Robotic Surgery: A Current Perspective

Anthony R. Lanfranco, BAS; Andres E. Castellanos, MD; Jaydev P. Desai, PhD; William C. Meyers, MD

Disclosures

Annals of Surgery. 2004;239(1) 

In This Article

Advantages of Robot-Assisted Surgery

The advantages of these systems are many because they overcome many of the obstacles of laparoscopic surgery ( Table 1 ). They increase dexterity, restore proper hand-eye coordination and an ergonomic position, and improve visualization ( Table 2 ). In addition, these systems make surgeries that were technically difficult or unfeasible previously, now possible.

These robotic systems enhance dexterity in several ways. Instruments with increased degrees of freedom greatly enhance the surgeon's ability to manipulate instruments and thus the tissues. These systems are designed so that the surgeons' tremor can be compensated on the end-effector motion through appropriate hardware and software filters. In addition, these systems can scale movements so that large movements of the control grips can be transformed into micromotions inside the patient.[6]

Another important advantage is the restoration of proper hand-eye coordination and an ergonomic position. These robotic systems eliminate the fulcrum effect, making instrument manipulation more intuitive. With the surgeon sitting at a remote, ergonomically designed workstation, current systems also eliminate the need to twist and turn in awkward positions to move the instruments and visualize the monitor.

By most accounts, the enhanced vision afforded by these systems is remarkable. The 3-dimensional view with depth perception is a marked improvement over the conventional laparoscopic camera views. Also to one's advantage is the surgeon's ability to directly control a stable visual field with increased magnification and maneuverability. All of this creates images with increased resolution that, combined with the increased degrees of freedom and enhanced dexterity, greatly enhances the surgeon's ability to identify and dissect anatomic structures as well as to construct microanastomoses.

processing....