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10.5005/jp-journals-10033-1304
Telerobotic Surgery: Transcending Barriers
RevieW aRticLe

Telerobotic Surgery: Transcending Barriers

J Rohan Krishna

ABSTRACT in New York. Following this landmark event, telerobotic

Telerobotic surgery has the potential to revolutionize the field surgery has been performed in various places around the
of medicine and health care delivery in the near future. Rapid world with successful results.
technological advancements have been made in the field of
robotic surgery, and telerobotic surgery in particular. Through AIM
telerobotic surgery, it is possible to provide advanced surgical
care to patients even in the remotest of places and for experi- The aim of this article is to study the origin, implementa-
enced surgeons to guide young surgeons to perform complex tion, and latest advancements in the field of telerobotic
surgeries. The aim of this study is to trace the origin, imple-
mentation, and developments in the field of telerobotic surgery. surgery.
Keywords: Minimally invasive surgery, Robotic surgery, Telero-
botic surgery, Telesurgery. MATERIALS AND METHODS
How to cite this article: Krishna JR. Telerobotic Surgery: A literature search was performed using PubMed and
Transcending Barriers. World J Lap Surg 2017;10(2):57-60. search engine Google. The following keywords were
Source of support: Nil used “telerobotic surgery,” “robotic surgery,” and “tele-
surgery.” Selected papers were screened for further ref-
Conflict of interest: None
erences with respect to the origin, implementation, and
latest advancements in the field of telerobotic surgery.
INTRODUCTION
Technological advancements continue to occur at a RESULTS AND DISCUSSION
rapid pace in all walks of life, and the field of surgery
is no exception to it. Minimally invasive surgery that A telerobotic system primarily consists of surgeon’s
“master” console from where the surgeon operates and
has revolutionized the field of surgery offering distinct
advantages over open surgery also has limitations a patient-side “slave” unit that performs surgery on the
like loss of dexterity and two-dimensional vision of patient using robotic arms. In telerobotic surgery, the
the operative field. Robotic surgery and telepresence surgeon operates from the surgeon’s console, which is
surgery have addressed the limitations of laparoscopic thousands of miles away from the slave robotic arm
procedures and have revolutionized the field of minimal mounted on the patient; the surgeon’s commands are
access surgery. In the early 1970s, NASA commissioned relayed to the slave manipulator via fiberoptic cables.
a project to perform surgeries on astronauts using Two major factors impacting the outcome of telerobotic
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remotely controlled robots. Kwoh et al used a Robot- surgery are data transmission speed and communication
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Puma 200 and performed neurosurgical biopsies with latency. Round-trip latency represents the time interval
greater precision. In 1988, ultrasound-guided prostatic between the initiation of movement by the surgeon and
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resection was done using PROBOT, a robotic system. the appearance of image on the monitor.
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Real breakthrough in telerobotic surgery came in 2001 Professor Marescaux et al performed the first success-
when Professor Marescaux performed the first transat- ful telerobotic surgery on September 7, 2001, which was
lantic telesurgical procedure (Operation Lindbergh) on a famously known as Operation Lindbergh. This surgery
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patient in France. Professor Marescaux et al performed was completed using a commercially available robotic
laparoscopic cholecystectomy on a 68-year-old lady in surgery system, called Zeus T, which featured a robotic
Strasbourg, France, using a Zeus robotic system located endoscope positioning system called AESOP (Automated
Endoscope System for Optimal Positioning). Professor
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Marescaux et al were able to minimize latency using a
Senior Resident dedicated multiservice transmission network provided
Department of General Surgery, Karpagam Faculty of Medical by France Telecom. First trial simulations of telesurgery
Sciences & Research, Coimbatore, Tamil Nadu, India took place in 2000 with a transmission delay of 200 ms.
Corresponding Author: J Rohan Krishna, Senior Resident Subsequent work reduced the time delay to 150 ms even
Department of General Surgery, Karpagam Faculty of Medical though the round-trip distance was 14,000 km. Flawless
Sciences & Research, Coimbatore, Tamil Nadu, India, e-mail: network quality with guaranteed bandwidth of 10 mega-
jrohankrishna@gmail.com
bits per second and transmission delays of less than 200 ms
World Journal of Laparoscopic Surgery, May-August 2017;10(2):57-60 57