Impact of robotic surgery
Implication of the technology to the environment
The healthcare sector has been one of the fundamental areas that have indubitably attracted various studies and theory inbuilt. In particular, most of the studies and research has focused on the improvement of technology and essentially change their way of doing things. Nevertheless, being one of the defining factors of human life, people have always focused to ensure that the level of technology is up to date (Springer & Feldman, 2014). This has been triggered by the current emerging trends which have necessitated technological improvement. Among others, realization of new terror diseases has been one of the factors that have put human on toes. This sector has therefore, experienced various improvements and discovery over the decades. In addition to medicine improvement and technology enhancement in other areas, surgery has remained one of the greatest critical and dangerous inventions in this sector. Though this can be referred among the greatest discovery on the planet, it is also one of the dangerous procedures that, if not carried out effectively, can lead to loss of lives (Chhabra, 2013). Therefore, it is in this reason that several technologies have been invented to ensure that this process succeeds to avoid loss of lives whenever carried out.
The controversy that has always surrounded within and around the improvement of technology is on the fact that they have side effects to other sectors of life such as environment which can also cause life devastation. This implies that human will always keep an eye to the implication of any technology invented not only in the surgical sector, but also in other health sectors. Therefore, an analysis and synthesis of the technology to ensure it does not lead to more harm than help has been essential in the current and moral world. More specific, social robotics is a technology heralding a new revolution in surgery today. This technology holds significance promises however, robotic devices are largely driven by the market. Although, there is lack of data comparing the cost and advantages of robotics and conventional techniques robot surgery is feasible. Strictly speaking, robotic devices are becoming vital tools in surgical armamentarium; however their use is still enfant and is evolving gradually. In this light, this paper focuses on the implication of robotic surgery, one of the invented technologies in medicine, to the environment.
In essence, technology refers to the collection of tools such as machinery and modifications intended to make work easier and improve the quality of life. It therefore, significantly influences the ability of human beings and animals to adapt to their natural environment. For instance, the recent technological developments in the communication such as in printing press, telephone and internet have turned the world into a global village. This has been made possible by lessening the physical barriers that hinder communication and allowing human beings to interact on a global platform. Likewise, robotic surgery being new technology, it has come with it different opinions. Notably, this new technology is taking the field of surgery by storm to an extend of becoming a marking strategy used by others. Those who are seeking to be known for minimally invasive surgery are now using this technology as the entry fee. While some individuals in the healthcare industry believe that this kind of surgery is essentially a helpful innovation that will enable efficiency in the medical field, others have come up with different opinions about the surgery as will be discussing in this paper.
In definition, Rosen, Hannaford and Satava (2011) provide that Robotic surgery, robotically assisted surgery and computer system surgery are terms used to refer to technologically development that use robotic system to supplement surgical procedures. Therefore, the authors assert that robotic surgery is principally, a method used to perform surgery using small instruments attached to the robotic arm. This procedure is aided by computers therefore; Surgeons control this robotic arm using the computers. From a deeper sense, robotic surgery is a type of minimally invasive surgery that was developed in a bid to overcome the limitations of minimally-invasive surgery and to increase the ability of surgeons in carrying out surgery. Minimally invasive surgery implies that rather than operating on patients through large incisions, miniaturized surgical instruments that can easily fit through the small incisions are used (Gharagozloo, & Najam, 2009).
Various impacts of robotic surgery have been presented by different scholars (Stock, Esposito, & Lanteri, 2008). According to Zender (2011), there are both positive and negative impacts of robotic surgery to the environment. In this case, the environment would refer to the surrounding which includes people. As Tulandi (2011) puts it, the positive effects of robotic surgery arises from the fact that robotic surgery was meant to overcome the existing limitations.
In essence, robotics has the capability to revolutionize the delivery of healthcare. This type of surgery has played a vital role in delivery of information and expertise and clinical cares over time as well as he geographical space barriers. It is in fact, irrefutably that robotics has provided a platform over which enhancement of quality of care through extension of clinical expertise and controlling of data sets and best actions. It has wide areas of application in the sense that it can be used in hospitals, primary care as well as homes. It also provides an opportunity for telemetering, education and training using a combination of robotics and telemedicine. It impacts (positive and negative) have been felt in the following environment.
