[Surgical robotics, short state of the art and prospects].
State-of-the-art robotized systems developed for surgery are either remotely controlled manipulators that duplicate gestures made by the surgeon (endoscopic surgery applications), or automated robots that execute trajectories defined relatively to pre-operative medical imaging (neurosurgery and orthopaedic surgery). This generation of systems primarily applies existing robotics technologies (the remote handling systems and the so-called "industrial robots") to current surgical practices. It has contributed to validate the huge potential of surgical robotics, but it suffers from several drawbacks, mainly high costs, excessive dimensions and some lack of user-friendliness. Nevertheless, technological progress let us anticipate the appearance in the near future of miniaturised surgical robots able to assist the gesture of the surgeon and to enhance his perception of the operation at hand. Due to many in-the-body articulated links, these systems will have the capability to perform complex minimally invasive gestures without obstructing the operating theatre. They will also combine the facility of manual piloting with the accuracy and increased safety of computer control, guiding the gestures of the human without offending to his freedom of action. Lastly, they will allow the surgeon to feel the mechanical properties of the tissues he is operating through a genuine "remote palpation" function. Most probably, such technological evolutions will lead the way to redesigned surgical procedures taking place inside new operating rooms featuring a better integration of all equipments and favouring cooperative work from multidisciplinary and sometimes geographically distributed medical staff.
Gravez
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Commissariat à l'Energie atomique, List/SRSI, centre de Fontenay-aux-Roses, BP6, 92265 Fontenay-aux-Roses, France. gravezp@zoe.cea.fr
D004724:Endoscopy / Q000379:methods; D005544:Forecasting; D006801:Humans; D021621:Imaging, Three-Dimensional; D008904:Miniaturization; D019060:Minimally Invasive Surgical Procedures; D019635:Neurosurgical Procedures / Q000295:instrumentation; D009873:Operating Rooms; D019637:Orthopedic Procedures / Q000295:instrumentation; D016634:Radiosurgery / Q000295:instrumentation; D012371:Robotics / Q000191:economics / Q000639:trends; D012449:Safety; D025321:Surgery, Computer-Assisted; D013523:Surgical Equipment; D017216:Telemedicine