Joe Farroha

7/18/2017
Research Essay
The Promise of Robotic Surgery

What is Robotic surgery? Robotic surgery is a form of surgery that requires the use of

robots and controllers. Robotic surgery is the newest form of surgery, which means it is not a

mainstream way to perform surgery on human patients yet. However, because of the speed

technology has been evolving, we may have robotic surgery as a common technique really soon.

In fact, in 2013, the Da Vinci robot did 400,000 surgeries, according to USA Today, which is

mind boggling, given that this technology was considered to be impossible a couple of decades

before. This paper will discuss the technological challenges in the first robotic surgery bot, the

current technologies used in robotic surgery, specifically the DaVinci along with the successes

and failures leveraging some of the emerging technologies. Robotic surgery is the surgery of the

future.

How did robotic surgery get its start and what was the first robotic surgery bot? The

answer is the PUMA 560, a robotic arm. The PUMA 560 was used in 1985, long before the FDA

approved of robotic surgery, to do specific, precise surgeries like micro invasive biopsies.

[https://www.britannica.com/topic/robotic-surgery#ref1225036] In October 1992, ROBODOC,

co-invented by Dr. William Bargar, was the first robotic surgical device to be granted FDA

approval for limited clinical trials in orthopedic surgeries, specifically the hip.

[http://www.upi.com/Archives/1993/09/29/ROBODOC-approved-for-clinical-

trials/8245749275200/] The early robotic devices were very application specific and were not

developed for general surgical use which made them quite expensive. These researchers,

however, were breaking new ground by pushing the available technology and revealing to
physicians what could be possible in robotic surgery. The da Vinci Surgery System was the first

robotic surgery system approved by the FDA for general surgery. The FDA had never approved

an entire system previously. All early robotic surgical systems depended on endoscopes and

numerous surgical assistants to perform surgery. The uniqueness of Da Vinci is that the robot

arms imitated the human wrists and it incorporated a vision system.

[https://www.youtube.com/watch?v=iGuotBcQeQY]

Robotic surgery, as defined by NYU, is a type of minimally invasive surgery. A

minimally invasive surgery as defined by NYU is instead of operating on patients through large

incisions, we use miniaturized surgical instruments that fit through a series of quarter-inch

incisions. [https://med.nyu.edu/robotic-surgery/physicians/what-robotic-surgery] What that

means is by the use of robotic arms, they can make smaller cuts into the human body, while do

surgery. The da Vinci Si is the most advanced robotic surgery system in the world. It has 3

robotic arms and there is a 4th with the camera, so the doctor can see what he is doing. As

mentioned earlier, the robotic arms work similar to human wrists. The da Vinci Si has been

used for multiple types of surgery; surgeries that were listed on the website were Cardiac

Surgery, Colorectal Surgery, General Surgery, Gynecologic Surgery, Head & Neck Surgery,

Thoracic Surgery, and Urologic Surgery. This machine is the one of the most advanced robotic

surgery tools and it is what defines modern robotic surgery.

The history behind the Da Vinci started back in 2000, when it was approved by the FDA.

Intuitive Surgical, Inc. built the Da Vinci based on technologies developed by NASA. In 2007,

NYU doctors performed over 750 surgeries with the da Vinci, and in 2013 they did 1200.

Though this is still a new technology, it has accomplished over 400,000 successful surgeries

nationwide, as stated earlier. There have been successes and failures in robotic surgeries.
Successes have been numerous, and the best part is that there is a small incision, which means a

small scar. As stated earlier, this form of surgery is limited to a few types, and seeing the

numbers of surgery and the few sad failures, that were on record. A few examples of failures that

were released to the public were sad and caused by the smallest error. The first is a woman who

died during a 2012 hysterectomy when the surgeon-controlled robot accidentally nicked a blood

vessel. Another was a robotic arm that wouldn't let go of tissue grasped during colorectal surgery

on Jan. 14. "We had to do a total system shutdown to get the grasper to open its jaws," said the

report filed by the hospital. The report said the patient was not injured. The final story was a

robotic arm hit a patient in the face during a hysterectomy. Intuitive Surgical filed the report and

said it's not known if the patient was injured but that the surgeon decided to switch to an open,

more invasive operation instead. Though there have been some failures, compared to the

mountain of success, the risks have been worth the results. This method hasnt been perfected

yet, so there will be a few mistakes, so dont just trust the machine because the machine/robot is

only as good as the people who designed it.

[https://www.usatoday.com/story/news/nation/2013/04/09/robot-surgery-fda/2067629/]

The hope for the future of this technology is for it to become the best method of surgery.

So far these robots are steadier because they are able to calibrate the shakiness of a human hand

and eliminate it. They can also go further, without making a bigger incision. So for improving,

we have to continually think beyond our imaginations so that we can accomplish what is thought

to be impossible today. The more the machine is programmed to know, the better prepared the

machine will be to help complete the different types of surgery. The Da Vinci may look

complicated, but in all honesty, it is quite simple to use. The da Vinci adapts to the surgeon, not

the other way, it will take tests to determine how wobbly (the little shake you have because you
cant be perfectly still) your hands are and itll eliminate it from causing the robotic arms

movement. Putting the tools in is as easy as sliding a radar detector into its holder on the

windshield. With these advances, surgeons will be able to perform surgeries without making

such a huge incision.

In the end, Robotic surgery is the new way of performing surgery. The FDA approved it,

meaning that it is safe to be used for humans. This technology, specifically the da Vinci has been

used for about 400,000 surgeries in 2013. This product does have little to improve physically, but

it must always adapt, meaning the code. The code needs to be updated constantly, so it can

combat the imperfections. Robotic surgery is the future to regular surgery, its steadier than a

human hand and it adapts to the surgeon.