While robotics has widely been spread, the surgeons have accepted and recommended robot surgery particularly in cardiac, prostate cancer and gynecologic surgery. However, minimal invasive surgery has attracted the attention of most of the researchers. Several research groups have been working extra miles in order to develop robotic procedures that magnify laparoscopic techniques. Encouragingly, this unexplored branch of cardiac surgery is now recording data showing that robotic surgery is possible. For example, a study by Prasad et al concluded that robotic technology played a major role for surgeons to perform endoscopic coronary anastomoses. In this study of 19 patients, 17 of 19 patients had a left internal thoracic artery (LITA) successful constructed into the left anterior descending (LAD) artery anastomoses by the help of a robotic system. However, the endoscopic coronary bypass showed a short-term success with no adverse effects. Also, a study, of 32 patients involving a robotic assisted coronary artery bypass grafting showed a graft patency of 93% after two months. In this study the patients took an endoscopic anastomosis of the LITA to LAD. In addition, a study by Mohr et al, 131 patients using the Da Vinci underwent an artery bypass grafting. From this study, a robotic system safely selected patients to perform cardiac surgery however it was not advanced far enough to undertake closed chest invasive surgery. Currently, surgeons in Europe have been able to perfume closed-chest coronary artery bypass using an endoscopic stabilizer. To sum it up, a study by Kappert and Cichon et al of 37 patients by use of the Da Vinci system an endoscopic stabilizer showed 3.4% rate of conversion to median sternotomy. Principally, their study showed optimism for totally endoscopic coronary artery bypass (TECAB).
Whereas the above, may be the case, the use of this kind of surgery has come with it several advantages in the surgical environment. Firstly, the robot system enhances the surgeons’ skills because the instrument can be manipulated and thus the tissues. In addition, leveraging a particular computer strengths such as tremor-filtered precision (removing surgeons ‘hand tremor), consequently improve the capabilities of the average surgeons. Further, robot system ensures that the hand and eyes are properly coordinated. Further, these system removes the issue of fulcrum effect, thus the instruments manipulation is made possible. Meaning that, the surgeons do not have to make awkward movement to properly use the instruments. In addition, robot system get data through imaging in 3-dimension. The kind of vision possible by this device is superior to that of the conventional laparoscopic camera views. The 3-dimensional view with depth perception enhance the freedom of the surgeons further because this data can be easily be manipulated through amplification. Principally, robots are added advantage to the skill of a surgeon.
Among other essential aspects in the surgical environment is that robots have made it possible for patients to receive treatment without surgeons’ physical presence. This fact has come with a number of advantages. For instance, the robots play a significant role in reducing occupational environment hazard for surgeons by protecting them from biohazards. For example, the case of patient who requires chemotherapy, surgeons operates from a console which is some distance from the patients. Therefore, the risk of the exposed to this radiation is reduced. In addition, robotics also can enhance extension of medical care to other areas that are geographically remote via telesurgery, including battlefield situations for the military.
In most instances, doctors can stay for long hours in theatre due to the long procedures. However, this has been greatly focused by robotic surgery. The technology’s speed and efficiency has made the whole procedures indefatigable. This is to mean, the machines is understandably does not get tired and bored by similar procedures in the operative sites. Which has helped doctors who in other cases suffer from back pain as a result of the long hours spent in the operation rooms. In addition, the issue of boredom by surgeons for doing the same procedure is now eliminated in the sense that they can now use robots surgery as alternative. However, the only challenge is that the surgeons will need to set the robot system in regard to the nature of the operation. For instance, in cases of prostate surgery, the surgeon can set the machines in a way that it does not get too close to the critical nerves. Hence, surgeons are able to integrate specific data of the patients before and during the procedure; which allows for less invasive surgery.
Not to forget, robotic surgery is beneficial to the patient in the sense that they experience less pain during surgery, few complications are expected/experienced and the patients less exposed to minimum levels of infection. In addition, the patients spend a shorter time in hospitals in conjunction with an assurance of quick recovery. Finally, robotic surgery is a less scary procedure compared to the normal practice that involves dissection.
