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The 21st century is a period associated with improvement in technological applications in almost every sector, medical field being one of the major areas upon which there has been a great achievement. Traditional surgeons have been struggling with many questions, some of which focused on how to reduce their patients’ pain after the operation, and how to minimize the chances of post operation wound infection, just to mention but a few. These numerous questions have prompted the attempt by surgeons and scholars to look for technological improvements which could help to eliminate the limitations associated with the traditional surgery. This has seen the development of human like machines (robots) to aid in the operating rooms.
The traditional surgery process has saved lots of lives, though it has not escaped the challenges of low technological levels among other existing challenges. Some of the operational procedures (brain surgery) take quite a lot of time, even up to 18 hours depending on the level of complications. It requires full concentration of the surgeons. In the theatres the surgeons are always on their feet. Standing for eighteen hours is not an easy task, and at the end they do feel exhausted and concentration levels may also reduce. It is not a surprise to hear of complications after operation resulting from an instrument left in the patient’s body accidentally after the operation. This can be pointed out to the fact that exhaustion can lead to some oversight. This has been a major challenge in the traditional surgical procedures. This exhaustion often leads to reduced eye and hand coordination and increased incidences of mistakes and omissions.
Another major problem arises from the fact that the video camera which is used to view the operating field is always held by the assistant surgeon (Bonsor, Strickland, 2010). Human beings cannot be able to hold a camera steadily for that long without a little tremor. Due to this reason, the camera is always unstable and gives a vision of the operating field in two dimensions. This forces the surgeons to take awkward positions to enable them to access certain regions within their operating fields. In these awkward positions, maneuvering of the operating field is always limited. Laparoscopic instruments have been very helpful, but still there is a need to advance these instruments further to help to improve the efficiency in the surgical field.
Traditional surgeries have very high possibilities of complications developing after the surgery process. Some of the se complications are those related to heart and lungs. There is also a high possibility of on table infection, which can worsen the problems further. Surgeons also have to make larger incisions when operating. These large incisions can reduce the possibility of having a clear visual of the operating field. For instance, when conducting a heart surgery, the doctors make a range of ten to twelve incisions to be able to gain access to the heart. After these incisions are made, the rib cage is opened and then the patient is put into a heart-lung machine. All these procedures can be associated with post operative pain and infection. There is also a possibility of excessive blood loss during the operation and this requires a lot of blood for transfusion purposes.
The healing period of the patients is longer due to the deep wounds resulting from numerous incisions, and the intensified after operation pain implies that a lot of pain reducing medication is to be taken.
Despite the various challenges faced by the traditional surgery surgeons, there have been developed great innovative technologies in the medical field which have helped to improve the surgery process. Telepresence and robotic surgery have significantly helped to address the limitation of thoracoscopic and laparoscopic procedures and have greatly revolutionized the minimal access surgical procedures. This has improved the level of completion of the rather advanced and complex surgical procedures with high levels of precision and reduced invasion. Robotic surgery development is expected to continuously improve, thus, compromising a significantly larger part of the surgery. It can be envisaged that in the nearest future almost all surgical procedures will be performed by these robots, and there will be an increased need for specialized training.
Baik (2005) in his book defines robotic surgery as a procedure which involves the use of programmed computer controlled device which helps in the manipulation and positioning of the surgical instruments. This enables the surgeons to perform complicated tasks more efficiently and with ease. These systems are not independent from the surgeons; they are their remote extensions. Instead of directly moving the instruments, the surgeon uses one of the two methods mentioned below to control the instruments (Bonsor, Strickland, 2010). These methods are:
- Direct telemanipulator
- Computer controls
The telemanipulator allows for the performance of the normal movements by the surgeons associated with the surgery, whereas the robotic arms carry out these movements using the manipulators and the end effectors for the actual surgery performance. Computer controls, on the other hand, control the robot arms through the systems (computer controlled systems). Telemanipulators can still be used in computer controls for their input. The major advantage of computer controls is that an operation can be done from any part of the world. In the case of advanced surgeries, the traditional steel tools are replaced by the autonomous instruments that ease the performance of certain movement or actions which could have never been achieved by the use of human hand. These instruments are mainly used to help to reduce or eliminate the trauma of the tissues resulting from open surgery. This approach seeks to and has helped to improve cardio-thoracic surgery by the minimal invasion; a situation which the traditional surgery has failed to achieve.
