Principle of Robotic Procedure
In open surgery the motility of the wrist and the hands inside the abdomen allow all kinds of movements in all kinds of directions. In laparoscopy, however, the fact that one has to work through a fixed opening with straight instruments means that the number of degrees of freedom is limited. Remaining degrees of freedom concern in and out, top to bottom, rotation and oscillatory movements. Procedures are performed under visual guidance from a two-dimensional screen which is relatively immobile and cannot always be placed in the working axis (1, 2, 3) throughout the procedure. These conditions result in awkward operating positions and impaired dexterity (4, 5, 6).A computer-guided mechanical interface, commonly referred to as a robot, allows for 1) restoration of lost degrees of freedom, thanks to an intra-abdominal articulation of the surgical tools, 2) three dimensional visualization of the operative field at all times in the same direction as the working direction, 3) modulation of motion amplitude by stabilizing or by downscaling and 4) remote control surgery (telesurgery). Thanks to these improvements, the surgical tasks can be performed with greater accuracy and in a perfect ergonomic position. (7).
To place a computer interface between surgeon and patient should allow enhancement of the surgeon’s skills and possibly revolutionize surgery in the same way as it did in aviation.
Mobility of the wrist. The finger allows all kind of movements in the abdomen
Degree of freedom is limited
With an articulation inside the abdomen, the degree of freedom is recuperated
Degree of freedom is limited
With an articulation inside the abdomen, the degree of freedom is recuperated