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Telesurgery pp 67–89Cite as

Robotic-Assisted Surgery: Low-Cost Options

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Abstract

Open surgery is based on the access to the treated organ via one large 5- to 30-cm incision dividing the skin and abdominal muscles or fascias. This large skin incision provides the surgeon and assistant(s) with a direct view of the anatomy, enabling the introduction of their hands and instruments. They can look down at their work with their heads and necks in a neutral position, using both hands, with natural hand-eye coordination (Fig. 6.1a). For delicate surgical actions, it is even possible to support the wrists by leaning on the patient’s body or on a specially developed armrest [7, 21, 33]. However, there are also some drawbacks, particularly in case of pelvic surgery:

- The light conditions might be suboptimal.

- The distance to the tissue/organ is relatively long (i.e., urethra).

- The view to the object might be hindered by bone (suprapubic spine).

- The view for the assistant might be suboptimal due to the narrow anatomical conditions.

- The position of the surgeon is ergonomically suboptimal (i.e., torsion of the body).

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References

  •  1. Ahlering TE, Skarecky D, Lee D et al (2003) Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. J Urol 170:1738–1741

    Article  Google Scholar 

  •  2. Aiono S, Gilbert JM, Soin B et al (2002) Controlled trial for the introduction of a robotic-camera assistant (EndoAssist) for laparoscopic cholecystectomy. Surg Endosc 16:1267–1270

    Article  Google Scholar 

  •  3. Antiphone P, Hoznek A, Benyoussef A et al (2003) Complete solo laparoscopic radical prostatectomy: initial experience. Urology 61:724–728

    Article  Google Scholar 

  •  4. Baba S, Egawa S, Iwamura M (2001) A novel multi-degrees-of freedom needle holder: a preliminary experience in laparoscopic surgery. J Endourol 15:A142 (abstract no. V10-P7)

    Google Scholar 

  •  5. Birkett DH (2001) Electromechanical instruments for endoscopic surgery. Minim Invasive Ther Allied Technol 10:271–274

    Article  Google Scholar 

  •  6. Boer den KT, Bruijn M, Jaspers JEN et al (2002) Time-action analysis of instrument positioners in laparoscopic cholecystectomy; a multicenter prospective randomized trial. Surg Endosc 16:142–147

    Article  Google Scholar 

  •  7. Breedveld P, Stassen HG, Meijer DW et al (1999) Theoretical background and conceptual solution for depth perception and eye–hand coordination problems in laparoscopic surgery. Minim Invasive Ther Allied Technol 8:227–234

    Google Scholar 

  •  8. Buess GF, Arezzo A, Schurr MO et al (2000) A new remote-controlled endoscope positioning system for endoscopic solo surgery. Surg Endosc 14:417–418

    Article  Google Scholar 

  •  9. Cathelineau X, Rozet F, Vallancien G (2004) Robotic radical prostatectomy: the European experience. Urol Clin North Am 31:639–699

    Article  Google Scholar 

  • Cuschieri A (1995) Whither minimal access surgery: tribulations and expectations. Am J Surg 169:9–19

    Article  PubMed  CAS  Google Scholar 

  • CONDOR Medicaltechnik (2007) Endoboy. http://www.condor-med.de

    Google Scholar 

  • Falk V, McLoughlin J, Guthart G et al (1999) Dexterity enhancement in endoscopic surgery by a computer-controlled mechanical wrist. Minim Invasive Ther Allied Technol 8:235–242

    Google Scholar 

  • Frede T, Stock C, Renner C et al (1999) Geometry of laparoscopic suturing and knotting techniques. J Endourol 13:191–198

    PubMed  CAS  Google Scholar 

  • Frede T, Stock C, Rassweiler JJ et al (2000) Retroperitoneoscopic and laparoscopic suturing: tips and strategies for improving efficiency. J Endourol 14:905–913

