Robots Playing Important Role In Operating Room

Oct 2, 2017

The types of surgeries involving robots are increasing.  The most recent examples are cochlear and dental implants. This comes as engineers slowly move ahead to make the robots smarter and more able to think on their own.

Cincinnati's Bethesda North Hospital does a lot of robotic surgeries, with a third of the operating rooms equipped with them.

The da Vinci XI is the most advanced robot Intutive makes and it is based on NASA technology.
Credit Used with permission / Intuitive Surgical, Inc.

Surgeon Benjamin Niver sits at a console controlling everything the robot does in a surgery to remove a kidney. He manipulates the machine’s arms and the robot mimics the doctor’s motions with ten times magnification. Small movements on the outside can become micro motions on the inside. Robotic Coordinator John Bires points out the da Vinci XI and the wall-mounted 40-inch monitor that we’re watching.

“So this is the XI robot. It’s a little different than the other robots we have. It’s got a different configuration, but it can reach a lot more parts of the patient easily. It also makes it easier for the staff to use.”

Other doctors, nurses and surgical techs are working in this particular operating room, driving home Bires’ point that the robot isn’t replacing anybody.

“We still need an assistant. We still need a surgical tech. Still need a surgeon. Still need an anesthesiologist, still need a nurse. All the people still have jobs. We just can do the job better with a robot.

Bethesda North and its doctors are embracing robotic surgery and the $1.7 million da Vinci robot, according to President of the Bethesda Foundation Andy Swallow.

“Bethesda North is the highest volume hospital in Cincinnati and Ohio for robotic assisted surgery. I think what makes it sort of interesting is the breadth and depth of types of surgeries.”

Robotic assisted surgery goes beyond urology. Dr. Mark Delworth, the director of robotic surgery for Tri-Health, says the machines are being used for heart bypass, gynecology, and general surgery.

“It’s really even better than the surgeon himself because you can see better than you normally would. There are additional benefits. The robot can make you ambidextrous, which most people are not. There is some tremor elimination, more advanced than your camera.”

The actual incision is very small--one and a half inches by one inch. The robot magnifies and projects the image in 3D to the surgeon who is controlling all movements.

According to Bires, “The robot is essentially a microprocessor that understands his motions. And there are sensors in these arms that then relay that to the robot that’s working with the doctor and it mimics his motions.”

Dr. Delworth says the future is better imaging where doctors can query the robot as to where a tumor is and that area will light up. He sees other improvements coming.

“In the future I think the advancements are going to be even more profound. I think potentially using natural Orpheus surgery is going to continue to grow where you can actually go through the mouth down to the stomach and go through the vagina and rectum and operate that way, not having to make any external incisions at all.”

Wired.com reports the first robot-assisted cochlear implant in a clinical trial, doesn’t just enhance a surgeon’s dexterity, but gives surgeons superpowers, allowing them to feel through tissue by measuring how the drill bit’s force changes against bone or flesh.

Science Robotics Editor Guang-Zhong Yang takes it a step farther in an editorial wondering where we go from here comparing robotic assisted surgery, level one to level 4 and 5 autonomy. He says, "The robot here is not only a medical device but also effectively practicing medicine.”