Robotic Surgery

Presented by: Kate McManus

Objectives
Describe Robotic Surgery Describe and evaluate the hardware and software used with robotic surgery Describe and evaluate the information system used with robotic surgery Assess the role and functions of the nurse informaticist when working with robotic surgery Examine related legal/ethical issues Discuss the advantages/disadvantages of robotic surgery from a nursing perspective

Description of Robotics
Laparoscopic approach to treat certain urologic problems
This presentation will focus on the treatment of prostate cancer

A robot is used to assist the surgeon (referred to as da Vinci robot) Master controls allow the surgeon to manipulate instruments
(The Bryn Mawr Urology Group, 2008)

Description of Robotics Continued

The surgeons natural hand and wrist movements correspond with the scaled movements of the robot #1 choice for prostate removal in the U.S. Used in tens of thousands of prostate cases in the past year
(The Bryn Mawr Urology Group, 2008)

Hardware used in Robotic Surgery

Robot with many arms Camera on one arm called an endoscope Dissectors, scalpels, scissors and forceps on other arms Joystick- surgeon uses to operate the robot Foot pedals
(Ezine Articles, 2008)

The Endoscope
Fiber optic instrument Inserted through a small incision Has a very tiny video camera Shows the surgeon a 3-dimensional, magnified view Projects to a television screen

(Ezine Articles, 2008)

Software used in Robotic Surgery

Da Vinci Surgical System Intuitive Surgical Combines propriety software and electronics Streamlines and perfects certain surgeries Software not based on any well-known operating system Software version 11 in use at present
(Business Strategies for Medical Technology Executives, 2001)

Proprietary Software
Closed-source software Restricted use Private modification Better quality than free software Robotic movements, driven by intuitive proprietary software
Simultaneous Fluid ambidextrous
(Wikipedia The Free Encyclopedia, 2008)

Information System in Robotic Surgery

Specialized software specifically for robotic surgery Used by physicians- controlled by physicians movements Special purpose system- used for performing various surgeries Function is treat disease via surgery (ex- removal of prostate)
(Business Strategies for Medical Technology Executives, 2001)

Information System in Robotic Surgery

There is no evidence that states that data standards have been put in place Specific robot used for surgery Nothing to compare it to

(Business Strategies for Medical Technology Executives, 2001)

Advantages of Robotic Surgery

Less invasive Shorter hospital stay Less pain Less scaring Less blood loss FDA approved

(The Bryn Mawr Urology Group, 2008)

Disadvantages of Robotic Surgery

Carries the same risk as any other surgery: heart attack, stroke, death Increased risk for impotence and incontinence in robotic prostatectomy

(The Bryn Mawr Urology Group, 2008)

Legal/Ethical Issues in Robotic Surgery

Time lag between surgeons commands and action of robot could harm the patient Loss of power in an electrical failure Robotics does not replace human intelligence, skill and experience

(Essortment, 2002)

The Professional Nurses Role in Robotic Surgery

The DaVinci Robot

Nurses must know what to assess in postop robotic surgery patients

Nurses must be able to document their assessment for physician viewing

(The Bryn Mawr Urology Group, 2008)

Summary
Laparoscopic surgery Robot controlled by a physicians movements Minimally invasive New-Age The surgery of the future

References
The Bryn Mawr Urology Group. (2008). Frequently asked questions and answers about a robotic prostatectomy. Retrieved September 19, 2008, from http://brynmawrurology.com Business Strategies For Medical Technology Executives. (2001). Robotic Surgery: The Future Is Now. Retrieved October 11, 2008, from http://www.devicelink.com/mx/archive/01/03/0103mx024.html Essorment. (2002). Electronic Devices: How Robotic Surgery Works. Retrieved November 19, 2008 from http://www.essortment.com/lifestyle/electronicdevic_sbnr.htm Ezine Articles. (2008). The Da Vinci Robot- Cutting Edge Surgical Technology. Retrieved October 11, 2008, from http://ezinearticles.com/?The-Da-Vinci-Robot---Cutting-edgeSurgical-Technology&id=1270346 Ken Swartzman, Intuitive engineer, personal communication, (September 22, 2008) Wikipedia The Free Encyclopedia. (2008). Proprietary Software. Retrieved October 11, 2008, from http://en.wikipedia.org/wiki/Proprietary_software