Page 32 - Laparoscopic Surgery Online Journal

10.5005/jp-journals-10033-1204
Mohammed Khairy Ali et al
REVIEW ARTICLE
Robotic Gynecological Surgery: A Clinical Approach

Mohammed Khairy Ali, Ahmed Y Abdelbadee, Sherif A Shazly, Ahmed M Abbas

ABSTRACT been introduced from about 25 years. The first application
Objective: To provide a review in the available literature in of a robot in surgery was in neurosurgery then in orthopedic
robotic gynecological surgery, focusing on history of robotic surgery which used a device to aide in total hip replacements,
surgery, basic setup, advantages and disadvantages of the also in the field of urology, transurethral resection of the
robotic surgery, uses of surgical robots, the future of the robotic
prostate can be performed by a robot through guidance from
surgery and finally laparoendoscopic single site robotic surgery.
a preoperatively constructed three-dimensional (3D) image. 1
Design: Literature survey.
Robotic surgery carries with it the potential to transform
Conclusion: Although it is not evident that robotic surgery is laparoscopic surgery by providing instruments with distal
superior to conventional laparoscopic surgery in surgical
ends that is similar to the fine movements of the human
outcomes, many studies demonstrate the positive feasibility of
hand and it can also provide the surgeon with a high-
robotic assisted laparoscopic surgery in many gynecological
fields including cancer. Robotic surgery is considered as a definition, 3D view of the operative field. As this technology
solution for the technical problems of minimal invasive surgery. grows and develops, the hope is that further development
However, the economic feasibility of robotic surgery still remains
will allow for more precise and even less invasive surgical
as an obstacle which should be overcomed. It is expected with
further development of robotic technology that the concept of options beyond laparoscopy and the current forms of surgical
2
high cost will be resolved. robots. The robotic systems begin to be put to many tests,
the surgeons are focusing on the surgical robot not as a
Keywords: Single-port laparoscopy, Robotic surgery,
Gynecologic surgery. mechanical device but as an information system, so robotic
system should be fused with other information systems. One
How to cite this article: Ali MK, Abdelbadee AY, Shazly SA,
Abbas AM. Robotic Gynecological Surgery: A Clinical Approach. example of this type of fusion is image-guided surgery, also
World J Lap Surg 2013;6(3):156-162. called surgical navigation. Robot-assisted surgeons will be
able to see real-time, 3D images electronically of the
Source of support: Nil
operative field that is displayed on the monitor. In other
Conflict of interest: None declared words, on the screen, human anatomy will be appear
translucent, and the surgeon will be able to determine the
INTRODUCTION
exact location of a lesion and more readily avoid damaging
Operative laparoscopy developed a lot in the last years and vital structures such as major vessels. In fact, with
the appearance of minimally invasive surgery (MIS) led to preoperative scanner images, surgeons could robotically
practice their patients’ surgery the night before, and
advances in general surgery as well. Operative laparoscopy
the robot’s computer could be programmed not to
was initiated in the 1970s, while laser and electric energy
allow its instruments to penetrate vital organs so avoid
technology was integrated into laparoscopic surgery in the 3
intraoperative accidents.
early 1980s. Now, laparoscopic surgery has become an
essential part of surgical treatment for many diseases HISTORY OF ROBOTIC SURGERY
including cancers. Compared with laparotomy, laparoscopic
The term ‘robot’ was first introduced to the public in 1921
approach offers several advantages, such as faster return to
when the Czech writer Karel Capek described the notion in
normal activity, better cosmetic results and shorter length
his play Rossum’s Universal Robots. The term ‘robot’
of hospital stay. The technology and techniques related to
originated from ‘robota,’ which means ‘work’ in the Czech
laparoscopic surgery are still evolving to the direction of
language. For many years, robots have achieved development
easier and less invasive laparoscopic surgery. So wherever from simple machines performing the same tasks to a highly
in the body a cavity exists or a cavity can be created, sophisticated machine capable of performing very delicate
laparoscopy is indicated and probably preferable. The operation. In the surgical field, automated endoscopic system
limiting factor is the availability of proper instruments, skill for optimal positioning (AESOP) was the first laparoscopic
and experience of the surgeon. Despite several advantages camera holder by robot. Although AESOP has been used
of laparoscopic surgery, the disadvantages of conventional in over 10,000 laparoscopic surgeries, it was only designed
laparoscopy limit its use. However, the robotic surgery has to offer greater vision control to the surgeon and to eliminate
been developed to overcome on the current limitations of the need for an assistant who manipulated the endoscope. 4
conventional laparoscopy. The use of robots in surgery has Computers and technology are increasingly interacting with
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