One year of experience working with the aid of a robotic assistant (the voice-controlled optic holder AESOP) in gynaecological endoscopic surgery

Mettler, L; Ibrahim, Maha; Jonat, W.

doi:10.1093/humrep/13.10.2748

Cited by 153 publications

(65 citation statements)

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“…Surgeons in Kiel, Germany, explored the use of AESOP in gynecological laparoscopic operations and compared voice control of AESOP with the older foot or hand control systems [27]. They found that the robotic arm allowed them to perform complex laparoscopic operations faster than when the camera was held by a human assistant.…”

Section: Aesopmentioning

confidence: 99%

Robotic surgery, telerobotic surgery, telepresence, and telementoring

2002

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Although laparoscopic cholecystectomy rapidly became the standard of care for the surgical treatment of cholelithiasis, very few other abdominal or cardiac operations are currently performed using minimally invasive surgical techniques. The inherent limitations of traditional laparoscopic surgery make it difficult to perform these operations. We, and others, have attempted to use robotic technology to (a) provide a stable camera platform, (b) replace two-dimensional with three-dimensional (3-D) imaging, (c) simulate the fluid motions of a surgeon's wrist to overcome the motion limitations of straight laparoscopic instruments, and (d) offer the surgeon a comfortable, ergonomically optimal operating position. In this article, we review the early published clinical experience with surgical robotic and telerobotic systems and assess their current limitations. The voice-controlled AESOP robot replaces the cameraperson and facilitates the performance of solo-surgeon laparoscopic operations. AESOP provides a stable camera platform and avoids motion sickness in the operative team. The telerobotic Zeus and da Vinci surgical systems permit solo surgery by a surgeon from a remote sight. These telerobots hold the camera, replace the surgeon's two hands with robotic instruments, and serve in a master-slave relationship for the surgeon. Their robotic instruments simulate the motions of the surgeon's wrist, facilitating dissection. Both telerobots use 3-D imaging to immerse the surgeon in a three-dimensional video operating field. These robots also provide operating positions for the surgeon console that are ergonomically superior to those required by traditional laparoscopy. The technological advances of these telerobots now permit telepresence surgery from remote locations, even locations thousands of miles away. In addition, telepresence permits the telementoring of novice surgeons who are performing new procedures by expert surgeons in remote locations. The studies reviewed here indicate that robotics and telerobotics offer potential solutions to the inherent problems of traditional laparoscopic surgery, as well as new possibilities for telesurgery and telementoring. Nonetheless, these technologies are still in an early stage of development, and each device entails its own set of challenges and limitations for actual use in clinical settings.

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Section: Aesopmentioning

confidence: 99%

Robotic surgery, telerobotic surgery, telepresence, and telementoring

2002

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“…The irst FDA-approved surgical robot, the automated endoscopic system for optimal positioning (AESOP, Computer Motion Inc.), was a teleoperated robotic endoscopic camera that followed the commands of the surgeon via either pedals or voices. The AESOP system was successfully used in laparoscopic surgical procedures in areas such as urology, gynecology, etc., [4][5][6][7]. The subsequent ZEUS robotic system (Computer Motion Inc.) complemented an AESOP camera with two teleoperated robotic manipulators that were also continuously controlled by the surgeon through motion or voice commands [1,8].…”

Section: Surgical Robots Todaymentioning

confidence: 99%

The Next-Generation Surgical Robots

Wang¹,

Liu²,

Peng³

et al. 2018

Surgical Robotics

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The chronicle of surgical robots is short but remarkable. Within 20 years since the regulatory approval of the irst surgical robot, more than 3,000 units were installed worldwide, and more than half a million robotic surgical procedures were carried out in the past year alone. The exceptionally high speeds of market penetration and expansion to new surgical areas had raised technical, clinical, and ethical concerns. However, from a technological perspective, surgical robots today are far from perfect, with a list of improvements expected for the next-generation systems. On the other hand, robotic technologies are lourishing at ever-faster paces. Without the inherent conservation and safety requirements in medicine, general robotic research could be substantially more agile and explorative. As a result, various technical innovations in robotics developed in recent years could potentially be grafted into surgical applications and ignite the next major advancement in robotic surgery. In this article, the current generation of surgical robots is reviewed from a technological point of view, including three of possibly the most debated technical topics in surgical robotics: vision, haptics, and accessibility. Further to that, several emerging robotic technologies are highlighted for their potential applications in next-generation robotic surgery.

