ABSTRACT
BACKGROUND: Minimally invasive colon surgery was first described in the early 1990s, decreasing the morbidity compared with open procedures. Recently, single port laparoscopy has emerged, with reports of applications to colon surgery. Although feasible, many new technical challenges exist. METHODS: An optimal operative technique for colon resection entirely through the umbilicus, using a robot and a GelPort is described. RESULTS: The robotic advantages of visualization and articulation minimize the disadvantages of single incision surgery. Programming the robotic arms in reverse decreases instrument clashing. In addition, the GelPort allows for trocar spacing and freedom of placement while providing a wound protector for specimen extraction. CONCLUSIONS: As single port surgery develops, disadvantages must be overcome. Using a combination of the robot and GelPort, these disadvantages are addressed and minimized.
Subject(s)
Colon/surgery , Colonic Neoplasms/surgery , Robotics/methods , Adenocarcinoma/surgery , Cecal Neoplasms/surgery , Equipment Design , Female , Humans , Laparoscopes , Laparoscopy/methods , Lymph Node Excision/methods , Middle Aged , Minimally Invasive Surgical Procedures , Time Factors , Umbilicus/surgeryABSTRACT
OBJECTIVE: To evaluate the role of force feedback with applications to minimally invasive surgery (MIS). Two research hypotheses were tested using our automated laparoscopic grasper. SUMMARY BACKGROUND DATA: Conventional laparoscopic tools do not have the ability of providing force feedback to a surgeon when in use with or without robotic surgical systems. Loss of haptic (force and tactile) feedback in MIS procedures is a disadvantage to surgeons since they are conventionally used to palpating tissues to diagnose tissues as normal or abnormal. Therefore, the need exists to incorporate force feedback into laparoscopic tools. METHODS: We have developed an automated laparoscopic grasper with force feedback capability to help surgeons differentiate tissue stiffness through a haptic interface device. We tested our system with 20 human subjects (10 surgeons and 10 nonsurgeons) using our grasper to evaluate the role of force feedback to characterize tissues and answer 2 research hypotheses. RESULTS: Our experiments confirmed 1 of our 2 research hypotheses, namely, providing both vision and force feedback leads to better tissue characterization than only vision feedback or only force feedback. CONCLUSIONS: We have validated 1 of our 2 research hypotheses regarding incorporating force feedback with vision feedback to characterize tissues of varying stiffness.
Subject(s)
Feedback , Minimally Invasive Surgical Procedures/instrumentation , Biocompatible Materials , Computer Simulation , Humans , Hydrogels , Touch , Visual PerceptionABSTRACT
OBJECTIVE: To review the history, development, and current applications of robotics in surgery. BACKGROUND: Surgical robotics is a new technology that holds significant promise. Robotic surgery is often heralded as the new revolution, and it is one of the most talked about subjects in surgery today. Up to this point in time, however, the drive to develop and obtain robotic devices has been largely driven by the market. There is no doubt that they will become an important tool in the surgical armamentarium, but the extent of their use is still evolving. METHODS: A review of the literature was undertaken using Medline. Articles describing the history and development of surgical robots were identified as were articles reporting data on applications. RESULTS: Several centers are currently using surgical robots and publishing data. Most of these early studies report that robotic surgery is feasible. There is, however, a paucity of data regarding costs and benefits of robotics versus conventional techniques. CONCLUSIONS: Robotic surgery is still in its infancy and its niche has not yet been well defined. Its current practical uses are mostly confined to smaller surgical procedures.
