What are the Different Types of Robotic Systems?

Supervisory-Controlled System

A supervisory-controlled system, also referred to as a computer assisted surgery, is the highest automated compared to other systems. When performing surgery with this type of system, a great deal of time is needed for preparation. First, specific data is inputted into the robotic system by the surgeon and the support team. They must plan all the actions that are going to take place, take x-rays, test the robotic machinery, and make sure the robot is in the appropriate and exact position so that nothing goes wrong during the procedure. The surgeon and support team must also use the 3-D medical imaging to map out the body. Before the surgery, the system is matched with the patient’s body to the mapping. Once this is complete, the surgery will begin and the robotic system will perform the procedure. The surgeon must pay close attention to the robot’s actions and be ready to intervene if something does not go as planned. An example of a supervisory controlled system is the RoboDoc system.

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Shared Control Robotic System

With this type of system, the surgeon does most of the work while the robotic system helps when needed.  The system helps monitor the activities of the surgeon by stabilizing and supporting the surgeon's movements using a technique called active constraint. For example, when a surgeon approaches dangerous areas, such as soft tissues, the robotic system responds by pushing back against the surgeon’s hand. If the surgeon continues to near the tissues, the robotic system will offer more resistance, and if that doesn’t work, the robot will lock into place to prevent any damage from happening. Prior to the procedure, some setup is required by the surgeon. 

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Radiosurgery System

Robotic systems are also used to deliver radiation for tumor treatment. The robotic system controls the beams of radiation to precise locations in the body. First, the tumor is located with medical imaging and a map of the surgical field is created. The physician enters specific data that instructs the system how to deliver the treatment. The patient is matched up to the system for proper positioning and the treatment finally begins.  The system will follow the instructions and deliver doses to the tumor.

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Telesurgery System

In a procedure with a telesurgery system, the surgeon actually controls the actions of the robotic arms. The system consists of surgical arms, a separate viewing, and a control console. First, the surgeon will make small incisions on the body. A small camera and tools are inserted through the incisions. At the console, the surgeon will be able to view the organ in the 3D viewing screen. The surgeon controls the robotic arms from the hand-held controls that are within the console. The support team stands nearby to assist or change the tools on the robotic arms during the surgery.

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How Exactly Does Robotic Surgery Work? 

• The surgeon sits and works at a computer console. There is an O.R. team by the patient's bed, along with the robotic equipment.

• The doctor makes tiny incisions about the size of a dime and guides the robotic arms with attached instruments and a tiny camera through the incisions.

•  At the computer console, the surgeon looks through a camera which magnifies the organs and other structures inside the body by 10x.

• The surgeon can change the surgical view instantly, using foot pedals to zoom in and out.

• The movement of the surgeon's fingers is transmitted via the computer console to the instruments on the robotic arms. These instruments mimic the movements of the surgeon's hands and wrists.

• The surgeon is always in control, sitting at the console a few feet from the patient.

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Check out this video to see how the da vinci system works in a prostatectomy procedure.  

(Video Citation 12)

 Current Applications in Robotic Surgery

Robotic surgery is emerging in the following areas:

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