Robotic invasion of operation theatre and associated anaesthetic issues: A review

Abstract

A Robotic device is a powered, computer controlled manipulator with artificial sensing that can be reprogrammed to move and position tools to carry out a wide range of tasks. Robots and Telemanipulators were first developed by the National Aeronautics and Space Administration (NASA) for use in space exploration. Today’s medical robotic systems were the brainchild of the United States Department of Defence’s desire to decrease war casualties with the development of ‘telerobotic surgery’. The ‘master-slave’ telemanipulator concept was developed for medical use in the early 1990s where the surgeon’s (master) manual movements were transmitted to end-effector (slave) instruments at a remote site. Since then, the field of surgical robotics has undergone massive transformation and the future is even brighter. As expected, any new technique brings with it risks and the possibility of technical difficulties. The person who bears the brunt of complications or benefit from a new invention is the ‘Patient’. Anaesthesiologists as always must do their part to be the patient’s ‘best man’ in the perioperative period. We should be prepared for screening and selection of patients in a different perspective keeping in mind the steep learning curves of surgeons, long surgical hours, extreme patient positioning and other previously unknown anaesthetic challenges brought about by the surgical robot. In this article we have tried to track the development of surgical robots and consider the unique anaesthetic issues related to robot assisted surgeries.

Anaesthesia for Robotic Gynaecological Surgery

“…The first robotic gynaecological operation was a reanastomosis of the Fallopian tube and was performed in Cleveland, USA in 1997, using the ZEUS system. The first robotic laparoscopic cholecystectomy was performed using the Da Vinci surgical system in April 1997 in Belgium 28 .…”

“…First there is a remotely located console where the surgeon sits and controls the arms/fingers of the robot (Figure 2). This console provides a threedimensional view of the surgical site 28 . A computer controls the console which simulates the surgical field for the surgeon 28 .…”

Anaesthetic management of a patient with Huntington′s chorea undergoing robot-assisted nephron-sparing surgery

“…Intraoperative management of patients undergoing robot-assisted procedure needs good communication between anaesthesiologist and surgeon. [8]…”

McSleepy, da Vinci, Kepler Intubation System et al.

“…I would like to congratulate the authors of the article, “Robotic invasion of operation theatre and associated anaesthetic issues: A review,”[1] printed in the February 2011 issue of your esteemed journal.…”