Human vs Robots – Possible Prospects in Robot-Assisted Heart Surgery
Human versus Robots – Possible Prospects in Robot-Assisted Heart Surgery: Robot assisted surgery allows a surgeon to operate via miniaturized surgical instruments that fit through a series of quarter-inch incisions, thus eliminating the need for large incisions. Advances in minimally invasive surgical technology could dramatically increase the acceptance of robotic surgeries and increase the number of such surgeries performed. Aimed at reducing the amount of extraneous tissue that is damaged during diagnostic or surgical procedures, such surgeries aid in reducing patient recovery time, discomfort, and deleterious side effects.
It will be wise to say that we’re on the verge of what we might call the second generation in robotic surgery. The new scientific innovations will boom the medical industry by integrating new technologies such as artificial intelligence with surgical robots. Today, surgical robots are believed to be prodigies of surgery. This next phase will mitigate the challenges such as backup plans, security, testing ethics, patient acceptance, etc. that are faced by this technology and will potentiate its capabilities. By 2023, surgical robotics market is expected to be worth approximately $6.5 billion.
Intuitive Surgical, an American corporation that develops, manufactures and markets robotic products designed to improve clinical outcomes of patients through minimally invasive surgery (most notably with the da Vinci Surgical System), has published maximum inventions in this technology domain. The analysis of portfolios that have strong interactions with each other reveals that Intuitive Surgical is strongly cited by most players which include but is not limited to MIT- Massachusetts Institute of Technology, Converge Medical, Cardeon Saratoga and Niemeyer Gunter D and is therefore likely to be a pioneering or a blocking portfolio.
The published inventions and scientific innovations suggest that the scientific community is mainly focusing on closed chest surgeries. Key industry players such as Intuitive Surgical, PLA General Hospital, Converge Medical, Medivas, East Carolina University etc. have published inventions that focus on surgical devices that allow closed chest surgery to be performed on a heart of a patient while the heart is beating. Majority of these inventions have their focus on stabilizer (such as a coronary tissue stabilizer used for beating heart surgery), or a retractor (for example, to retract tissue to expose a desired area of the cystic duct to the surgeon during cholecystectomy).
There are several reasons why researchers have filed their inventions for such stabilizers. One reason being, it requires enhanced skill of the surgeon to properly create the anastomosis during heart surgery, because, even with use of sutures to suspend a portion of the surface of the heart upon which the surgery is conducted, the beating heart continues to move more than desired in the relevant area. In addition, the sutures may cause a myocardial tear, an injury of the coronary artery branches, or such complications as embolism or focal arteriosclerosis resulting from the pressures of the ligatures upon the artery. Another reason is the application of devices such as local myocardial compression device that causes local compression to the heart and can lead to considerable local deterioration of cardiac function, particularly when cardiopulmonary bypass is not used to supplement blood circulation. At the same time, this device does not address the problem of bleeding from a locally dissected coronary artery intended for anastomosis. Thus, there is a need for new and better devices and methods of using them to stabilize a surgical site – such as the surface of the beating heart, or for stabilizing an interior therapeutic or diagnostic treatment site during minimally invasive or robotic surgery.
Numerous patents have been filed to provide solutions on other key aspects of the robot-assisted surgical systems (Robot-Assisted Heart Surgery) such as:
- Devices, systems, and methods that allow components of a tele surgical robotic system to be selectively and independently repositioned.
- Protective function for a surgical head support frame, systems and methods which use servo-mechanisms under surgeon control to augment a surgeon’s ability to perform surgical procedures on a beating heart.
- Methods for heart imaging.
While this technology is emerging, key industry players are also collaborating and merging with organizations and academia to improve their portfolio. In March 2015, Ethicon Inc. (medical device company under the umbrella of pharma giant Johnson & Johnson) collaborated with Google to work on advanced surgical robots and expecting it to cost far less than Intuitive Surgical’s da Vinci, thus, making these state-of-the-art systems more attainable.
Concluding Thoughts on Robot-Assisted Heart Surgery
Today, robotic heart surgeons perform complex mitral valve repairs, coronary revascularizations, atrial fibrillation ablations, intracardiac tumor resections, and congenital heart surgery procedures. Minimally invasive tele surgical robotic systems are being developed to increase a surgeon’s dexterity when working within an internal surgical site, as well as to allow a surgeon to operate on a patient from a remote location. The adoption of robotic surgery has been comparatively slow, likely related to its complexity and absence of formal training programs. While the proposed robotic surgery systems offer significant potential to increase the number of procedures that can be performed in a minimally invasive manner, further improvements are still desirable.
However, proposed methods of performing robotic heart surgeries also create many new challenges. Therefore, there is still a need for a system that can enhance the dexterity of the surgeon compared to standard endoscopic techniques. This can be done by providing more degrees-of-freedom to perform the surgery. An easily controlled mechanism allows surgeons to use different tools (end-effectors) that are interchangeable, relatively quicker, with the ability to move from one type of end effector to another task during the course of an operation.
– The Life Sciences and Editorial Team