Robotics the future of surgery

Abstract

The frontiers of surgery as we know them are expanding at an astounding pace. As medical students, it is essential that we brace ourselves for what this field may have in store for us when we take our places as surgeons. Developments in technology coupled with the demand for improved patient safety and surgical finesse are fuelling a revolution in the field of surgery. This has brought about the introduction of minimally invasive or laparoscopic surgery. Nowadays for several routine operations this has become the gold-standard, replacing the open-approach. However, laparoscopic surgery has several flaws; it employs the use of long rigid instruments. This results in the exaggeration of a surgeon’s natural tremor and a reduction in haptic feedback. The arrangement of the instruments relative to the surgeons’ hands and eyes does not provide an ergonomically favoured position. The use of ports on the patient’s torso creates a fulcrum effect, whereby the surgeon must move the handle of an instrument to the left in order to manoeuvre the tip of the instrument to the right. The human hand provides seven degrees of movement whereas a laparoscopic instrument only provides four, thus limiting manoeuvrability. Visualisation of the body cavity is made with a two-dimensional (2D) image rather than a three-dimensional view used during open surgery. This 2D image is provided by a human-controlled camera that is susceptible to movement making a surgeon’s work difficult. These limitations made it clear that new techniques were required to improve minimally-invasive surgery. 1–3