The use of robotic surgery has been applied in the various areas within the medical field. Pancreatic surgery, which has proved to be a more complicated one, has been changed into a simpler process thanks to the development of the robotic surgery. Cardio- thoracic surgery has also adopted the robot technology. This has helped in the reduction of the number of incisions to be made in a human body. Other areas include the gastrointestinal surgery, gynecology, neurosurgery, orthopedics, pediatrics, urology, radio surgery, etc.
The adoption of robotic surgery has various advantages associated with it. Firstly, it has helped to solve the problem of awkward positioning by the surgeons through the development of a stable camera holder. This has enabled the improvement of the vision of the operation field from a 2- dimensional to a 3-dimensional view. This has eased the maneuvering and also improved the surgeon’s direct control of a highly stable field due to increased magnification. This has resulted in high resolution images with high freedom levels and increased dexterity, which elevates the surgeon’s ability to spot and reconstruct the abnormalities. Secondly, the coordination of the eye and the hand is restored. These systems make the manipulation of the instruments more intuitive. This has been achieved through the elimination of the fulcrum effect. With surgeons now able to sit at comfortable position during the procedures, these systems have helped to reduce the exhaustion levels significantly. Another advantage associated with the robotic surgery is the reduced hospital stays for the patients. Healing time has reduced significantly and, hence, the time required for an individual to recover is reduced significantly. An operation which initially required a period of 5 days has now been reduced to 2 days. This can also be associated with reduced hospital bills. Research has also shown that those who undergo robotic surgery often get back to their jobs faster and regain their strengths 50% faster than the individuals who underwent traditional surgical procedures. The use of pain medication has also been reduced significantly, given the fact that robotic surgery does not involve numerous incisions of the operating field and, hence, quicker healing time. There is also a significant reduction in the level of blood loss. The traditional surgery is also associated with unlimited space in the operation rooms, given the fact that there is a need for a large number of medical personnel, who are to assist in ensuring that everything is in order. This includes the anesthetic personnel, the nurses, the cardiac surgeons, etc.
Besides the numerous advantages, it also has some major disadvantages. Firstly, the investment required for the robot machines is enormous. It has been proved that it can cost up to $1.2 million dollars with a yearly maintenance of $100,000 (Medscape News Today). This is a huge amount and, hence, an obstacle in ensuring that all operations are conducted using the technology. Although the costs can be predicted to increase with its development, it will eventually come down when it gains a worldwide acceptance. Robotic surgery has helped to reduce the crowding in the operating rooms, which is always a common feature, since the procedures do require a large number of personnel to ensure that everything runs smoothly (Baik, 2010).
The availability of space has created room for the robot placements and increased the efficiency in the operating rooms.
This technology is highly advanced, and there is a need for advance training to ensure that the surgeons can handle the operation effectively without any problem. This takes quite a while as the surgeon needs to practice on twelve to eighteen patients for familiarization with the procedures. During the training period, these invasive operations can take up to twice as long as the traditional surgery would take, leading to operation rooms tie ups. This, in turn, leaves no option other than to keep the patients in anesthetic state for quite a longer period and this can result to negative consequences, for instance, a failure to wake up. Another setback is the bulkiness of the equipment which occupies lots of space in the operating rooms. They reduce the space available in the operating room, given the fact that the surgical staff is also present in the same room. This technology has not been well established. Not all are willing to try it, since it is still in its infancy stages.
Development and adoption of robotic surgery is still in its infant stage, but it has proved to be a worthwhile investment given its achievements in the medical field. However, the robots should not completely phase out the human surgeons. There should be guidelines that will look into the interests of the medical personnel, the various institutions, and, most importantly, the patients who are the subjects of the operations. The governments should also adopt this technology with a positive attitude and dedicate their resources towards training and education of both, medical staff and the patients.