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The History of Robotics in Surgical Specialties. 机器人技术在外科专业的历史。
Pub Date : 2014-06-01 DOI: 10.1166/AJRS.2014.1006
J. Shah, A. Vyas, D. Vyas
A major positive step in the field of surgery was made when a robot was first used in the theater of surgery about 25 years ago. The robot was a PUMA 200 (Westinghouse Electric, Pittsburgh, PA) which was used for needle placement in a CT-guided brain biopsy1. Since then it has been exciting to see that the field of robotic surgery grow in leaps and bounds. Part of the reason for this is the plethora of benefits afforded by robotics that are simply absent in traditional surgical methods. For example, robots offer stability, accuracy, integration with modern imaging technology, greater range of motion, telesurgery, in addition to multiple other benefits inherent to individual surgical specialties2. Since the introduction of robotic surgery, many advances have been made in the field. In order to fully utilize the potential of the surgical robot it is important to understand the past in order to build towards the future. In order to understand the past, it is important to look at both the advances and achievements of robotic surgery in the various fields of surgery such as otolaryngological, neurosurgery, gynecological, cardiothoracic, gastric, urologic, orthopedic, endoscopy, and miniature after which the future developments that are on the horizon can be evaluated. This article will enumerate major milestones and will continue with limitations in subsequent articles.
大约25年前,机器人首次在手术室中使用,这是外科手术领域迈出的重要的积极一步。该机器人是PUMA 200(西屋电气公司,宾夕法尼亚州匹兹堡),用于在ct引导下的脑活检中放置针头1。从那时起,看到机器人手术领域突飞猛进的发展令人兴奋。造成这种情况的部分原因是机器人技术带来了传统手术方法所没有的诸多好处。例如,除了个别外科专业所固有的许多其他优点外,机器人还具有稳定性、准确性、与现代成像技术的结合、更大的活动范围、远程手术等优点。自从机器人手术问世以来,这一领域取得了许多进展。为了充分利用外科手术机器人的潜力,了解过去以迈向未来是很重要的。为了了解过去,重要的是要看看机器人手术在各个外科领域的进展和成就,如耳鼻喉科、神经外科、妇科、心胸外科、胃外科、泌尿外科、整形外科、内窥镜和微型外科,之后可以评估未来的发展。本文将列举主要里程碑,并在后续文章中继续讨论限制。
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引用次数: 82
Robotic Surgery: Applications. 机器人手术:应用。
Pub Date : 2014-06-01 DOI: 10.1166/AJRS.2014.1004
Tiffany Leung, D. Vyas
In a relatively short amount of time, robots have made its way into both general and subspecialty surgical fields. The da Vinci Surgical System (Intuitive Surgical Inc., Sunnyvale, CA) has been around for over a decade now. The first da Vinci surgical system came out in 1999 and was FDA approved in 2000. In 2003, a fourth robotic arm was added. The da Vinci S model came out in 2006 and offered improved robotic arm movements, console displays, and simpler set up. As of 2009, the latest model called da Vinci Si, now offers dual consoles so two individuals can collaborate simultaneously. Controls, vision, and ergonomics have been improved as well.
在相对较短的时间内,机器人已经进入了普通和亚专科外科领域。达芬奇手术系统(Intuitive Surgical Inc., Sunnyvale, CA)已经存在了十多年。第一个达芬奇手术系统于1999年问世,并于2000年获得FDA批准。2003年,又增加了第四个机械臂。达芬奇S型号于2006年问世,改进了机械臂运动、控制台显示和更简单的设置。截至2009年,最新型号的达芬奇Si现在提供双控制台,因此两个人可以同时协作。控制、视觉和人体工程学也得到了改进。
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引用次数: 16
Current Status of Single-Site Robotic Cholecystectomy, its feasibility, economic and overall impact. 单点机器人胆囊切除术的现状、可行性、经济性和整体影响。
Pub Date : 2014-06-01 DOI: 10.1166/AJRS.2014.1007
D. Vyas, Cara Weiner, A. Vyas
This paper reviews recent, though limited, articles on the topic of robotic single-site cholecystectomy (RSSC), a relatively new approach that is rapidly advancing in both research and clinical application. Laparoscopy has typically been the standard method of performing a cholecystectomy, but recent medical advances have led to usage of the da Vinci® Surgical System robot technology to assist in performing the procedure. Several studies have compared outcomes of the RSSC to single-port laparoscopic cholecystectomies and to the traditional multiport laparoscopic cholecystectomies. Single port advocates think it as a tool with better cosmetic results and questionable less post-operative pain; however, single port also limits the maneuverability of the instrument arms, making some tasks more difficult, bigger single incision, more chances of post operative hernia. Overall, the RSSC is considered as safe with no worse outcomes regarding pain, hospital stay length, operative time, and patient satisfaction when compared to other cholecystectomy methods. Future direction includes expanding use of the miniature instruments and further advanced tools to overcome manipulation and visualization limitations. Thus far, though, there may be enough evidence with these smaller studies to support lack of harm with more use of resources.
本文综述了机器人单部位胆囊切除术(RSSC)这一在研究和临床应用中都迅速发展的相对较新的方法。腹腔镜检查通常是执行胆囊切除术的标准方法,但最近的医学进步已经导致使用达芬奇®手术系统机器人技术来协助执行程序。一些研究比较了RSSC与单孔腹腔镜胆囊切除术和传统的多孔腹腔镜胆囊切除术的结果。单一端口的支持者认为它是一种更好的美容效果和更少的术后疼痛的工具;然而,单端口也限制了器械臂的可操作性,使一些任务更加困难,单切口更大,术后疝气的可能性更大。总的来说,与其他胆囊切除术方法相比,RSSC被认为是安全的,在疼痛、住院时间、手术时间和患者满意度方面没有更差的结果。未来的方向包括扩大微型仪器和更先进的工具的使用,以克服操作和可视化的限制。然而,到目前为止,这些较小的研究可能有足够的证据支持更多地使用资源不会造成伤害。
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引用次数: 5
Robotics in Colonoscopy. 结肠镜检查中的机器人技术。
Pub Date : 2014-06-01 DOI: 10.1166/ajrs.2014.1008
Dan Cater, Arpita Vyas, Dinesh Vyas

