Flexible Robotics

FlexibleFlexible RoboticsRobotics

Presented by:Presented by:

Autum ArtzAutum Artz

ObjectivesObjectives::

Understand Flexible Robotics and the growth of Understand Flexible Robotics and the growth of tele-surgical devices.tele-surgical devices.

Describe and evaluate hardware and software Describe and evaluate hardware and software used in flexible robotics. used in flexible robotics.

Assess the role and functions of the robotics Assess the role and functions of the robotics nurse specialists.nurse specialists.

Examine and understand ethical dilemmas in Examine and understand ethical dilemmas in regards to flexible robotics.regards to flexible robotics.

Describe advantages and disadvantages of Describe advantages and disadvantages of flexible robotics in the health field and in nursing.flexible robotics in the health field and in nursing.

What is flexible robotics?What is flexible robotics?

Medical robotic technology, that has Medical robotic technology, that has transformed surgical procedures, using transformed surgical procedures, using

smaller incisions with a telesurgical smaller incisions with a telesurgical device with shared control from the device with shared control from the

surgeon and the robotic system.surgeon and the robotic system.

Information System UsedInformation System Used::

Medical/Clinical Information systemMedical/Clinical Information system

Used clinically by medical professionalsUsed clinically by medical professionals

Information System Review:Information System Review:

Clinical information systemClinical information system

Used by Physicians and nursesUsed by Physicians and nurses

Purpose to diagnose and treat operativelyPurpose to diagnose and treat operatively

Configuration-stand alone workstationConfiguration-stand alone workstation

Perioperative nursing dataset classification Perioperative nursing dataset classification systemsystem

Excellent information system and tool on Excellent information system and tool on many levels, highly recommendedmany levels, highly recommended

Uses:Uses:

Cardiac Cardiac RevascularizationRevascularizationGastric BypassGastric BypassRadical Radical ProstatectomyProstatectomyHysterectomyHysterectomyCardiac Tissue Cardiac Tissue AblationAblationEpicardial Pacemaker Epicardial Pacemaker Lead PlacementLead Placement

Hardware and software used:Hardware and software used:

Fiber optic instrumentsFiber optic instruments

Small video camerasSmall video cameras

Joysticks to perform surgical tasksJoysticks to perform surgical tasks

Telemanipulation to guide robotic armsTelemanipulation to guide robotic arms

Three dimensional images vs. two Three dimensional images vs. two dimensionaldimensional

Usability:Usability:

The equipment is ergonomically appealing:

There is great ease of learning, using, and remembering how to manageThe system.

The hardware and software work well together and each part has a specificRole which enables the others parts to perform with ease.

Davinci Robot Davinci Robot Vs.Vs. Zeus RobotZeus Robot

Davinci is made by Davinci is made by Intuitive Surgical Inc.Intuitive Surgical Inc.First used July 2000.First used July 2000.Used for cutting and Used for cutting and suturing.suturing.Ergonomic interface Ergonomic interface surgeon uses hand surgeon uses hand movements and foot movements and foot petals.petals.4 interactive arms with 4 interactive arms with endowrist action.endowrist action.3 dimensional image of 3 dimensional image of surgical sites.surgical sites.

Zeus is made by Zeus is made by Computer Motion Inc.Computer Motion Inc.First used October 2001.First used October 2001.Used for grasping, Used for grasping, holding, and moving holding, and moving things out of the way.things out of the way.3 robotic arms.3 robotic arms.One arm voice activated One arm voice activated to hold endoscope.to hold endoscope.Surgeon wears glasses to Surgeon wears glasses to create 3 dimensional create 3 dimensional image.image.

Nurse Informaticist Role:Nurse Informaticist Role:

Assists intra operatively with Assists intra operatively with all robotic procedures.all robotic procedures.Brings observations and Brings observations and concerns to proper staff concerns to proper staff members to seek resolution.members to seek resolution.Orients and trains nurse Orients and trains nurse personnel and students.personnel and students.Keeps database of types of Keeps database of types of procedures and times, assists procedures and times, assists with research.with research.Acts as liason with institution Acts as liason with institution and manufacturer.and manufacturer.Builds comprehensive picture Builds comprehensive picture of how, why, and when to use of how, why, and when to use system.system.

