Surgery: Definition And Robotic-assisted Surgeries

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Since its introduction to the healthcare system, robotic surgical systems (RSS) have become routinely used in minimally invasive general surgery (MIGS). Multi-disciplinary research has shown robotic surgical systems provide increased precision, lowered overall costs, reduced exposure of infectious diseases, and a more overall ergonomic workload. This emerging technology provides patients, undergoing minimally invasive procedures, access to a decreased length of stay, lowered overall costs, and increased surgery efficiency. The technology still faces complications concerning the lack of study and protocols involved in the use of robotic systems in the surgical sector. The introduction of robotics in surgery provides an enhanced surgical method due to its superior efficiency performing surgery and decreased overall costs. Advancements in training methods and further research into robotic systems are required to utilise the system fully.

Compared to traditional surgical methods, RSS provide attending surgeons with a more overall ergonomic workload when performing MIGS. The scientific discipline of ergonomics studies human interactions with elements of a system; the profession applies principles, data, and methods to design, optimizing human interaction and system performance (The International Ergonomics Association, as cited in Lee et al., 2014). When performing surgery, surgeons encounter two different types of ergonomic workloads; cognitive and physical. Physical ergonomics is concerned with the body’s interaction with equipment or its environment, and the impact on the body in terms of posture, repetitive movement, occupational design, control, and related injuries or disorders. Cognitive ergonomics is concerned with the occurrence of mental processes, memory, sensory-motor response, and perception (Lee et al., 2014). Lee et al. (2014) conducted a study with thirteen MIS surgeons with three different levels of robotic surgery experience; laparoscopy experience with no robotic experience, novices with little to no robotic experience, and robotic experts. They each conducted six surgical training tasks while their physical and cognitive workload was assessed. Lee et al. (2014) concluded that robotic surgery provides significantly less challenging ergonomics, with robotic experts benefiting most. With surgeons being able to sit comfortably while remotely controlling the RSS, the lessened awkward upper-body movement provides surgeons with a decreased risk of musculoskeletal injury (Herron et al., 2008; Lee et al., 2014). Furthermore, due to the shorter learning curve of RSS, participants with little experience in robotics and/or surgery experienced less mental workload. Less mental stress was recorded throughout all participants. The enhanced ergonomic design of RSS makes it the superior surgical method, allowing surgeons to perform MIGS with lessened physical and cognitive strain.

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The technical training and capability medical staff must undergo to operate RSS, provide a lessened learning curve when performing MIGS, compared to traditional training methods. Surgical tasks such as suturing present surgeons with a substantial learning curve when using traditional methods (Lee et al., 2014; Marecik et al., 2007). The enhanced visualisation RSS provides, gives surgeons training better visuals of difficult anatomic regions by using the RSS articulated-arm (Herron et al., 2008). Easier access to these regions allows training surgeons to train more efficiently without causing unnecessary fatigue (Lee et al., 2014; Herron et al., 2008). More than half of the medical students surveyed by Krause and Bird (2018) reported that they’ve been exposed to robotic surgery during their medical education (98.08%) and that they believe robotic surgery will be somewhat important in their career (98.08%). Both statistics from Krause and Bird (2018), and Lee et al. (2014) from the first paragraph, suggest that if proper technical training isn’t implanted in medical education surgeons won’t be able to utilise the system fully leading to possible misuse (Mathew et al., 2018; Heemskerk, J. W. M. et al., 2007). The technical training and capability surgeons must have to perform MIGS with RSS provides surgeons with a lessened learning curve providing surgeons with a more efficient learning method.

Compared to traditional methods, robotic-assisted surgery (RAS) gives patients undergoing MIS a better cost-effective procedure, providing both patients and hospital staff with an overall lowered cost and more efficient result. RSS’s enhanced visualisation and lessened learning curve allow surgeons to make smaller incisions lowering complication rates, mortality, and reduced exposure of disease for both the surgical staff and the patient (Chandra, & Frank, 2003; Salman et al., 2013). These results may also mean patients will take a decreased amount of postoperative pain medication lowering costs in postoperative care, and a decreased amount of transfusions during surgery (Rowe et al., 2012; Hassan et al., 2015). The indirect costs such as purchasing an RSS, maintaining the system, and the insurance, still do remain as major factors. However, the high surgical volume and the lowering prices when more competitors enter the market are expected to overcome these economic factors (Rowe et al., 2012). Patients undergoing RAS receive a lowered overall cost and a more efficient result compared to traditional MIS methods.

Robotic-assisted surgeries have shown promise in lowering costs for patients, hospitals and medical staff, while also generating a more physical and cognitive ergonomic procedure. Less invasive and more effective procedures can be performed with the lessen learning curve when performing MIGS. However, robotic-assisted surgery shows promise that it’ll have a significant in the medical sector, more in-depth and extensive studies need to be conducted to better understand how to utilise robotics in surgery before becoming implemented in health institutions. 

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