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Twenty-first century surgery using twenty-first century technology: surgical robotics.
Curr Surg. 2004 Sep-Oct; 61(5):466-73.CS

Abstract

INTRODUCTION

The "Nintendo" surgery revolution, which began in 1987, has impacted every surgical specialty. However, our operating rooms remain isolated worlds where surgeons use awkward, primitive, rigid instruments with suboptimal visualization. We need "smart instruments," "smart technology," and "smart imaging." Is surgical robotics the answer?

METHODS

We provide an analysis of current surgical technology and skills, propose criteria for what the next generation of surgical instruments and technology should achieve, and then examine the evolution and current state of surgical robotic solutions, assessing how they answer future surgical needs. Finally we report on the U.S. Military's early experience with surgical robotics and the lessons learned therein.

RESULTS

Current surgical robotic technology has made remarkable progress with miniaturization, articulating hand-imitating instruments, precision, scaling, and three-dimensional vision. The specialty-specific early clinical applications reviewed are promising, but they do have limitations. Surgical robotics offers enormous military application potential. Needed future refinements are identified, including haptics, communications, infrastructure, and information integration.

CONCLUSIONS

Laparoscopic surgery is a transition technology, constrained by instrument, equipment, and skill limitations. Surgical robotics or, more properly, computer-assisted surgery may be the key to the future. The operating room of the future will be an integrated environment with global reach. Surgeons will operate with three-dimensional vision, use real-time three-dimensional reconstructions of patient anatomy, use miniaturized minimally invasive robotic technology, and be able to telementor, teleconsult, and even telemanipulate at a distance, thus offering enhanced patient care and safety.

Authors+Show Affiliations

Department of Surgery, Uniformed Services University, Bethesda, Maryland, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

15475097

Citation

Marohn, Michael R., and Eric J. Hanly. "Twenty-first Century Surgery Using Twenty-first Century Technology: Surgical Robotics." Current Surgery, vol. 61, no. 5, 2004, pp. 466-73.
Marohn MR, Hanly EJ. Twenty-first century surgery using twenty-first century technology: surgical robotics. Curr Surg. 2004;61(5):466-73.
Marohn, M. R., & Hanly, E. J. (2004). Twenty-first century surgery using twenty-first century technology: surgical robotics. Current Surgery, 61(5), 466-73.
Marohn MR, Hanly EJ. Twenty-first Century Surgery Using Twenty-first Century Technology: Surgical Robotics. Curr Surg. 2004 Sep-Oct;61(5):466-73. PubMed PMID: 15475097.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Twenty-first century surgery using twenty-first century technology: surgical robotics. AU - Marohn,Michael R, AU - Hanly,Eric J, PY - 2004/10/12/pubmed PY - 2005/1/29/medline PY - 2004/10/12/entrez SP - 466 EP - 73 JF - Current surgery JO - Curr Surg VL - 61 IS - 5 N2 - INTRODUCTION: The "Nintendo" surgery revolution, which began in 1987, has impacted every surgical specialty. However, our operating rooms remain isolated worlds where surgeons use awkward, primitive, rigid instruments with suboptimal visualization. We need "smart instruments," "smart technology," and "smart imaging." Is surgical robotics the answer? METHODS: We provide an analysis of current surgical technology and skills, propose criteria for what the next generation of surgical instruments and technology should achieve, and then examine the evolution and current state of surgical robotic solutions, assessing how they answer future surgical needs. Finally we report on the U.S. Military's early experience with surgical robotics and the lessons learned therein. RESULTS: Current surgical robotic technology has made remarkable progress with miniaturization, articulating hand-imitating instruments, precision, scaling, and three-dimensional vision. The specialty-specific early clinical applications reviewed are promising, but they do have limitations. Surgical robotics offers enormous military application potential. Needed future refinements are identified, including haptics, communications, infrastructure, and information integration. CONCLUSIONS: Laparoscopic surgery is a transition technology, constrained by instrument, equipment, and skill limitations. Surgical robotics or, more properly, computer-assisted surgery may be the key to the future. The operating room of the future will be an integrated environment with global reach. Surgeons will operate with three-dimensional vision, use real-time three-dimensional reconstructions of patient anatomy, use miniaturized minimally invasive robotic technology, and be able to telementor, teleconsult, and even telemanipulate at a distance, thus offering enhanced patient care and safety. SN - 0149-7944 UR - https://www.unboundmedicine.com/medline/citation/15475097/Twenty_first_century_surgery_using_twenty_first_century_technology:_surgical_robotics_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S014979440400042X DB - PRIME DP - Unbound Medicine ER -