Ethical Dilemmas:Ethical Dilemmas:

Waste of resources, procedures can be done Waste of resources, procedures can be done with simple microscope already.with simple microscope already.Cost is significantly more.Cost is significantly more.Surgeon is not at patient bedside but at Surgeon is not at patient bedside but at computer during procedure.computer during procedure.

Advantages:Advantages:

Robot allows for more efficient use of Robot allows for more efficient use of Instruments.Instruments.

60% less blood loss.60% less blood loss.

No tremor with robot.No tremor with robot.

Allows for 3 dimensional view instead of 2 Allows for 3 dimensional view instead of 2 dimensional.dimensional.

Decreased length of stay.Decreased length of stay.

Use of multiple arms. Use of multiple arms.

Disadvantages:Disadvantages:

Has limitations.Has limitations.

Not useful for very complicated resections.Not useful for very complicated resections.

Technical difficulty.Technical difficulty.

Learning curve for surgeons, takes at least Learning curve for surgeons, takes at least 12-18 surgeries to feel confident.12-18 surgeries to feel confident.

Cost.Cost.

Length of surgery is longer.Length of surgery is longer.

CompetenciesCompetencies

Turning equipment onTurning equipment on

Cleaning equipmentCleaning equipment

Changing out equipmentChanging out equipment

Patient carePatient care

Knowledge of hardware and softwareKnowledge of hardware and software

SummarySummary

Physicians are not scrubbedPhysicians are not scrubbed

Physicians are not at the bedsidePhysicians are not at the bedside

Alternative surgery to open proceduresAlternative surgery to open procedures

Many advantagesMany advantages

Nurses play an intricate roleNurses play an intricate role

Multiple patient care benefitsMultiple patient care benefits

References:References:Bonsor, Kevin, and Jonathan Strickland. "HowStuffWorks "Shared-control Bonsor, Kevin, and Jonathan Strickland. "HowStuffWorks "Shared-control Robotic Robotic

Surgery Systems"" Surgery Systems"" Howstuffworks "Science"Howstuffworks "Science" How Stuff Works, How Stuff Works, Inc., 30 Inc., 30 Oct. 2008. Web. 02 June 2010. Oct. 2008. Web. 02 June 2010. <http://science.howstuffworks.com/robotic-<http://science.howstuffworks.com/robotic-surgery4.htm>.surgery4.htm>.

Francis, Paula. "The Evolution of Robotics in Surgery and Implementing a Francis, Paula. "The Evolution of Robotics in Surgery and Implementing a Perioperative Robotics Nurse Specialist Role." Perioperative Robotics Nurse Specialist Role." ElsevierElsevier. AORN, Mar. . AORN, Mar. 2006. 2006. Web. 04 June 2010. Web. 04 June 2010. <http://www.aornjournal.org/article/PIIS0001209206601919/fulltext#sectio<http://www.aornjournal.org/article/PIIS0001209206601919/fulltext#sectio n9>.n9>.

"Intuitive Surgical, Inc. - Da Vinci Surgical System." Intuitive Surgical, Inc., "Intuitive Surgical, Inc. - Da Vinci Surgical System." Intuitive Surgical, Inc., 2005. 2005. Web. 03 June 2010. Web. 03 June 2010. <http://www.intuitivesurgical.com/index.aspx>.<http://www.intuitivesurgical.com/index.aspx>.

University of Florida. "Urologists Use Robot to Shave Time off Vasectomy University of Florida. "Urologists Use Robot to Shave Time off Vasectomy Reversal, Raise Sperm Counts." Reversal, Raise Sperm Counts." Science Daily: News & Articles in Science Daily: News & Articles in Science, Health, Science, Health, Environment & TechnologyEnvironment & Technology. Science Daily, 8 Jan. 2010. . Science Daily, 8 Jan. 2010. Web. Web. 04 June 2010. 04 June 2010.

<http://www.sciencedaily.com/releases/2010/01/100107183140.htm>.<http://www.sciencedaily.com/releases/2010/01/100107183140.htm>.

All pictures taken from intuitivesurgical.comAll pictures taken from intuitivesurgical.com