Robotics in Laparoscopic Surgery
Laparoscopic surgery procedures have improved the medical care provided to patients by reducing complication rates, hospital stays, patient trauma and recovery time. With over 7.5 million laparoscopic procedures performed annually worldwide, laparoscopic surgery is the fastest-growing discipline within the surgery market today.
Laparoscopic surgery relies on imaging using a laparoscope, which is a narrow, rigid tube that is connected to a small camera. The camera captures images from within the abdominal cavity, which are then projected onto a video monitor in the operating room. Guided by these images, surgeons manipulate surgical instruments that are inserted into patients through small incisions.
During these procedures, a surgical assistant is required to hold and adjust the angle of the laparoscope in order to project the relevant image from the surgical cavity on the video monitor. The surgeon and assistant working two separate systems as one seamless unit is a major challenge in laparoscopic surgery.
Laparoscope holders are subject to fatigue, abrupt movements, distraction, miscommunication with the surgeon and natural hand tremors, all of which can result in movement of the image on the viewing screen1.
Performing laparoscopic surgery under these conditions has been compared to “tying your shoelaces with three-foot-long chopsticks while someone else is holding your glasses”. (The New York Times, February 24, 2005)
Lack of surgeon-assistant coordination and unstable image have been linked in various studies to poor performance, increase in OR time and increase in error rate2, along with decreased surgeon and staff efficiency.
The move towards higher quality imaging systems has only intensified the need for improved laparoscope control. New technologies such as 3D, HD and 4K imaging offer surgeons very high resolution images and potentially higher operating benefits; but most healthcare providers cannot fully maximize these technologies without stable images and complete surgeon control.
1 Mastery of Endoscopic and Laparoscopic Surgery, W. Stephen Eubanks, MD