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Latest in health: Robots make surgery easier for everyone involved

Senior Airman Jenay Randolph/U.S. Air Force
Robotic surgery allows surgeons to use controls to remotely perform surgery while projecting the procedure on a large screen.

Robotic-assisted surgery is an ever-expanding field in medicine, and new technology is allowing surgeons to perform procedures better, easier and safer than past methods, an Ohio surgeon said.

Dr. Jihad Kaouk, director of the Center for Robotic and Image Guided Surgery in the Glickman Urological and Kidney Institute at Cleveland Clinic, spoke with “Take Care” about how far robotic surgery has come and still has to go. 

Technological advances are continually changing medicine, but the use of robotics in surgery takes things a bit further. Kaouk said robotics has advanced considerably since its beginning in medicine.

“The way innovations go in surgery is that it’s a continuum,” Kauok said. “It’s a progress.”

In the ’90s, keyhole surgery, also known as laparoscopy, was introduced, allowing surgeons to make small incisions through which to insert small cameras to assist in performing surgery. Modern robotic surgery can now perform everything that used to be done laparoscopically, Kauok said.

“Any time you need to stitch something together, the robot is the best suturing machine,” Kauok said.

Completely autonomous robotic surgery does not exist yet, Kauok said, which means currently, doctors sit at a control chair to move a robot holding various instruments using pedals and joysticks.

Kauok said there are two main advantages of this method over laparoscopy: the robot’s movements are more articulate than a surgeon’s, and two cameras mounted on the instruments give the perception of depth when operating. The video received on those cameras can then be magnified and projected on a screen for multiple surgeons to observe.

“Everything that the surgeon is doing inside the patient is being seen so clearly by all the staff in the operating room, while, in open surgery, only if you have a certain angle above the shoulder of the surgery, you can see what’s going on,” Kauok said.

Some of the most common procedures for robotic surgery are for prostate cancer, enlarged prostate, kidney tumors and reconstructive procedures.

To prevent accidents in robotic-assisted surgeries, algorithms detect and filter tremors in the equipment and allow for the fine control of movements, Kauok said. In addition, there is an infrared sensor in the consul that will freeze the robot if the surgeon removes their head from the consul.

The barriers to adopting robotic-assisted surgery come from both the patient and the doctor, Kauok said. Factors like the patient’s body type, the severity of a tumor and the surgeon’s experience in robotics play a role in whether robotics will be involved in the surgery, he said.

“Every patient presents with a different scenario than another patient, so every patient is unique,” Kauok said.

Kauok said he has seen many doctors embrace robotic surgery, with little reluctance. This attitude has allowed for faster integration of the technology, he said, making way for more advances in the future.

“Robotics, in some specialties like urology, have taken over most of our minimally invasive approaches for prostate, kidney and bladder cancer, and that’s because it comes with [a] shorter curve,” Kauok said. “We are able to teach the next generation of surgeons much quicker and effectively than we used to.”

Kauok sees robotic-assisted surgery advancing to include remote telesurgery in the future, where a surgeon in one region can perform surgery on a patient in another region using robots. The technology is in its rough stages right now, but Kauok said he knows there is potential for it to help many people in areas struggling for specialists.

“There are certain challenges, but this is coming,” Kauok said. “I think we’re going to reach a day where remote telesurgery will be part of our common practice.”