Operating room of the future

Bharathan, Rasiah; Aggarwal, Rajesh; Darzi, Ara

doi:10.1016/j.bpobgyn.2012.11.003

Cited by 38 publications

(30 citation statements)

References 80 publications

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“…Further, robotic technique is the preferred method of performing a radical prostatectomy as the definitive treatment for prostate cancer (2). In gynecology, it is estimated that over 60% of minimally invasive hysterectomies performed in patients with endometrial cancer were done robotically (3). There are several reasons why urologists and gynecologists perform more robotic procedures than their other surgical counterparts.…”

Section: Surgical Specialtiesmentioning

confidence: 99%

Robotic Surgery: Applications

Leung¹,

Vyas²

2014

Amer J Robot Surg

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In a relatively short amount of time, robots have made its way into both general and subspecialty surgical fields. The da Vinci Surgical System (Intuitive Surgical Inc., Sunnyvale, CA) has been around for over a decade now. The first da Vinci surgical system came out in 1999 and was FDA approved in 2000. In 2003, a fourth robotic arm was added. The da Vinci S model came out in 2006 and offered improved robotic arm movements, console displays, and simpler set up. As of 2009, the latest model called da Vinci Si, now offers dual consoles so two individuals can collaborate simultaneously. Controls, vision, and ergonomics have been improved as well.The specialties that use the da Vinci system frequently are urological, gynecological, and gastrointestinal surgery (1). In 2010, Intuitive Surgical Inc., the manufacturer of the da Vinci robot, reported that over 70% of robotic procedures were for both prostatectomy and hysterectomy combined (1). Further, robotic technique is the preferred method of performing a radical prostatectomy as the definitive treatment for prostate cancer (2). In gynecology, it is estimated that over 60% of minimally invasive hysterectomies performed in patients with endometrial cancer were done robotically (3). There are several reasons why urologists and gynecologists perform more robotic procedures than their other surgical counterparts. These include balance of surgeon endoscopic skill level, meaning how often endoscopic or laparoscopic techniques are performed in their field; equipment limitations, especially when working with anatomically complex areas; and procedure complexity, taking into account which procedures are better performed open versus minimally invasive versus robotically, the latter having the greatest precision (2).Robotic options do exist for surgical treatment in other specialties although it is used much less frequently. These include cardiothoracic surgery, for cases of coronary bypass and heart defects repairs; general surgical oncology, for esophageal tumors, gastric cancer, colon cancer, thymoma; and pediatrics, to resolve congenital heart diseases, gastroespohageal reflux disease, or uretopelvic junction obstruction (4).

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Section: Surgical Specialtiesmentioning

confidence: 99%

Robotic Surgery: Applications

Leung¹,

Vyas²

2014

Amer J Robot Surg

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“…Surgeons must embrace and exploit the use of simulation to improve performance and outcomes for our patients or face the reality that the payers and legal system will mandate its adoption. 4 …”

Section: The Role Of Simulationmentioning

confidence: 99%

Trends in Evolving Technologies in the Operating Room of the Future

Kopelman

Lanzafame²,

Kopelman

2013

JSLS

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“…Firstly, devices for high-performance 3D imaging during surgery are now entering clinical practice, including systems for cone-beam computed tomography (CBCT) and 3D ultrasound. [1] Secondly, tracking systems for surgical navigation (e.g., infrared stereoscopic cameras, electromagnetic sensors) are in widespread clinical use in many surgical sub-specialties, and are now being extended to provide real-time fusion of endoscopic video with 3D imaging. [2] Finally, optical imaging systems may serve to exploit the clinical potential of molecular contrast agents for improved tumour delineation.…”

Section: Introductionmentioning

confidence: 99%

A surgical navigation system for non-contact diffuse optical tomography and intraoperative cone-beam CT

et al. 2014

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A freehand, non-contact diffuse optical tomography (DOT) system has been developed for multimodal imaging with intraoperative cone-beam CT (CBCT) during minimally-invasive cancer surgery. The DOT system is configured for near-infrared fluorescence imaging with indocyanine green (ICG) using a collimated 780 nm laser diode and a nearinfrared CCD camera (PCO Pixelfly USB). Depending on the intended surgical application, the camera is coupled to either a rigid 10 mm diameter endoscope (Karl Storz) or a 25 mm focal length lens (Edmund Optics). A prototype flatpanel CBCT C-Arm (Siemens Healthcare) acquires low-dose 3D images with sub-mm spatial resolution. A 3D mesh is extracted from CBCT for finite-element DOT implementation in NIRFAST (Dartmouth College), with the capability for soft/hard imaging priors (e.g., segmented lymph nodes). A stereoscopic optical camera (NDI Polaris) provides real-time 6D localization of reflective spheres mounted to the laser and camera. Camera calibration combined with tracking data is used to estimate intrinsic (focal length, principal point, non-linear distortion) and extrinsic (translation, rotation) lens parameters. Source/detector boundary data is computed from the tracked laser/camera positions using radiometry models. Target registration errors (TRE) between real and projected boundary points are ~1-2 mm for typical acquisition geometries. Pre-clinical studies using tissue phantoms are presented to characterize 3D imaging performance. This translational research system is under investigation for clinical applications in head-and-neck surgery including oral cavity tumour resection, lymph node mapping, and free-flap perforator assessment.

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Operating room of the future

Cited by 38 publications

References 80 publications

Robotic Surgery: Applications

Robotic Surgery: Applications

Trends in Evolving Technologies in the Operating Room of the Future

A surgical navigation system for non-contact diffuse optical tomography and intraoperative cone-beam CT

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