    PubMed  CAS  Google Scholar 

  • Frede T, Erdogru T, Zukosky D et al (2005) Analysis of transferability and open surgical skills for performing laparoscopic radical prostatectomy – experience with 1000 patients. J Urol 174:673–678

    Article  PubMed  Google Scholar 

  • Frede T, Hammady A, Klein J et al (2007) The Radius Surgical System – a new device for complex minimally invasive procedures in urology. Eur Urol 51:1015–1022; discussion 1022

    Article  PubMed  Google Scholar 

  • Green PE, Piantanida TA, Hill JW et al (1991) Telepresence: dexterous procedures in a virtual operating field. Am Surg 57:192 (abstract)

    Google Scholar 

  • Guillonneau B, Cappèle O, Bosco J et al (2001) Robotic assisted laparoscopic pelvic lymph node dissection in humans. J Urol 165:1078

    Article  PubMed  CAS  Google Scholar 

  • Janetschek G, Rassweiler J (1996) Future outlook. In: Janetschek G, Rassweiler J, Griffith D (eds) Laparoscopic surgery in urology. Thieme, Stuttgart, pp 276–280

    Google Scholar 

  • Janetschek G, Bartsch G, Kavoussi LR (1998) Transcontinental interactive laparoscopic telesurgery between the United States and Europe. J Urol 160:1413–1415

    Article  PubMed  CAS  Google Scholar 

  • Jaspers JEN (2006) Simple tools for surgeons. Design and evaluation of mechanical alternatives for “robotic” instruments for minimally invasive surgery (thesis). Ridderprint, Ridderkerk, The Netherlands

    Google Scholar 

  • Jaspers JEN, Den Boer KT, Sjoerdsma W et al (2000) Design and feasibility of PASSIST, a passive instrument positioner. J Laparoendosc Surg 10:331–335

    Article  CAS  Google Scholar 

  • Jaspers JEN, Bentala M, Herder JL et al (2004) Mechanical manipulator for intuitive control of endoscopic instruments with seven degrees of freedom. Minim Invasive Ther Allied Technol 13:191–198

    Article  PubMed  Google Scholar 

  • Kavoussi LR, Moore RG, Adams JB et al (1995) Comparison of robotic versus human laparoscopic camera control. J Urol 154:2134–2136

    Article  PubMed  CAS  Google Scholar 

  • Dr. Keutterling MTC (2007) LapMan, Laparoscopic Manipulator. http://www.medsys.de

    Google Scholar 

  • Lirici MM, Papaspyropoulos V, Angelini L (1997) Telerobotics in medicine and surgery. Minim Invasive Ther Allied Technol 6:364–378

    Google Scholar 

  • Lotan Y, Cadeddu JA, Gettman MT (2004) The new economics of radical prostatectomy: cost comparison of open, laparoscopic and robot assisted techniques. J Urol 172:1431–1435

    Article  PubMed  Google Scholar 

  • Luke PP, Girvan AR, Al Omar M et al (2004) Laparoscopic robotic pyeloplasty using Zeus telesurgical system. Can J Urol 11:2396–2400

    PubMed  Google Scholar 

  • Marescaux J, Leroy J, Gagner M et al (2001) Transatlantic robot-assisted telesurgery. Nature 413:379–380

    Article  PubMed  CAS  Google Scholar 

  • Menon M, Shrivastava A, Tewari A et al (2002) Laparoscopic and robot assisted radical prostatectomy: establishment of a structured program and preliminary analysis of outcomes. J Urol 168:945–949

    Article  PubMed  Google Scholar 

  • Pietrabissa A, Scarcello E, Carobbi A et al (1994) Three dimensional versus two-dimensional video system for the trained endoscopic surgeon and the beginner. Endosc Surg 2:315–317

    CAS  Google Scholar 

  • Polet R, Donnez J (2004) Gynecologic laparoscopic surgery with a palm-controlled laparoscopic holder. J Am Gynecol Laparosc 11:73–78