One the other hand, with the many benefits of robotic surgery, its advancement is limited by some factors. First, robotic surgery is a new technology, its efficacy and use has not been full established. Most researchers have been made of its feasibility however there seems to be existing disadvantages that robotic surgery comes along with. Weather there is a chance to completely eliminate these disadvantages, time will tell. Before then, one of the limiting factors have rose from the fact that the initial price, annual maintenance fees among other costs amount to millions of dollars. This cost gives little hope to investors of supports of the technology. In most case, robotic surgery lead to long pay time or more often does not achieve a return on the investment. One of the eminently observed cases is on the fact that many hospitals have purchased the robots but have lied idle. In addition, robotic surgery requires that doctors, surgeons and nurse be trained to use this rare technology. To do this training in a world were technology is changing every day may be an expensive venture. In fact, it becomes noble to do the surgery in the old fashion than using a technology that you are note used to a human life. Principally, this technology is expensive however for now. However, technology remains then factor that has the key to pricing.
Also the, big size of robotic systems is another disadvantage. Robotic systems demand a big sized the large cumbersome robotic arm and large footprints. This aspects proofs it hard for the surgical team and the robotic system to fit in already crowded operation rooms. However, wall mounting may solve this problem but the fact remains that the current operation rooms may be minute for a robotic system. Thus, the process of constructing new rooms might further increase the cost of the already expensive technology.
The final disadvantage, of robotic technology is the lack of compatibility of instruments and equipment. It is a disadvantage in the sense that robotic surgery may lead to reliance on tableside assistants for a successive surgery. However, there is a possibility that technology might be able to address this problem.
ROBOTIC PHARMACY ENVIRONMENT
In this field, there are three main types of hospital-based pharmacy robots available. These include solid medication or “pill” dispensers. Solid medication or pill robots carry out almost all duties in pharmacy which increases efficiency and effectiveness. Using bar coded medication containers, the robots stock medicine and prepare patients for daily drawers of medication using information from pharmacy. Their speed and accuracy has improved quality of care and safety hence creating time for pharmacists and technicians to carry out other cerebral roles.
Liquid medication preparation-these computer assisted robots choose a vial, remove the prescribed dosage as well as adding the diluent into the dosages. Controlled by a hospital-based CPOE and Pharmacy information systems, they increase accuracy, save time and create time for both technicians and pharmacists.
Robotic delivery of medication drawers hospital nursing unites; using system commands, these robots carry patient drawers and are then sent by the command various individual nursing units. In fact on arriving, they announce that “I have medication for you” after which the respective nurses will take the medication and then the robots will proceed to the next unit. These robots have impacted the environment they work positively through time saving, accuracy and safety.
The future of robotic surgery is bright, despite the obstacles and distavantagess, it a new avenue that needs exploration. Notably, it needs to address areas such as training requirements, malpractice liability, interstate licensing for telesurgeons among others. However, the many advantages that come with this technology have ensured gradually development of this technology. For instance, the high tech of instrument control has enabled surgeons to eliminate the issue of hand tremor. In addition, surgeons have used the sophisticated vision to identify with precision the part to dissect. One of the possible avenue that this technology might take the use of preoperative and intraoperative videos images fusion identifying pathology and guiding the surgeon in dissection. Robotic surgery has proved to be of great value. It the kind of technology that mankind cannot turn his back on particulary, in the areas of laparoscopic procedures. This technology is now replacing the conventional laparoscopic procedure instruments in less technologically demanding procedures. Principally, surgical technology may soon evolve fast enough to expanding laparoscopic procedures into the digital age. Otherwise, robotic technology has the potential of expanding surgery as a means of treatment to the levels that are far beyond human ability.
Bedeski, R. E., & Lansdowne, H. (2012). Information technology, new dimensions of government and citizen interaction, and human security in Mainland China, and the Taiwan experience. Victoria, B.C.: Centre for Asia-Pacific Initiatives.
Chhabra, S. (2013). ICT influences on human development, interaction, and collaboration. Hershey, PA: Information Science Reference.
