ROBOTICS A minimally invasive approach to traditional surgery
ROBOTICS A minimally invasive approach to traditional surgery https: //www. davincisurgerycommunity. com/web/guest/home
Student Learning Objective Student will list and describe three major components of the Da. Vinci Robotic System, including the principles of each component as they relate to patient applications and safety.
ROBOTIC SURGERY A surgical procedure or technology that adds a computer‐assisted electromechanical device to the interaction between the surgeon and the patient (Association of Surgical Technologists: AST) • console‐manipulated devices • remote‐controlled endoscopes enhancing a surgeon’s “vision, tissue manipulation, and tissue‐ sensing” • altering the traditional relationship between surgeon and surgical site.
EVOLUTION OF ROBOTICS Robotics > developmental stage > accepted and preferred method of practice Healthcare is purchasing surgical robots Robotics is constantly evolving, stay current through professional development
AST GUIDELINES Standards of Practice, Perioperative Roles and Duties http: //www. ast. org/uploaded. Files/Main_Site/Content/About_Us/SOP_Rol e_Duties_ST_Robotic_Surgery(1). pdf
Robotic System: Clinical applications ADVANTAGES: robotic assistance > surgeons enhanced capabilities and precision > simulating open surgical environment > minimally invasive approach Technical Advantages: conventional rigid laparoscopic instruments<> robotic surgeons + 7 degrees of freedom with wristed laparoscopic instruments.
Technical Advantages: – a 3 D HD view of the surgical field – up to 10 x magnification – motion scaling – elimination of hand tremor and significantly improved ergonomics.
Surgeon Benefits – capabilities beyond the limits of the human hand – improved visibility – improved precision of dissection – time‐saving intracorporeal suturing for water‐tight anastomoses – access and maneuverability in tight pelvic spaces
Surgeon Benefits ‐handling, examining and excising potentially cancerous tissue – accessing difficult‐to‐reach lymph nodes – avoidance of intra‐operative conversions and – elimination of post‐ operative wound infections
DECONTAMINATION AND STERILIZATION COMPONENTS ‐robotic instruments are no different than traditional or laparoscopic instruments ‐thus should be handled accordingly ‐follow your clinical site’s (HCF) policy for all decontamination and sterilization instrumentation
Patient Console ‐camera and 3 instrument arms ‐motorized for simplified docking ‐each interactive robotic arm utilizes intuitive motion control ‐each arm equipped with clutch buttons for vital rapid instrument exchange ‐each arm moves around a fixed pivot point and uses simple click‐lock cannulas ‐the CST is responsible for draping the patient console
Surgeon Console ‐surgeon operates> viewing magnified 3 D image of the body’s interior ‐as controls are manipulated, da Vinci responds to surgeon’s input in real time ‐translates wrist & finger movements> precise movements of miniaturized instruments ‐surgeon may modify console settings to meet personal needs and save them
Vision Console ‐high‐definition monitor allowing assistant or CST to view entire operation – used to control settings like camera calibration – capable of digital zooming and tiling screen to accommodate multiple feeds – monitor is touchscreen and can be used as a proctoring tool – monitor can be draped sterilely
Vision Console ‐also contains built‐in microphones for intraoperative communication ‐contains a core which is its processing center ‐contains a camera assembly for a variety of scopes ‐contains a integrated or adapted power unit for an array of energy instruments
Manipulators and Instrumentation ‐surgeon uses precisely controlled Endo. Wrist instruments into body through a series of endoscopic ports. ‐broad range of instrument types available > help surgeon perform specialized surgical tasks with precision and control. ‐each instrument has a specific surgical mission> clamping, suturing, and tissue manipulation. ‐quick‐release levers speed instrument changes during surgery
Manipulators and Instrumentation Examples: – vessel sealer – electrocautery hook – suction‐irrigator – graspers and scissors – each instrument has lifespan of ten surgical procedures
Patient Safety ‐fewer days in the hospital, ‐less pain, ‐avoidance of a large abdominal incision, ‐decreased risk of blood transfusion, ‐quicker return to normal daily activities
Patient Safety remains primary concern –The same standards of practice are required by the surgical technologist for robotic surgery.
Preparation, Positioning & Troubleshooting
Geometric Systems Applied to Robotic Arms –Cartesian coordinate geometry –Cylindrical coordinate geometry –Revolute geometry geometric systems related to a group of classes used to identify manipulators according to the combination of joints used in their construction
________ helps the surgeon localize sound sources in noisy, complex auditory environments like the operating room. _______ is a movable, rotating joint, as in the human wrist or a Davinci Endowrist instrument. _______devices used to manipulate specific materials without direct contact. The robotic instruments are examples of tissue manipulators.
______ ___the amount from which a figure is rotated either clockwise or counterclockwise from a fixed point. ______ ___the number of independent parameters that define the configuration of a mechanical system. ______ ___three critical parameters used in flight dynamics also known as angles of rotation. These parameters allow the surgeon to maintain control and orientation during surgical procedures.
______: the detail an images holds or the capability of sensors to observe or measure the smallest objects clearly with distinct boundaries. ______: a complex robot that is remotely controlled by a human operator or in this case, the patient console. ______: a sophisticated form of robotic control in which a human operator has a sense of being on location so that the experience resembles virtual reality.
1. How does robotic surgery compare to more traditional forms like laparoscopic and open surgery? 2. How does the use of robotics relate to patient safety? 3. What are some of the surgical applications of robotics?
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• How does the use of robotics relate to patient safety?
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