    Article  Google Scholar 

  • Rassweiler J, Binder J, Frede T (2001) Robotic and telesurgery: will they change our future? Curr Opin Urol 11:309–320

    Article  PubMed  CAS  Google Scholar 

  • Rassweiler J, Frede T, Seemann O et al (2001) Telesurgical laparoscopic radical prostatectomy – initial experience. Eur Urol 40:75–83

    Article  PubMed  CAS  Google Scholar 

  • Rassweiler J, Frede T (2002) Robotics, telesurgery and telementoring – their position in modern urological laparoscopy. Arch Esp Urol 55:610–628

    PubMed  Google Scholar 

  • Rassweiler J, Safi KC, Subotic S et al (2005) Robotics and telesurgery – an update on their position in laparoscopic radical prostatectomy. Minim Invasive Ther 14:109–122

    Article  CAS  Google Scholar 

  • Reichenspurner H, Damiano R, Mack M et al (1999) Use of the voice-controlled surgical system ZEUS for endoscopic coronary bypass grafting. J Thorac Cardiovasc Surg 118:11–16

    Article  PubMed  CAS  Google Scholar 

  • Satava RM (1992) Robotics, telepresence and virtual reality: a critical analysis of the future of surgery. Minim Invasive Ther 1:357–363

    Google Scholar 

  • Schurr MO, Buess G, Rininsland H et al (1996) Artemis – Manipulatorsystem für die endoskopische Chirurgie. Endoskopie Heute 9:245–251

    Google Scholar 

  • Schurr MO, Arezzo A, Neisius B et al (1999) Trocar and instrument positioning system TISKA. An assist device for endoscopic solo surgery. Surg Endosc 13:528–531

    Article  PubMed  CAS  Google Scholar 

  • Schurr MO, Kunert W, Arezzo A et al (1999) The role and future of endoscopic imaging systems. Endoscopy 71:557–562

    Article  Google Scholar 

  • Schurr MO, Buess G, Schwarz K (2001) Robotics in endoscopic surgery: can mechanical manipulators provide a more simple solution for the problem of limited degrees of freedom? Minim Invasive Ther 10:289–293

    Article  Google Scholar 

  • Steers WD, Lebeau S, Cardella J et al (2004) Establishing a robotics program. Urol Clin North Am 31:73–780

    Article  Google Scholar 

  • TrueVision (2007) Microsurgery teaching system. http://www.truevisionsys.com

    Google Scholar 

  • Wagner AA, Varkarakis M, Link RE et al (2006) Comparison of surgical performance during laparoscopic radical prostatectomy of two robotic camera holders, EndoAssist and AESOP: a pilot study. Urology 68:70–74

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Urology, Heilbronn Clinic, University of Heidelberg, Am Gesundbrunnen 20, 74074, Heilbronn, Germany

    Jens Rassweiler, Ali S. Goezen, Walter Scheitlin, Dogu Teber & Thomas Frede

Authors
  1. Jens Rassweiler
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  2. Ali S. Goezen
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  3. Walter Scheitlin
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  4. Dogu Teber
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  5. Thomas Frede
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Editor information

Editors and Affiliations

  1. Lions Eye Institute, Centre of Excellence in e-Medicine, University of Western Australia, 2 Verdun Street, 6009, Nedlands, Australia

    Sajeesh Kumar

  2. IRCAD/EITS (European Institute for Telesurgery), 1 place de l’Hôpital, BP 426, 67091, Strasbourg, France

    Jacques Marescaux

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© 2008 Springer-Verlag Berlin Heidelberg

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Rassweiler, J., Goezen, A., Scheitlin, W., Teber, D., Frede, T. (2008). Robotic-Assisted Surgery: Low-Cost Options. In: Kumar, S., Marescaux, J. (eds) Telesurgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-72999-0_6

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  • DOI: https://doi.org/10.1007/978-3-540-72999-0_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-72998-3

  • Online ISBN: 978-3-540-72999-0

  • eBook Packages: MedicineMedicine (R0)

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