Dasgupta, P. (2008). Urologic robotic surgery in clinical practice. London: Springer.
Energy and environment in the European Union. (2002). Luxembourg: Office for Official Publications of the European Communities.
Gharagozloo, F., & Najam, F. (2009). Robotic surgery. New York: McGraw-Hill Medical.
Pratelli, A. (2011). Urban transport XVII urban transport and the environment in the 21st century. Southampton, UK: Wit Press.
Springer. T., & Feldman, I. (2014). Implementing ISO 14000: a practical, comprehensive guide to the ISO 14000 environmental management standards. Chicago: Irwin Professional Pub..
Stock, J. A., Esposito, M. P., & Lanteri, V. J. (2008). Urologic robotic surgery. Totowa, N.J.: Humana.
Tibor, Ramkumar, M. (2013). On a sustainable future of Earth’s natural resources. Berlin:
Tulandi, T. (2011). Robotic surgery in gynecology. Oak Park, Ill.?: Bentham eBooks.
Watanabe, G. (2014). Robotic Surgery. Tokyo: Springer Japan.
Zender, J. (2011). Robotic surgery. Philadelphia, Pa.: Saunders.
1. Satava RM. Surgical robotics: the early chronicles: a personal historical perspective. Surg Laparosc Endosc Percutan Tech. 2002;12:6–16. [PubMed]
2. Felger JE, Nifong L. The evolution of and early experience with robot assisted mitral valve surgery. Surg Laparosc Endosc Percutan Tech. 2002;12:58–63. [PubMed]
3. Marescaux J, Leroy J, Rubino F, et al. Transcontinental robot-assisted remote telesurgery: feasibility and potential applications. Ann Surg. 2002;235:487–492. [PMC free article] [PubMed]
4. Cheah WK, Lee B, Lenzi JE, et al. Telesurgical laparoscopic cholecystectomy between two countries. Surg Endosc. 2000;14:1085. [PubMed]
5. Jones SB, Jones DB. Surgical aspects and future developments in laparoscopy. Anesthiol Clin North Am. 2001;19:107–124. [PubMed]
6. Kim VB, Chapman WH, Albrecht RJ, et al. Early experience with telemanipulative robot-assisted laparoscopic cholecystectomy using Da Vinci. Surg Laparosc Endosc Percutan Tech. 2002;12:34–40. [PubMed]
7. Fuchs KH. Minimally invasive surgery. Endoscopy. 2002;34:154–159. [PubMed]
8. Allendorf JD, Bessler M, Whelan RL, et al. Postoperative immune function varies inversely with the degree of surgical trauma in a murine model. Surg Endosc. 1997;11:427–430. [PubMed]
9. Satava RM, Bowersox JC, Mack M, et al. Robotic surgery: state of the art and future trends. Contemp Surg. 2001;57:489–499.
10. Prasad SM, Ducko CT, Stephenson ER, et al. Prospective clinical trial of robotically assisted endoscopic coronary grafting with 1 year follow-up. Ann Surg. 2001;233:725–732. [PMC free article] [PubMed]
11. Kwoh YS, Hou J, Jonckheere EA, et al. A robot with improved absolute positioning accuracy for CT guided stereotactic brain surgery. IEEE Trans Biomed Eng. 1988;35:153–161. [PubMed]
12. Davies B. A review of robotics in surgery. Proc Inst Mech Eng. 2000;214:129–140. [PubMed]
13. Schurr MO, Buess GF, Neisius B, et al. Robotics and telemanipulation technologies for endoscopic surgery: a review of the ARTEMIS project. Advanced robotic telemanipulator for minimally invasive surgery. Surg Endosc. 2000;14:375–381. [PubMed]
14. Dario P, Corrozza MC, Peitrabissa A. Development and in vitro testing of a miniature robotic system for computer-assisted colonoscopy. Comput Aided Surg. 1999;4:1–14. [PubMed]
15. Tholey G, Chanthasopeephan T, Hu T, et al. Measuring Grasping and Cutting Forces for Reality-Based Haptic Modeling. Computer Assisted Radiology and Surgery, 17th International Congress and Exhibition, June 2003, London, UK.