Colorectal cancer is the second leading cause of mortality in men and women in the United States. While there is a definite advantage regarding the use of colonoscopies in screening, there is still a lack of widespread acceptance of colonoscopy use in the general public. This is evident by the fact that up to 75% of patients diagnosed with colorectal cancer present with locally advanced disease. In order to make colonoscopy and in turn colorectal cancer screening a patient friendly and a comfortable test some changes in tool are necessary. The conventional colonoscope has not changed much since its development. There are several new advances in colorectal screening practices. One of the most promising new advances is the advent of robotic endoscopic techniques.

结直肠癌是美国男性和女性死亡的第二大原因。虽然结肠镜检查在筛查中有明显的优势,但在公众中结肠镜检查的使用仍然缺乏广泛的接受度。高达75%被诊断为结直肠癌的患者存在局部晚期疾病,这一事实证明了这一点。为了使结肠镜检查和结直肠癌筛查成为一种对患者友好和舒适的检查,一些工具的改变是必要的。传统的结肠镜自发展以来并没有太大的变化。结直肠筛查有一些新的进展。最有希望的新进展之一是机器人内窥镜技术的出现。
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引用次数: 4
Current Status of Single-Site Robotic Cholecystectomy, its feasibility, economic and overall impact. 单点机器人胆囊切除术的现状、可行性、经济性和整体影响。
Pub Date : 2014-06-01
Dinesh Vyas, Cara Weiner, Arpita K Vyas

This paper reviews recent, though limited, articles on the topic of robotic single-site cholecystectomy (RSSC), a relatively new approach that is rapidly advancing in both research and clinical application. Laparoscopy has typically been the standard method of performing a cholecystectomy, but recent medical advances have led to usage of the da Vinci® Surgical System robot technology to assist in performing the procedure. Several studies have compared outcomes of the RSSC to single-port laparoscopic cholecystectomies and to the traditional multiport laparoscopic cholecystectomies. Single port advocates think it as a tool with better cosmetic results and questionable less post-operative pain; however, single port also limits the maneuverability of the instrument arms, making some tasks more difficult, bigger single incision, more chances of post operative hernia. Overall, the RSSC is considered as safe with no worse outcomes regarding pain, hospital stay length, operative time, and patient satisfaction when compared to other cholecystectomy methods. Future direction includes expanding use of the miniature instruments and further advanced tools to overcome manipulation and visualization limitations. Thus far, though, there may be enough evidence with these smaller studies to support lack of harm with more use of resources.

本文综述了机器人单部位胆囊切除术(RSSC)这一在研究和临床应用中都迅速发展的相对较新的方法。腹腔镜检查通常是执行胆囊切除术的标准方法,但最近的医学进步已经导致使用达芬奇®手术系统机器人技术来协助执行程序。一些研究比较了RSSC与单孔腹腔镜胆囊切除术和传统的多孔腹腔镜胆囊切除术的结果。单一端口的支持者认为它是一种更好的美容效果和更少的术后疼痛的工具;然而,单端口也限制了器械臂的可操作性,使一些任务更加困难,单切口更大,术后疝气的可能性更大。总的来说,与其他胆囊切除术方法相比,RSSC被认为是安全的,在疼痛、住院时间、手术时间和患者满意度方面没有更差的结果。未来的方向包括扩大微型仪器和更先进的工具的使用,以克服操作和可视化的限制。然而,到目前为止,这些较小的研究可能有足够的证据支持更多地使用资源不会造成伤害。
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引用次数: 0
Nanorobotic Applications in Medicine: Current Proposals and Designs. 纳米机器人在医学中的应用:当前的提案和设计。
Pub Date : 2014-06-01 DOI: 10.1166/ajrs.2014.1010
Yamaan Saadeh, Dinesh Vyas

Advances in technology have increased our ability to manipulate the world around us on an ever-decreasing scale. Nanotechnologies are rapidly emerging within the realm of medicine, and this subfield has been termed nanomedicine. Use of nanoparticle technology has become familiar and increasingly commonplace, especially with pharmaceutical technology. An exciting and promising area of nanotechnological development is the building of nanorobots, which are devices with components manufactured on the nanoscale. This area of study is replete with potential applications, many of which are currently being researched and developed. The goal of this paper is to give an introduction to the emerging field of nanorobotics within medicine, and provide a review of the emerging applications of nanorobotics to fields ranging from neurosurgery to dentistry.

技术的进步提高了我们操纵周围世界的能力,而且其规模还在不断缩小。纳米技术在医学领域迅速崛起,这一子领域被称为纳米医学。纳米粒子技术的使用已为人们所熟悉,而且越来越普遍,尤其是在制药技术方面。纳米技术发展的一个令人兴奋和充满希望的领域是制造纳米机器人,即在纳米尺度上制造部件的设备。这一研究领域有许多潜在的应用,其中许多目前正在研究和开发中。本文旨在介绍医学中的纳米机器人这一新兴领域,并回顾纳米机器人在神经外科和牙科等领域的新兴应用。
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引用次数: 0
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American journal of robotic surgery
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