Robotic surgery and keyholes

R.o.b.o.t.i.c S.u.r.g.e.r.y a.n.d K.e.y.h.o.l.e

Will surgeons be replaced by robots?

Robo-surgery. The notion of robotic surgery is apt to seem not only futuristic but it may also sound like some distant scenario from a Jetsons episode. The prospect of lying unconscious while an electromechanical device cuts and probes is hazardous and disconcerting. However, if computer-controlled machinery can mimic the awareness, adaptability and knowledge of a human surgeon, such a takeover in the operating theatre is actually realistic. In the decades to come, robots may even be needed to perform certain tasks requiring great precision.

For example, when a surgeon has to replace a hip, he has to remove the head of the thigh bone, excavate its interior, and then insert the shaft of the artificial joint. In real practice the contact area between the bone and prosthesis is often less than half, and the space is filled with cement. For a longer-lasting replacement, the area of contact between the bone and the metal has to be increased. By having a robot to excavate the interior of the bone, this can be precisely achieved.

A similar degree of precision is needed for brain surgery. This organ is ideally suited to robotic surgery because the skull provides fixed reference points for mounting instruments and locating brain parts.

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How can this be done? The controlling computer will be supplied with the details of the anatomy of the bony structures in form of pictures taken using X-rays or other systems. Two computers will process the data before taking any action to double control and minimize the risk of mishap. And mind this, a human surgeon will be there to supervise the whole procedure.

The continual development of minimally invasive techniques will have a great influence on surgery. Surgeons can operate from outside the body, thus eliminating the surface area of extensive cuts. Less anesthesia, less postoperative pain, less recovery time -- in many cases, the patient will be released on the day of the surgery, or the day after.

A viewing tube or endoscope in conjunction with a miniature TV camera is often used to see inside the body cavity.The endoscope is pushed through a small hole in the wall of the abdomen, while specially designed instruments are inserted through one or two more holes. This procedure is already in use with the removal of the gall bladder, the appendix, the kidneys, the hernias and even quite large sections of bowel.