History of Robotic Surgery Systems

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Questions and Answers

What primary characteristic distinguishes active surgical robotic systems from semiactive systems?

Active systems require constant manual input from the surgeon.

Active systems rely solely on real-time feedback.

Active systems are fully autonomous without human intervention.

Active systems complete pre-programmed tasks guided by imaging. (correct)

Which of the following technological advancements was first approved for clinical use in 2000?

ZEUS robotic system

CT-guided surgical procedures

EndoWrist® technology

da Vinci surgical system (correct)

What was a notable feature of the initial da Vinci surgical system released in 1999?

It had the ability to operate without the surgeon's input.

It was the first remote surgical device used in clinical settings.

It provided real-time 3D imaging capabilities.

It included three robotic arms for surgery. (correct)

Which robotic surgical procedure was performed remotely in 2001, showcasing the capabilities of remote operating?

Cholecystectomy Signup and view all the answers

What is one of the advantages offered by the da Vinci surgical system?

Tremor reduction during surgery Signup and view all the answers

What led to the discontinuation of the ZEUS robotic system in 2003?

Merger of Computer Motion with Intuitive Surgical Signup and view all the answers

What was the first documented clinical robotic procedure?

CT-guided brain biopsy Signup and view all the answers

How does the navigation system in active surgical robots typically function?

It utilizes preoperative imaging and real-time anatomical cues. Signup and view all the answers

What is the primary function of teleoperated (master-slave) robotic surgical systems?

To enable a surgeon to control robotic instruments remotely. Signup and view all the answers

Which category of robotic surgical system specifically allows for remote operation?

Teleoperated (master-slave) systems. Signup and view all the answers

What capability does the ZEUS robot provide that enhances its performance in microsurgical procedures?

Motion scaling and tremor correction. Signup and view all the answers

In which surgical procedures has the teleoperated robotic system been widely used?

Cholecystectomy and hernia surgery. Signup and view all the answers

What describes the relationship between the surgeon and the robotic system in a teleoperated system?

The surgeon is the master, and the robot acts as the slave. Signup and view all the answers

What is a unique feature of the ZEUS robotic system compared to earlier robotic systems?

It incorporates three robotic arms for different functions. Signup and view all the answers

What is currently rare about remote surgical operations in teleoperated systems?

They are seldom performed despite being technologically possible. Signup and view all the answers

What aspect of the teleoperated surgical system has contributed to its popularity?

The use of voice control and computerized platforms for operation. Signup and view all the answers

What advantage does robotic surgery provide regarding surgical precision?

It filters out tremors in the surgeon's hands. Signup and view all the answers

How does robotic surgery improve ergonomic conditions for surgeons?

By enabling surgeons to be seated at a remote console. Signup and view all the answers

What is a significant drawback of straight stick laparoscopic surgery mentioned in the content?

It can result in physical discomfort for the surgeon. Signup and view all the answers

Which specialty particularly highlights the ergonomic challenges during surgery?

Bariatric surgery Signup and view all the answers

What is one consequence of using robotic systems in the surgical field mentioned in the passage?

It prolongs the learning curve for users. Signup and view all the answers

In what way does robotic surgery affect the positioning of surgeons during operations?

Surgeons can position themselves further away from the patient. Signup and view all the answers

What is a potential downside of robotic surgery concerning consumable costs?

It increases consumable costs significantly. Signup and view all the answers

What role does the computer play in robotic surgery with respect to the surgeon's actions?

It translates the surgeon's movements while filtering out tremors. Signup and view all the answers

Which surgical specialties have adopted robot-assisted techniques?

General surgery and cardiothoracic surgery Signup and view all the answers

What is a key feature of the Medtronic Hugo Robotic-Assisted Surgery system?

It aims to provide a low-cost alternative Signup and view all the answers

What does the term 'master-slave' model refer to in robotic surgery?

A hierarchical control system for surgical robots Signup and view all the answers

What is the primary focus of current robotic surgery technologies?

In-house operating procedures Signup and view all the answers

What was sacrificed in the da Vinci X system to lower costs?

