, is more than 15 years old and has performed over 2 million operations worldwide.
The future of surgery is full of promise as it reduces pain, cost, healing times, scarification, disability, and morbidity. Robot-assisted surgery(RAS) enables surgeons to perform minimally invasive yet complicated procedures that are more precise and more controlled than conventional, ‘manual’ surgeries, even if performed by the most skilled surgeon with the steadiest of hands.
The da Vinci robot:
The da Vinci robot is a state of the art technology which enables remote surgery and teleoperation. There are two components of this system: The robot itself (which operates on the patient) and the separate control console (which is controlled by a surgeon). The robot has three small, nimble robotic arms that attach to various instruments such as a scalpel, scissors or electrocautery instruments. Each instrument can easily be swapped out for different functions. The last arm holds an endoscopic camera that gives the surgeon 3-D vision from the control console.
These robots have enabled surgeons the mobility and nimbleness to perform abdominal surgery within the limited space of the human body. Combine this nimbleness with 3D imaging technology and augmented reality and surgeons will be able to ‘see right through you’ by superimposing 3D information from CAT scans and MRIs onto the view of the actual tissue. This 3D virtual environment will enable the surgeon to ‘see the invisible’ as certain areas in the body can be ‘illuminated’ in order to track the movement of, for instance, cancer as it spreads through the lymphatic system, enabling the surgeon to intervene where possible. Apart from their primary focus, the abdomen, the bots are now also correcting vision problems, reshaping joints and even drilling into brains.
One of the biggest drawbacks of the da Vinci robot is that they work exclusively with solid objects like bones or eyes which remain stationary during surgery. In contrast, soft tissues vary in shape and size from patient to patient, and they are, by definition, pliant. This is especially problematic when we want to stitch soft tissues together. Stitch them all together and each stitch will alter their shape. Sometime a stitch may even cover the previous stitch or hide the location of the next switch. Sometimes leaking blood obscures the tissue. Moreover, there is no fixed value of spacing and tension as such.
The other drawbacks of the da Vinci robot include:
1)Very expensive and costly
2)Longer operating and anesthesia time
3)Since the robot has multiple arms, it takes skill and practice to work with the da Vinci robot
4)As with any surgical device, there is also the risk that the da Vinci robotic surgical system could malfunction or fail, leading to serious injury or the need to switch to another type of surgical approach.
5)No automation at all. The da Vinci is a teleoperated system, where the surgeon makes every decision and controls every move.