16. Hu T, Castellanos A, Tholey G, et al. Real-Time Haptic feedback Laparoscopic tool for use in Gastro-intestinal Surgery. Fifth International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI), Tokyo, Japan, September 2002.
17. Kennedy C, Hu T, Desai JP, et al. A Novel Approach to Robotic Cardiac Surgery using Haptics and Vision. Cardiovascular Engineering: An International Journal, 2002.
18. Kennedy C, Hu T, Desai JP. Combining Haptic and Visual Servoing for Cardiothoracic Surgery. 2002 IEEE International Conference on Robotics and Automation, Volume: 2, 2002 Page(s): 2106–2111, Washington DC, May 2002.
19. Kennedy CW, Desai JP. Force Feedback Using Vision. The 11th International Conference on Advanced Robotics, June 30–July 3, 2003 University of Coimbra, Portugal.
20. Cadierre GB, Himpens J. Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg. 2001;25:1467–1477. [PubMed]
21. Falcone T, Goldberg JM, Margossian H, et al. Robotic-assisted laparoscopic microsurgical tubal anastomosis: human pilot study. Fertil Steril. 2000;73:1040–1042. [PubMed]
22. Margossian H, Falcone T. Robotically assisted laparoscopic hysterectomy and adnexal surgery. J Laparoendosc Adv Surg Tech A. 2001;11:161–165. [PubMed]
23. Marescaux J, Smith MK, Folscher D, et al. Telerobotic laparoscopic cholecystectomy: initial clinical experience with 25 patients. Ann Surg. 2001;234:1–7. [PMC free article] [PubMed]
24. Abbou CC, Hoznek A, Saloman L, et al. Laparoscopic radical prostatectomy with a remote controlled robot. J Urol. 2001;165:1964–1966. [PubMed]
25. Damiano RJJr, Tabaie HA, Mack MJ, et al. Initial multicenter clinical trial of robotically assisted coronary artery bypass grafting. Ann Thorac Surg. 2001;72:1263–1268. [PubMed]
26. Mohr FW, Falk V, Diegeler A, et al. Computer-enhanced “robotic” cardiac surgery: experience in 148 patients. J Thorac Cardiovasc Surg. 2001;121:842–853. [PubMed]
27. Kappert U, Cichon R, Schneider J, et al. Technique of closed chest coronary artery surgery on the beating heart. Eur J Cardiothorac Surg 2001;20:765–769. [PubMed]
28. Boehm DH, Reichenspurner H, Gulbins H, et al. Early experience with robotic technology for coronary artery surgery. Ann Thorac Surg. 1999;68:1542–1546. [PubMed]
29. Cisowski M, Drzewiecki J, Drzewiecka-Gerber A, et al. Primary stenting versus MIDCAB: preliminary report-comparison of two methods of revascularization in single left anterior descending coronary artery stenosis. Ann Thorac Surg. 2002;74:S1334–S1339. [PubMed]
30. Hollands CM, Dixey LN. Technical assessment of porcine enteroenterostomy performed with Zeus robotic technology. J Pediatr Surg. 2001;36:1231–1233. [PubMed]
31. Hollands CM, Dixey LN. Robot-assisted eophagoesophagostomy. J Pediatr Surg. 2002;37:983–985. [PubMed]
32. Morimoto AK, Foral RD, Kuhlman JL, et al. Force Sensor for laparoscopic babcock. Stud Health Technol Inform. 1997;39:354–361. [PubMed]
33. Tozzi P, Corno A, von Segesser L. Sutureless coronary anastomoses: revival of old concepts. Eur J Cardiothoracic Surg. 2002;22:565. [PubMed]
34. Buijsrogge MP, Scheltes JS, Heikens M, et al. Sutureless coronary anastomosis with an anastomotic device and tissue adhesive in off-pump porcine coronary bypass grafting. 2002;123:788–794. [PubMed]
35. Eckstein FS, Bonilla LF, Schaff H, et al. Two generations of the St. Jude Medical ATG coronary connector systems for coronary artery anastomosis in coronary artery bypass grafting. Ann Thorac Surg. 2002;74:S1363–S1367. [PubMed]