Robotic surgery, 301025.pptx, by Lt Col SM Shahadat Hossain Thoracic Surgeon CMH Dhaka

I'm am Lt Col SM Shahadat Hossain,Thoracic Surgeon, Bangladesh Army, and this pptx for training purposes of young Surgeons .

1. Robotic Surgery Lt Col SM Shahadat Hossain

2. Introduction Czech word “ robota ”, meaning “labor ” Robot is a programmable device doing complex actions automatically with speed & precision Robotic surgery or robot-assisted surgery is any type of surgical procedure that is performed with the use of robotic systems

3. Why it is important? Overcome the limitations of pre-existing minimally invasive surgical procedures Enhance the capabilities of surgeon

4. History 1985: The PUMA 560 ( Unimation Inc.) Programmable Universal Machine for Assembly— robot placed needle for CT guided brain biopsy

5. In 1992, Robodoc

6. d a Vinci System (Intuitive Surgical Inc.) Surgeon's Console Vision Car t Patient Car t 2003 — Intuitive Surgical Inc .

7. Types 1. Supervisory controlled robotic surgery system. 2. The T ele surgical system. 3 . da V inci robotic surgical system. 4. ZEUS robotic surgical system. 5.Automated Endoscopic System for Optical Position(AESOP) robotic surgical system . 6. Shared control robotic surgical system . 7. Cyber knife System.

8. Application of robotic surgery Gastrointestinal Urology Thoracic Gynecology Colorectal General surgery Orthopaedic Cardiac Transplant surgery Plastic and Reconstructive Surgery Ophthalmology ENT Dentistry and Orthodontics

9. Supervisory controlled robotic surgery system Most automated system Specific set of instruction required R obot programing Mapping of patients in 3 ways 1. Planning 2. Registration 3.Navigation Used in hip and Knee replacement procedure

10. Tele surgical system Also called remote surgery Surgery is performed by robotic system controlled by surgeon at distant site Advantages: 1 . Assisting and training surgeons in developing countries . 2. Collaborating and mentoring during surgery by surgeons around the globe .

11. da V inci robotic surgical system First FDA approved robotic system in American operating rooms Provides 7 degree of freedom in instruments Surgeon directs motion of robots Components: 1. Viewing and controlling console. 2. Surgical arm unit (4 arms ).

12. 7 Degrees of Freedom 3 Translational DOF 3 Rotational DOF 1 Grasping Yaw Rotation Wristed Yaw Wiced Pñ‹:h

13. da V inci system Uses: 1.Thoracic surgical procedure 2.Prostatic cancer surgery 3. Mitral valve repair 4. Hysterectomy

14. Fourth generation robot Third generation robot

15. ZEUS robotic surgical system Made up of ergonomic surgical control console and 3 table mounted robotic arms Voice control and touch screen interfaces with 2 monitors are used in surgical control console Used in: 1 . Micro surgical tasks. 2 . Endoscopic surgery.

16. ZEUS

17. AESOP robotic surgical system End effectors: Endoscope coupled to a robotic arm assembly which move endoscope relative to patient System includes: 1. Computer control movement of robotic arms. 2. Cart. 3. Spring loaded mount plate .

18. AESOP

19. Shared control robotic surgical system Robotic system monitors surgeon performance and provides stability and support through active constraint Surgeon must first go through planning, registration and navigation phages with operative area Only after inputting that information into robots system robot can offer guideline

20. Shared control

21. Cyber knife System Delivers multiple beams of radiation to the tumour Prior to the procedure patient is imaged using HRCT scan, to determine dimension and location of tumour Image data is transferred to the Cyber knife System’s workstation

22. Cyber knife

23. Approaches to Automation Predefining m otions execution of steps without ability to adapt to environment will fail in real surgical situations if there is movement Automated suturing using EndoBot system on simulated tissue

24. Preparing & Draping system Roll-up — Positioning patient- cart next to patient bed Deployment — adjusting angles of robotic arms to ensure clearance between arms & patient Docking — Securing connection b/w arm & patient Undocking > Undraping > Cleaning Stowing arms to minimize storage space required

25. How to work? Preparing & Draping system Roll-up — Positioning patient-cart next to patient bed Deployment —adjusting angles of robotic arms to ensure clearance between arms & patient Docking — Securing connection b/w arm & patient Undocking> Undraping > Cleaning Stowing arms to minimize storage space required

26. Learning Curve C ost Tele- Surgical Latencies Challenges

27. Advantages Be tt er accuracy, precision, dexterity Tremor corrections Scaled motion Haptic corrective feedback - gives a sense of touch, vibration and other information Tele- Surgery

28. Robotic round

29. Robotic Scrub Nurse

30. Future operating room

31. Conclusion Robotic surgery has proven value in areas of inaccessible, during conventional laparoscopic procedure Robotic surgery is a rapidly evolving technology and artificial intelligence integration a new way to interpret modern surgery

32. REFERENCES 1.Principles and Practice of Robotic Surgery 1st Edition by Anthony J. Costello. 2.Kwoh YS, Hou J, Jonckheere EA, Hayati S. A robot with improved absolute positioning accuracy for CT guided stereotactic brain surgery. IEEE Trans Biomed Eng. 1988;35(2):153–160. 3 .Gaboardi F, Pini G, Suardi N, et al. Robotic laparoendoscopic single-site radical prostatectomy (R-LESS-RP) with daVinci Single-Site(r) platform Concept and evolution of the technique following an IDEAL phase 1. J Robot Surg. 4. Internet

33. Thank you for attention !