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“…The technology is, however, very expensive and the overall benefit is still under evaluation [26]. Simpler automated control devices for the laparoscope and camera have been developed including voice activated camera control, AESOP [27]. They may have a place, particularly in the era of fewer surgical assistants.…”

Section: Introductionmentioning

confidence: 99%

Risks of Laparoscopic Surgery

Ahmed¹

2015

OGIJ

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Laparoscopic surgery, like any operative intervention carries risks. In gynaecology in particular the patients are largely young fit women and significant complications, although rare, have devastating consequences. We review in short the issues to consider with regards to minimising risks and obtaining informed consent. be controlled with direct pressure accompanied by aggressive resuscitation whilst awaiting the arrival of a vascular surgeon [18]. Keywords:A number of blunt trocars have been developed which are designed to push structures away during insertion rather than cause a laceration e.g. the Endotip® device (Karl Stortz, Tuttlingen, Germany). Alternatively a small bore flexible cannula is inserted and radially expanded with sequentially larger diameter blunt trocars to reduce type 1/2a bowel injuries (STEP® Innerdyne Salt Lake City, Utah, USA). Blunt trocars have also been designed for insertion under direct vision of the abdominal layers through the laparoscope e.g. the Endopath® Bladeless visual obturator trocar (Ethicon Endosurgery, Cincinnati, OH). There is even an optical Veress needle to allow the passage of a micro laparoscope for visualisation prior to in sufflation [19]. Although these new technologies have a logical basis to theoretically reduce the risks of injuries of entry, none have been robustly tested against either standard closed technique or open Hasson laparoscopy.Less frequently injury may occur as a result of the operative procedure. The risks are directly related to the complexity of the procedure and the experience of the surgeon [4]. In this large multicentre French study, which included almost 30,000 procedures, the overall complication rate was low (4.64 per 1000). Mortality risk from Chapron's study (3.3 per 100 000) is less than half the rate quoted by the Jansen study and was as a result of one death following a vascular injury which was discovered immediately. Compared to the risk of mortality quoted for abdominal hysterectomy (AH) of 1 in 4000 [20] the mortality rate from all laparoscopies was over eight fold lower. Major laparoscopic surgery carries significantly higher risk of complication at 4.3 per 1000 and advanced laparoscopic surgery higher still at 17.45 per 1000. The study period was divided into two and the complication risks significantly reduced in the later cases, implying increasing surgeons experience led to reduced risks. Surgeons experience has since been confirmed as an important modifying factor for risks [21,22]. Surgical complications are either identified intraoperatively, in the early post operative period or late. Although only 43% of complications arise as a result of the procedure [10] 28.6% remain unrecognised at the index laparoscopy [4]. With regard to bowel injuries alone up to 15% are not detected during surgery [23] and when diagnosis is late, the mortality rate is as high as 20%. A high index of suspicion is necessary for any patient who does not recover quickly from a laparoscopic procedure.Bladder injury may result from direct ...

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One year of experience working with the aid of a robotic assistant (the voice-controlled optic holder AESOP) in gynaecological endoscopic surgery

Cited by 153 publications

References 1 publication

Robotic surgery, telerobotic surgery, telepresence, and telementoring

Robotic surgery, telerobotic surgery, telepresence, and telementoring

The Next-Generation Surgical Robots

Risks of Laparoscopic Surgery

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