Robotics and Surgery

Andrea Blust Sefcheck Penn State University School of Nursing Nursing 457: Nursing Informatics

Objectives
To inform viewers of the uses of Robotics in Surgery and the increasing use of the trend To better understand the hardware and software used in the DaVinci Surgical System To understand the software and hardware used in the surgical system along with the usability of the product To understand how the Nurse is involved in robotic surgery To inform about the advantages and disadvantages To better understand the Ethical and Legal issues involved

Robotics
Robots do not actually replace humans, they improve their ability to operate through small incisions that are being made Computer assisted surgeries are used in neurosurgery, orthopedics, urology, and cardiology (Au, 2009)
/

http://www.core.form-ula.com/2009/03/16/da-vinci-surgical-system

Robotics and Surgery

Computer Assisted Surgery
 

Robotic surgery:


Image guided surgery Offers a way of viewing the different tissues while performing surgery

Requires a surgical robot Surgeon may or may not have a direct role (Au, 2009)

Nursing Role
Robotics nurse specialist  New role created for perioperative to create positive team and patient outcome  Nurse trained to make observations and bring concerns to the appropriate staff member to be resolved  Ensures instrument care  Assists intraoperatively (Francis, 2006)

Hardware
DaVinci Surgical System Endowrist Instruments

Hardware
Davinci Surgical System


 

Ergonomic surgeons console 4 Interactive robotic arms High performance vision system Provide maximum responsiveness WristWrist-like movements UserUser-friendly

Endowrist Instruments


 

http://www.core.form-ula.com/2009/03/16/da-vincisurgical-system/

Software
Master/Slave Stereoscopic vision system Redundant sensors

Software
Master/Slave software that provides control Stereoscopic vision display Redundant sensors to make the operation safe

Usability
Early and Central focus on user Iterative Design Observations of users

Advantages and Disadvantages

Source: Table from Howe, RD, Matsuoka, Y. Robotics for Surgery. Annual Review Biomedical Engineering. 1999, 01:213.

(Au, 2009)

Information System
Telesurgery Surgical Navigation

Information System
Review of Robotic Surgery Type?


Special Purpose Surgeons and OR nurses Images Mechanical, etc. Robotic surgical system

Who?


How?
 

What?


Advantages of Robotic Surgery

Shorter Recovery Period Smaller Incisions Less Invasive Decreased Pain Level Post Operatively (Chua, 2009)

Disadvantages of Robotic Surgery

Robots have poor judgment Expensive to obtain and also to fix Limited dexterity and hand eye coordination (Au, 2009)

Legal and Ethical Issues

Privileges Insurance Physician Movement Confidentiality

Competencies
Surgical System
 

Hardware Software

Patient Care

Informatics Nurse Specialist

Surgical System Patient Care

Robotic Surgery

References
Au, K. (2009). Robotic-Assisted Surgery. RoboticRetrieved June 2, 2009, from Robotic Surgery Web site: http://biomed.brown.edu/Courses/BI108/BI10 8_2005_Groups/04/contact.html Berlinger, N. (2006, May, 18). Robotic Surgery - Squeezing into Tight Places. The New England Journal of Medicine, 354, Retrieved Medicine, 354, July 9, 2009, from http://content.nejm.org/cgi/content/full/354/20/2099 Chua, P. (2009, May 25). Minimally Invasive Surgery. Cebu Daily News, News, Retrieved July 9, 2009, from http://globalnation.inquirer.net/cebudailynews/opinion/view/2000525http://globalnation.inquirer.net/cebudailynews/opinion/view/2000525207001/Minimally-invasive207001/Minimally-invasive-surgery Dickens, B, & Cook, R (2006). Legal and ethical issues in telemedicine. International Journal of Gynecology and Obstetrics, 94, 73-78. Obstetrics, 94, 73Francis, P. (2006, March). The evolution of robotics in surgery and implementing a perioperative robotics nurse specialist role. Retrieved June 2, 2009, from AORN Web site: http://www.aornjournal.org/article/S0001http://www.aornjournal.org/article/S00012092(06)601912092(06)60191-9/fulltext Intuitive Surgical, (2008). DaVinci Surgery. Retrieved June 23, 2009, from http://www.davincisurgery.com/davinciDaVinci Surgery Web site: http://www.davincisurgery.com/davincisurgery/davinci- surgicalsurgery/davinci- surgical-system/