Surgical Robots - Research Paper

Introduction

Robotic surgery that is also known as robot-assisted surgery in the medical field helps doctors in performing many types of complex procedures with more control, precision and flexibility than it would be with conventional techniques. It is a surgery that is associated with minimal invasion meaning that they are procedures that are performed through tiny incisions. Such surgeries are created with the aim of making surgery convenient to people. Robotic surgery was created as a result of the advancement of different technologies across the globe. This surgical procedure allows people to undergo numerous processes that involve robots. With its advancement, there has been speculations as well as issues regarding the convenience and danger that this surgery has brought to the people and despite the fact that it has benefits, people opt to understand and consider the risks associated with the robotic surgical procedure. This paper tries to explain more about robotic surgery as well as the pros and cons of this surgical procedure.

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Robotic surgery by the use of the da Vinci surgical system was approved in 2000 by the Food and Drug Administration. The procedure has been adopted rapidly by hospitals in Europe and the United States to be employed in the treatment of a variety of conditions. The mechanical arms and the camera arm with attached surgical instruments are the most widely used clinical robotic surgical system whereby the surgeon while seated at the operating table at a computer console, controls the arms. The surgeon is able to get a magnified, high-definition, 3-D view from the console of the surgical site. The surgeon then principals other team members who help in the operation. These procedures were made to be able to enhance the abilities of those surgeons who perform open surgery. The instruments despite being controlled by the use of a computer, they can be controlled through direct telemanipulator, a remote manipulator which enables surgeons to do the normal movements that are associated with the surgical procedure while the movements are carried out by robotic arms by the use of manipulators and end-effectors to complete the actual surgery on patients.

The use of the da Vinci Surgical System in the United States was approved in 2000 by the United States Food and Drug Administration in the robotically assisted surgery performance. The rate of growth in the use of this system has increased impressively. Since its approval in 2000 up to 2013, the system had performed 367,000 surgical procedures in the United States and 1.5 million procedures across the globe. For specific kinds of surgeries, the robotic system is becoming the system of choice by many surgeons. According to the Intuitive Surgical of Sunnyvale California, a staggering 87% of prostatectomies, as well as 27% of all Hysterectomies for benign conditions, used the da Vinci system as of 2013. It is as a result of this that the number of risky open surgery procedures has reduced in cases where large incisions have to be done as well as where the patient's body is opened up in order to allow operations of traditional surgical techniques.

In the world of surgical robotics, the da Vinci system acts as the monopoly despite there being more systems under enhancement and inevitability of competition. The makers of this system claim that it is a tool which utilizes or uses enhanced robotic technologies aiming at assisting the surgeons in conducting operations or surgeries. The system operates by the surgeon controlling the movements at the console. Among the four arms of the system, one arm has a 3D high definition vision system with a magnifying capacity of up to 10 times which gives the surgeon an enhanced vision while the computer system and the special instruments enable the surgeon to conduct the operation with enhanced control, precision as well as dexterity. The system instruments have mechanical wrists which rotate and bend that mimics the movements of a human wrist that enables the surgeon to make movements that are small and precise inside the patient's body.

During the operation, some small incisions known as keyhole incisions are usually made on the body of the patient. Carbon dioxide is then passed into the abdomen in order to expand it giving the doctor an easier view area. an endoscope attached to one of the arms is then passed through one of the keyhole incisions. It lights, projects and magnifies an image of the interior organs on a video screen. The other arms hold tools which are able to cut, stitch, grasp, as well as dissect which may include the scalpels, forceps, dissectors, and scissors. Robotic surgeries are associated with the shorter time of stay in hospitals, less postoperative scarring, and pain as well as lower infection risks and blood transfusion need than the open surgery. This surgery utilizes tools which perform certain actions with feedback-controlled and smoother motions which a human hand could achieve. The main reason for the use of such smart instruments is to eliminate or reduce the tissue trauma which traditionally was associated with open surgery which does not require much time for surgeons to train.

Robotic surgery has aided major advances such as unmanned surgery, remote surgery, and minimally invasive surgery. Robotic surgery has ensured smaller incisions such as quicker healing time, less pain, decreased blood loss, it has also ensured precision, as well as miniaturization. The three-dimensional magnification and articulation beyond the normal manipulation help in ensuring improved ergonomics which as a result leads to fewer stays in hospitals, less, transfusion, less blood loss as well as less use of pain medication. Robotic surgery requires some additional training by the surgeons and physicians in order to operate the system.

