[Essentials aspects of robotic systems].
Most advances in Surgery can now be seen to have been preceded by the invention of new instruments. Conventional surgery progressed as new instruments became available. Transurethral resections became routine following the introduction 80 years ago of the resectoscope: a highly revolutionary instrument at that time. Ureterorenoscopes and nephros- copes opened new windows of opportunity for urologists. When the therapeutic potential of extracorporeal lithotripsy, was first mentioned in the literature most surgeons thought it was mere science-fiction fantasy. Very soon however, this new technique, the fruit of close collaboration between urologists and engineers, became a common-place reality. Laparoscopy met with similar disbelief and the early applications gave rise to controversy and even consternation, yet only a few years later most of our urological surgical procedures have adopted this technique.



At the beginning of the 20th century the astounding advances in engineering led many to forecast that before its end those systems might mimic human intelligence. However, many attempts to construct a rational thinking device revealed that even today this ambitious project was a still an unattainable dream. Consequently, attempts to design an autonomous urological surgical robot that might carry out unsupervised transurethral resections were unfruitful because the inherent and unpredictable complexity of surgical procedures obliges close and rigorous control by the surgeon. This important limitation led to the creation of 'master-slave' systems similar to those designed by our team in 1998 for transurethral resection. These are relatively simple tools and are infinitely safer than autonomous robots because they aim to effectively help the surgeon rather than replace him.



The oft-repeated argument about whether or not a robot might ever replace the surgeon now has little sense because today it is merely a tool, an instrument for the surgeon's hands. The devices available today lack the all-important tactile feedback and to use them effectively, the surgeon is obliged to serve a new and arduous apprenticeship and the learning curve is unavoidably steep. Consequently, many prestigious authors understandably feel unable to recommend their use. Our accumulated experience with master-slave manipulators stimulates us to confidently predict that sooner than later, whether we like it or not, surgical robots will evolve to become indispensable tools that enhance the surgeon's skill, precision and speed in many surgical procedures.
Sanchez de Badajoz
Eduardo
E
Area de Conocimiento de Urología, Departamento de Cirugía, Facultad de Medicina y Departamento de Ingeniería, de Sistemas y Automática, Escuela Técnica Superior de Ingenieros Industriales, Universidad de Málaga, España. edusaba@telefonica.net
Jiménez Garrido
Adolfo
A
Muñoz Martínez
Víctor Fernando
VF
D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D012371:Robotics