Robotic Surgery

The use of Robots will rise in the future, and despite the evil reputation given to them by the film and game industry, the robots we see and use are quite the opposite. Robots used in surgery are completely controlled by surgeons, so do not worry . It is not a seven year old kid at the other end…….

Robots are used in surgery because they have certain advantages over humans.

• More arms and hands and fingers and types of fingers
• Hands and minds that do not tire even after hours of work
• Ability to hold positions indefinitely
• Precision
• 3-D vision
• Get closer to the area of surgery than the human vision will allow

They do have disadvantages like the lack of tactile sensation and inability to tell the surgeon if he is doing something wrong! They are liable to technical failures and depends on on a power supply. If doing remote surgery the communication system has to work well too. Since the patient is still operated by a surgeon sitting behind a console, the surgeon tiring will still be a limitation. However some of these these will be attended to in the future. The present day robots will be laughably simple in 10 years time.

The da Vinci Robotic Surgical System is the most widely used and known. It is used to perform Laparoscopic surgery as well as Cardiac and Neurosurgery. The whole system is controlled by a surgeon. The surgeon can be in the operating theatre, outside it or even in another hospital in another country. He sits at a control and handles the equipment stuck into the patient by moving his hands which are put into the controls which are something like gloves. He also uses his feet to press pedals like that of a car to handle the gears that move the instruments, like a clutch.

This is the da Vinci robotic surgical system. Teh surgeon is seated at the far left of the picture behind the console.
Other than the da Vinci, there are the ZEUS and AESOP (Automated Endoscopic System for Optimal Positioning ) robotic systems as well.

While these big systems are actually in use, there is another set of robots that are growing. These are tiny robots that will grow with the development of nano technology. These robots can get into the human body and work from within. They too will be controlled by surgeons but will elevate treatment of many conditions to a totally new level. They wil also play an important part in diagnosis.

Nanomedicine is a whole new field of medical science that is developing. Nanobots will be really tiny robots maybe the size of a human cell! They could get to sites in the body that we cannot imagine and deliver medicines, radiotherapy, chemotherapy, induce the immune system to be attracted to a site, repair genes and perform minutely precise surgery.

Imagine what these little robots can get ina and do under remote control? You could be on earth and “operate” on people in space! Far fetched? Read this:

http://www.medgadget.com/archives/2005/10/tiny_robots_for.html

KIT!

Surgical Audit

Auditing one’s work is very important for an individual surgeon. It gives him a record of ones achievements, success as well as failures. The process of undertaking audit improves one’s attitude to work and brings to the whole team a sense of understanding and purpose in their duties. It brings science to what is in reality a practice of an art.

The audit of

• Structure
• Process
• Outcome

are all necessary, but the most valuable to the surgeon is that of Outcome. To be valuable it must be continuous, fairly comprehensive and most importantly, honest.

The conduction of audit is personal and private. It must not compromise the individual freedom and right to privacy of the patients as well as the surgeon. But there are some things that need to be made public as well.

The individual audit of a surgeon must be discussed with colleagues in audit meetings at fairly regular intervals. The outcomes must be compared with those of colleagues in the same institution as well as those of the country. They have then to be compared with the rest of the world.

How best to do this is to be discussed. The use of digital media is generally accepted as the best way to collect and distribute data. What devices, software are we to use and how?