The reduced cost of medical bills is important to both the patient and people. The surgical procedure can be conducted when the surgeons are the distance from the patient and still provide quality services as well as health care support to their patients. The robotic surgical procedure in comparison to regular surgical procedures is not much tiring mainly because the surgeons and the assistants using the robotic surgical procedure eliminates body pains as well as straining since the procedure only lasts for less period of time. In comparison to other surgical procedures which are usually rendered by physicians and doctors, robotic surgery ensures precision and accuracy of the surgery.

Some of the disadvantages of robotic surgery are that it takes longer operation hours depending on the procedural extent meaning that the costs or the bill payable by the patient will be too high too because of the use of the higher quantity of amnesia that is injected in the body of the patient. Robotic surgery has no fixed price or cost and therefore, those patients that intend to undergo the procedure has been always prepared with higher amounts of money which will be enough to pay high medical bills. In robotic surgery procedure, there is limited compatibility of the technology or system used and therefore the patient is required to ensure that before being operated, they have the assurance that every equipment required is compatible and safe to use.

For a surgeon to become adept to the use of robotic surgeries, research has shown that they require to perform between 150 to 250 procedures since the whole learning process is intensive. During training, minimally invasive procedures might take up to two times as long as traditional surgery which may lead to tie-ups in the operating room as well as patients being kept under anesthesia by the surgical staffs for longer periods. The procedures chosen is usually based on expectations of less pain, decreased morbidity, reduced blood loss as well as improved outcomes. In robotic surgery, the hand tremors that occur naturally are filtered out by the computer software of the robot. Rotating surgical teams can continuously use the surgical robot. The positioning of the camera is usually meaningfully steadier under the robotic controls with less inadvertent movements in comparison to humanitarian assistance.

There is usually no haptics in current robotic surgery usage meaning that there is no tactile feedback or force feedback and surgeons are not able to feel the interaction with the patient by the instrument. There are possibilities that the robots can be very large, may have issues with multi-quadrant surgery as well as may have instrumentation limitations since the devices are mainly for the single-quadrant application. There are critics of the system which claim that the learning curve for surgeons is steep of those who employs the use of the system also that studies indicating long-term results of the system are superior in comparison to traditional laparoscopic surgery results are minimal or even lacking. Despite having many benefits to the patients, the robotic surgery system is not clear as to whether it is cost-effective for the physicians and hospitals mainly because there is usually no additional reimbursement that is paid by the insurance companies or the government whenever the system is used.

This system seems to be an awesome additional tool to surgery but there have been safety concerns that have been raised concerning this system. Questions of cost and safety have been raised. Some scholars argue that there are circumstances where the is not riskier in comparison to alternative surgery type even though it has cost expensive problem. Other scholars say that the system is more expensive and dangerous to patients since there have been reports that this system causes injuries to patients undergoing robotic-assisted surgeries. The advantages of robotic surgery are that it can be done in a manner that is less restraining. This means that the patients undergoing the surgery are operated by very few numbers of physicians which intern reduces the costs of medical bills.

Therefore, according to John Sullins, it's better that people should be hopeful since the robotic surgery promises a lot for the beneficial outcomes to patients. By this, John bases his argument on the fact that by the use of robots in surgery, the operation times have increased as the patient's recovery time has decreased. John claims that if safety can increase and the cost of care decreases, also a way to cross the digital divide which separates the robotic surgery use in the less developed countries is found, then robotic surgery will be additional technoscience of surgery. John claims that in the contrary, the prognosis for the surgery professionals or physicians is a mixed bag mainly because some will end up receiving many academic as well as financial rewards due to their innovative works of bringing more enhanced and autonomous machines in the operation theatres but such a success may mean that the surgery profession will be no longer open to new practitioners as it was in the past.

If surgical robots are considered and seen as skilled technicians, then the human surgeons in the future will lose their statuses as important professionals in the field of surgery. John argues that any surgeon has to be driven or guided by altruistic motivations and not self-interests and therefore, surgeons have to not allow the potential for financial gain to impact their assessment of if a groundbreaking procedure benefits their patient truly if they are to maintain their position as professionals in the society hence the future of surgical enhancement is tense with ethical concerns. According to John, some of these future concerns will be much more challenging which one of them would be the grafting of the robotic devices or equipment in humans.

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