Robotics and telepresence urologic surgery Where do we stand?

Minimally Invasive Surgery [MIS] is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. Open surgery requires precise movements by the surgeon, while laparoscopic surgery requires even more small and precise movements. The use of long, rigid laparoscopic instruments amplify the normal tremor of the human hand and produce a fulcrum effect because of the trocars. Unfortunately, these disadvantages reduce dexterity, workspace, and sensory input to the surgeon which is only available through a single video image. With the telesurgical workstation, the conventional surgical tools are replaced with robotic instruments which are under direct control of the surgeon through teleoperation. The goal is to restore the manipulation and sensation capabilities of the surgeon which were lost due to minimally invasive surgery. A 6 DOF slave manipulator, controlled through a spatially consistent and intuitive master will restore the dexterity, the force feedback to the master will increase the fidelity of the manipulation, and the tactile feedback will restore the lost tactile sensation