Robotic assistant for laparoscopy.
BACKGROUND
With the advent of technologies allowing for wider application of minimally invasive surgeries, the integration of telerobotics for mentoring by a surgeon at a remote site will make it possible to include a wider audience in surgical consultations and collaboration.


METHODS
Two surgery research fellows performed 8 laparoscopic cholecystectomies each in a swine model, as the animate portion of the study. Using the Zeus robotic system, a senior surgeon participated as a robotic assistant and consulted remotely. Teleconsultation was achieved using Hermes voice-activated software to display an on-screen pointer highlighting significant anatomic structures. To clarify the workspace space constraints on the robotic arms, an inanimate study was conducted to carry out retrieval, delivery, and complex object movement.


RESULTS
All the laparoscopic cholecystectomies were completed successfully, with minimal blood loss and no complications. The robotic assistant surgeon participated in all surgeries and instructed on anatomical landmarks. The robotic tools were at a disadvantage due to the radius of movement. The simpler tasks were easier to complete than the complex movement, which required bimanual coordination.


CONCLUSIONS
This study confirms the feasibility of integrating robotics as a surgical assistant and to consult distant audiences by a single senior surgeon. Incorporating remote access assistance and education capacities extends the limits of physical restrictions in completing surgical procedures safely.
Panait
Lucian
L
Department of Surgery, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
Rafiq
Azhar
A
Mohammed
Ahmed
A
Mora
Francisco
F
Merrell
Ronald
R
D000818:Animals; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation*; D002983:Clinical Competence; D013502:General Surgery / Q000193:education*; D006801:Humans; D012371:Robotics; D013552:Swine