16. Robotics in Laparoscopic and Thoracoscopic Surgery

Abstract

Advanced technology used in modern surgery includes telerobotic and robotic surgical instrumentation. The device currently used for most general surgical, and thoracic procedures (daVinci, Intuitive Surgical Sunnyvale, CA, USA) is more precisely defined as a telerobotic computer-assisted telemanipulator. Current clinical applications include image-guided robotic surgeries and computer enhanced robotic telesurgery. Operative procedures include a wide variety of cardiac procedures that can be accomplished without open sternotomy or thoracotomy. Most general surgical procedures have demonstrated some feasibility using robotic devices, although few have demonstrated superiority when compared to standard laparoscopic procedures. Selected procedures may show benefit such as esophagomyotomy. Urology and gynecology have seen significant growth in computer assisted surgery for the last decade as well as noncardiac thoracic procedures. There are limitations that will continue to slow the adoption of computer assisted surgery in general surgery; however, many examples of emerging technology are in place that will allow us to increase the use of technology to enhance patient outcomes. Ongoing evaluation of this technology is important in order that it be applied appropriately. This chapter gives an overview and introduction to these emerging technologies and their applications.