A consensus document on robotic surgery

Herron, Daniel M.; Marohn, Michael R.; Advincula, Advincula A.; Aggarwal, Sandeep; Palese, Michael; Broderick, Tim; Broeders, I. A. M. J.; Byer, A; Curet, Myriam J.; Earle, David; Giulianotti, Piero; Grundfest, Warren S.; Hashizume, Makoto; Kelley, William E.; Lee, David I.; Weinstein, Gregory S.; McDougall, Elspeth M.; Meehan, John J.; Melvin, Scott; Menon, Mani; Oleynikov, Dmitry; Patel, Vipul; Satava, Richard M.; Schwaitzberg, Steven D.

doi:10.1007/s00464-007-9727-5

Cited by 350 publications

(195 citation statements)

References 84 publications

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“…The development of the single-site systems signifies further new options for the gynecological surgeon ( Figure 2). For instance, freedom of movement is now maximized by the introduction of one or more additional working trocars (4,5). The low level of postoperative pain appears to be another advantage.…”

Section: Robotic Surgery In Gynecologymentioning

confidence: 99%

Robotic surgery in gynecology

Alkatout

Mettler

Maass

et al. 2016

J Turkish German Gynecol Assoc

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Review 224 Robotic surgery in gynecologyRobotic surgery is a dynamic development for minimally invasive procedures. The specialty of gynecology consistently offers new opportunities for innovative surgical techniques and the advancement of existing therapy approaches (Figure 1). Ever since the American FDA granted approval of the Da Vinci operation robot for gynecological operations in 2005, about three million robotic operations have been performed worldwide. 3500 Da Vinci systems are currently in use: 586 of these in Europe and 77 in Germany (4 th quarter of 2015). According to the figures of Intuitive Surgical, about 600,000 interventions were performed on a worldwide basis in the year 2014, of which 50% were performed in gynecology, approximately 30% in urology, and about 20% in general and chest surgeries. In 2011, the proportion of robotic hysterectomies performed for benign indications in the USA was as high as 27% (1). Currently, we have experience in robotic surgery for the majority of gynecological operations and fields of application. The known advantages of minimally invasive surgery, such as less blood loss, shorter durations of hospital stay, and lower patient morbidity compared to open procedures, have been observed here as well. Better exposure of the operating field by 3D technology and the extension of surgical instruments to 7 degrees of freedom permit the use of minimally invasive surgery, even for complex indications. Robot-assisted manipulation of the instruments permits tremor-free handling and reduces work fatigue for the surgeon, which is very advantageous for the surgeon as well as the patient in long and complex interventions. The possibility of working simultaneously on two parallel consoles shortens the learning curve, reduces complication rates, and facilitates the training of surgeons (2). The advancement of robotic surgery in terms of the Da Vinci Xi permits the variable use of optics in all four trocars (paraaortic lymphadenectomy, omentectomy, or interdisciplinary surgery in the upper abdomen can be performed without re-docking) and ensures markedly greater flexibility due to the optimized geometry of the so-called patient cart. Robotic surgery has been criticized for the fact that it requires the use of larger trocars compared to conventional laparoscopy, and is therefore associated with more numerous and larger cosmetic scars; this is avoided by the smaller trocars now used in robotic surgery (3). The development of the single-site systems signifies further new options for the gynecological surgeon (Figure 2). For instance, freedom of movement is now maximized by the introduction of one or more additional working trocars (4, 5). The low level of postoperative pain appears to be another advantage. It is accompanied by a lesser need for analgesics and even shorter hospital stays compared to traditional laparoscopic surgery. One explanation could be the fact that the abdominal wall need not be used as a counter bearing. The absence of irritation and the advantage of tissue protec...

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Section: Robotic Surgery In Gynecologymentioning

confidence: 99%

Robotic surgery in gynecology

Alkatout

Mettler

Maass

et al. 2016

J Turkish German Gynecol Assoc

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“…Several factors including establishing adequate access, two dimensional vision, decreased depth perception, restricted instrument maneuverability, decreased dexterity and dampened tactile feedback are all unique limitations that make robotic assisted surgery challenging for surgeons trained in traditional open approaches [17,18].…”

Section: Future Trendsmentioning

confidence: 99%

Bridging the gap between robotic technology and health care

Andrade

Pereira

Walter

et al. 2014

Biomedical Signal Processing and Control

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Although technology and computation power have become more and more present in our daily lives, we have yet to see the same tendency in robotics applied to health care. In this work we focused on the study of four distinct applications of robotic technology to health care, named Robotic Assisted Surgery, Robotics in Rehabilitation, Prosthetics and Companion Robotic Systems. We identified the main roadblocks that are limiting the progress of such applications by an extensive examination of recent reports. Based on the limitations of the practical use of current robotic technology for health care we proposed a general modularization approach for the conception and implementation of specific robotic devices. The main conclusions of this review are: (i) There is a clear need of the adaptation of robotic technology (closed loop) to the user, so that robotics can be widely accepted and used in the context of heath care; (ii) For all studied robotic technologies cost is still prohibitive and limits their wide use. The reduction of costs influences technology acceptability, thus innovation by using cheaper computer systems and sensors are relevant and should be taken into account in the implementation of robotic systems.

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“…More than 850 robotic systems are currently in use for laparoscopic procedures in abdominal, urologic, pelvic, cardiothoracic, and neurologic surgery, [1][2][3][4][5][6][7][8] showing a broad spectrum of advantages. Worldwide, more than 20 000 robotic surgical procedures have been performed each year since 2004.…”

Section: Introductionmentioning

confidence: 99%

‘The Microhand’: a new concept of micro-forceps for ocular robotic surgery

Hubschman

Bourges

Choi³

et al. 2009

Eye

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Purpose To test the feasibility of retinal manipulations using a new micromanipulator (Microhand) for ocular robotic microsurgery. Methods Pneumatically actuated four-finger microhands were developed at UCLA with micro electromechanical systems (MEMS) technology to mimic a human hand for small object manipulation. Microhands with four 4 mm finger lengths were used for this study to lift caliper weights and fresh retinal tissue of porcine cadaver eyes to find the maximum force at a given pressure and feasibility of the microhands for retinal manipulation in real surgery. Results A full closure of the microhand used for caliper weight lifting was achieved under 65 psi (448 kPa) of air pressure. The fourfingered microhand was able to develop about 20 mN of total lifting force and 5 mN per finger at 80 psi (551 kPa), and was strong enough to displace and lift the retina of pig eyes. Conclusions The microhand is able to apply calibrated forces to ocular tissues and is suitable for ocular microsurgical procedures. This new tool would be useful in the development of robotic microsurgery.

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A consensus document on robotic surgery

Cited by 350 publications

References 84 publications

Robotic surgery in gynecology

Robotic surgery in gynecology

Bridging the gap between robotic technology and health care

‘The Microhand’: a new concept of micro-forceps for ocular robotic surgery

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