ABSTRACT
BACKGROUND: The authors believe it would be useful to have surgical robots capable of some degree of autonomous action in cooperation with the human members of a surgical team. They believe that a starting point for such development would be a system for delivering and retrieving instruments during a surgical procedure. METHODS: The described robot delivers instruments to the surgeon and retrieves the instruments when they are no longer being used. Voice recognition software takes in requests from the surgeon. A mechanical arm with a gripper is used to handle the instruments. Machine-vision cameras locate the instruments after the surgeon puts them down. Artificial intelligence software makes decisions about the best response to the surgeon's requests. RESULTS: A robot was successfully used in surgery for the first time June 16, 2005. The operation involved excision of a benign lipoma. The procedure lasted 31 min, during which time the robot performed 16 instrument deliveries and 13 instrument returns with no significant errors. The average time between verbal request and delivery of an instrument was 12.4 s. CONCLUSIONS: The described robot is capable of delivering instruments to a surgeon at command and can retrieve them independently using machine vision. This robot, termed a "surgical instrument server," represents a new class of information-processing machines that will relieve the operating room team of repetitive tasks and allow the members to focus more attention on the patient.
Subject(s)
Forearm , Lipoma/surgery , Robotics , Surgery, Computer-Assisted , Surgical Instruments , Adult , Electronic Data Processing , Equipment Design , Female , Humans , Robotics/instrumentation , Speech Recognition Software , Surgery, Computer-Assisted/instrumentationABSTRACT
Healing is a mystery that can be so profound that even the most intellectual among us cannot understand it. Healing is a life-affirming process that builds on a one-to-one relationship. We can change. We can be different. We are able to change relationships by influencing others. The past can be altered and brought into the moment, and change begins. We do this by changing our belief system, altering our behavior, and opening our hearts to healing. Changing is a personal choice. Healing allows one to move beyond the present, let go of judgments, nurture oneself and others, and balance growth opportunities. It is through natural processes that healing is allowed to happen even though we may not be familiar with the healing methods or they may be beyond what we consider natural.
Subject(s)
Holistic Nursing/organization & administration , Interprofessional Relations , Nursing Staff, Hospital/psychology , Patient Care Team/organization & administration , Perioperative Nursing/organization & administration , HumansABSTRACT
The continued demand for more efficient and functionally rich automated systems will force health care facilities into a changing and complex marketplace. As the Request for Proposal (RFP) will be the key document in the systems acquisition process, it is imperative that a systematic process must be established to evaluate the vast array of data collected. It is suggested in this paper that the effective application of the Advanced Multi-Attribute Scoring Technique (AMAST) will assist in this process, enhance the decision making process and reduce the risk associated with systems development and procurement.
