Page 26 - World Association of Laparoscopic Surgeons - Journal

WJOLS
10.5005/jp-journals-10007-1146
Role of Robotics in Whipple’s Surgery
REVIEW ARTICLE
Role of Robotics in Whipple’s Surgery

B Srinivas

ABSTRACT In computer-controlled systems, the surgeon uses a
computer to control the robotic arms and its end-effectors,
Whipple is one of the most demanding and complex surgeries
of the abdomen. It is the most commonly performed operation though these systems can also still use telemanipulators for
for pancreatic cancer, the fourth leading cause of cancer death their input. One advantage of using the computerized
in the United States. For patients with benign as well as
malignant pancreatic tumors, it is believed that the robotic method is that the surgeon does not have to be present,
Whipple procedure will be a major improvement over the indeed the surgeon could be anywhere in the world, leading
traditional procedure. The robotic surgery involves five small to the possibility for remote surgery.
incisions (one to accommodate a miniature camera), rather than
a large incision and separation, not cutting of muscles.
HISTORY
Keywords: Robotic Whipple’s surgery, Robotic surgery, Da Vinci
Whipple’s surgery. • 1985: A robot, the PUMA 560, was used to place a
needle for a brain biopsy using CT guidance. 3,4
How to cite this article: Srinivas B. Role of Robotics in
Whipple’s Surgery. World J Lap Surg 2012;5(1):39-45. • 1988: The PROBOT, developed at Imperial College
London, was used to perform prostatic surgery.
Source of support: Nil
• 1992: The ROBODOC from Integrated Surgical Systems
Conflict of interest: None declared was introduced into mill out precise fittings in the femur
for hip replacement. 9
INTRODUCTION
• 1997: A reconnection of the fallopian tubes operation
A robotic device is a powered, computer-controlled was performed successfully in Cleveland using
manipulator with artificial sensing that can be reprogrammed ZEUS.
to move and position tools to carry out a wide range of • May 1998: Dr Friedrich Wilhelm Mohr using the da
tasks. 1 Telemanipulators and robots were first developed Vinci surgical system performed the first robotically
by the National Aeronautics and Space Administration assisted heart bypass.
(NASA) for use in space exploration. In 1985, NASA • September 2010: The Eindhoven University of
instituted a research program in telerobotics to develop the Technology announced the development of Sofie
technology for the United States Space Program. 2 surgical system, the first surgical robot to employ force
The medical robotic systems of present generation are feedback.
the brainchild of the United States Department of Defence’s The intuitive surgical introduced the da Vinci
desire to decrease war casualties with the development of surgical system and computer motion with the AESOP
‘telerobotic surgery’. The ‘master-slave’ telemanipulator and the ZEUS robotic surgical system. (Intuitive surgical
concept was developed for medical use in the early 1990s bought computer motion in 2003; ZEUS is no longer
where the surgeon’s (master) manual movements were being actively marketed). 5-7
transmitted to end-effector (slave) instruments at a remote Three main types of surgical robots available at present
site. The field of surgical robotics has undergone massive are as follows:
transformation since then and the future is even brighter. 2 1. Supervisory-controlled Robotic Surgery Systems (e. g.
Robotically-assisted surgery was developed to overcome the ROBODOC ® system from CUREXO Technology
the limitations of minimally invasive surgery. Corporation): It is the most automated surgical robots
Methods of controlling the instruments in robotic available till date. Surgeons can plan their surgery
surgery: preoperatively in a 3D virtual space and then execute
1. Telemanipulator the surgery exactly as planned in the operating theater.
2. Computer-controlled system 2. Shared-control Robotic Surgery Systems: These robots
A telemanipulator is a remote manipulator that allows aid surgeons during surgery, but the human does most
the surgeon to perform the normal movements associated of the work.
with the surgery, while the robotic arms carry out those 3. Telesurgical devices: Here, the surgeon directs the
movements using end-effectors and manipulators to perform motions of the robot, e.g. the da Vinci robotic system,
the actual surgery on the patient. the ZEUS surgical system.

World Journal of Laparoscopic Surgery, January-April 2012;5(1):39-45 39