Flexibility in multi-quadrant surgeries Signup and view all the answers

What emerging technologies could revolutionize robotic surgery?

Robotic autonomy and machine learning Signup and view all the answers

What is a significant advantage of current robotic systems in surgery?

Multifunctionality across various specialties Signup and view all the answers

Which of the following describes the development stage of robotic surgery systems like Verb Surgical?

Early phase of development Signup and view all the answers

What is a common complication associated with minimal access surgery?

Inadvertent visceral injury from trocar insertion Signup and view all the answers

Why is appropriate theatre time particularly important for robotic cases?

Longer operation times Signup and view all the answers

Which condition may contraindicate a minimal access surgical approach?

Chronic obstructive airways disease Signup and view all the answers

What concern might patients have regarding the use of robotic technology in surgery?

The experience of the surgeon with robotics Signup and view all the answers

What design feature is essential for modern operating theatres to enhance efficiency?

Moveable booms for equipment Signup and view all the answers

What could be a result of carbon dioxide insufflation during a minimal access procedure?

Cardiac arrhythmias Signup and view all the answers

How does morbid obesity affect minimal access surgery?

It requires specialist instrumentation Signup and view all the answers

What should be ensured before proceeding with a proposed surgical approach?

That patients are well-informed and agree Signup and view all the answers

Study Notes

Robotic Surgery History and Systems

The first documented robotic surgical procedure was a CT-guided brain biopsy.
Early robotic systems were teleoperated (master-slave), with the surgeon controlling robotic arms remotely.
The AESOP system mounted an endoscopic camera on a robotic arm, controlled by voice command. Used in cholecystectomy, hernia surgery, and mammary conduit harvesting.
The ZEUS robot (1996) offered three arms, including one for a voice-controlled endoscope, enabling motion scaling and tremor correction. Facilitated microsurgery and the first fully endoscopic robotic procedure (Fallopian tube reanastomosis in 1998). The first remote surgery (cholecystectomy) was performed using ZEUS in 2001.
The da Vinci Surgical System (approved 2000, released 1999) became the dominant system, offering 3D vision, EndoWrist instruments, tremor reduction, motion scaling, and improved ergonomics.

Robotic System Types

Teleoperated (master-slave) systems: Surgeons operate via a robot and instruments through a computerized platform. Can be onsite or remote.
Active systems: Robots complete pre-programmed tasks guided by preoperative imaging and real-time anatomical data.
Semiactive systems: Combine pre-programmed elements with surgeon control.

Ergonomic Advantages of Robotic Surgery

Robotic surgery improves surgeon ergonomics compared to laparoscopic surgery, reducing physical strain from extended procedures and awkward positioning.
Master-slave systems allow surgeons to operate from a remote console, optimizing positioning.

Uptake and Future Directions of Robotic Surgery

Many specialties utilize robotic surgery (general, cardiothoracic, urology, orthopedics, ENT, gynecology, pediatrics, microsurgery).
Systems aim for multifunctionality across specialties and environments (operating theatre and remote). Remote surgery is still rare.
Newer systems like the Medtronic Hugo RAS system aim for lower cost and flexibility.
Future systems may incorporate robotic autonomy and machine learning.

Da Vinci X

A lower-cost option from Intuitive Surgical, offering features of the Xi system but with reduced multi-quadrant surgical flexibility.

Complications and Patient Considerations

Potential complications include shoulder tip pain, minor surgical emphysema, and rare visceral injury.
Patients may have concerns about the technology and require clear explanations.

Preoperative Considerations

Routine preoperative physical examination is necessary.
Longer operating times are possible.
Carbon dioxide insufflation can cause cardiac arrhythmias.
Severe chronic obstructive airway disease and ischemic heart disease may be contraindications.
Morbid obesity may require specialized instrumentation.

Theatre Setup

Modern theatres have moveable booms for video, diathermy, and laparoscopic equipment, along with high-resolution monitors.

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Description

Explore the fascinating history of robotic surgery, starting from the first documented procedure to the advanced da Vinci Surgical System. Learn about key developments in teleoperated systems and the innovations that have shaped surgical practices. This quiz covers significant milestones and technologies in robotic surgery.