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Robotic surgery, also called robot-assisted surgery, is a growing medical field. It involves trained surgeons using specialized robotic tools to enhance their own skills and surgical capabilities. Despite misconceptions, machines involved in robot-assisted surgery cannot act on their own. A robot's operator directly dictates every move a robot makes.

Though robotic surgery is becoming more popular, its use is controversial among some medical professionals. Some experts claim that surgical robots allow surgeons to make smaller, steadier, and more precise movements. Others argue that using a robot reduces a surgeon's own sensory input, increasing the chances of a surgeon making mistakes. Despite concerns, more than 1.7 million robot-assisted surgeries were performed in the United States between 2004 and 2013, and this number continues to grow.

Minimally Invasive Surgery

In standard surgeries, also called open surgeries, a surgeon makes a large incision in a patient's body to give the surgeon access to the interior body. In minimally invasive surgery, also called keyhole surgery, a surgeon makes one or more very small incisions in a patient's body. The surgery area then is inflated with carbon dioxide, and a tiny camera is inserted into one of the incisions. This allows the surgeon to see inside the patient without having to make a large incision. Next, the surgeon inserts long, specially designed tools through the other incisions. The surgeon uses these tools to perform the operation. The surgeon removes the tools and closes the incisions when the surgery is complete. If complications arise that cannot be repaired through minimally invasive means, the operation is converted to an open surgery.

Because of the lack of large incisions, patients who receive minimally invasive surgery normally lose less blood and recover more quickly than patients who receive open surgeries. In most circumstances, patients who receive minimally invasive surgery also recover with little visual scarring. However, minimally invasive surgery does have downsides. This method of surgery is more difficult for surgeons than open surgery, and surgeons need to be specially trained for minimally invasive operations.

Modern Robotic Surgery

Robot-assisted surgery is a form of minimally invasive surgery. In robotic surgery, several mechanical arms of a robot are inserted into the patient through small incisions. These contain cameras and a variety of surgical tools. The surgeon sits away from the robot at a console equipped with a screen showing a three-dimensional video feed from the cameras inside the patient. Sensitive controls on the console allow the surgeon to maneuver the robot's arms in any direction. These controls scale down the surgeon's movements, which means if the surgeon moves the controls one inch, the robot may only move one-eighth of an inch. Additionally, the robot is programmed to remove the tremors that could occur in surgeons' hands during long operations. These tools allow the surgeon a degree of precision impossible with human hands alone.

Robot-assisted operations have become popular, and surgeons perform numerous robot-assisted surgeries every year throughout the world. Despite the advantages, reactions to robot-assisted surgery have been mixed. Proponents of robotic surgery argue that robots allow surgeons greater precision, maneuverability, and a significantly larger field of vision than the traditional tools for minimally invasive surgery. However, critics argue that using a robot removes the surgeon's sense of touch, making it harder for the surgeon to notice mistakes. Robotic surgery also tends to take longer than traditional surgery. Several complications related to robot-assisted surgery have been reported and include internal burns, lacerations, and organ damage. However, in these cases, both operator errors and robot malfunctions were to blame. Lastly, surgical robots are extremely expensive. Robot-assisted surgery may cost patients thousands of dollars more than minimally invasive or open procedures.

Published medical studies about robot-assisted surgery have reported conflicting results. Because this technology is still relatively new, few extensive studies have been conducted. Some studies report that robot-assisted surgery causes less complications than minimally invasive surgery, while other report that it causes more complications. Other factors such as surgeon errors or lack of practice with surgical robots further influence robotic surgery studies.

Future of Robotic Surgery

Experts believe that robot-assisted surgery will continue to advance. They assert that as the market for surgery robots grows, robots will become more affordable and shrink in size, allowing hospital staff to acquire more robots and quickly move them between operating rooms. In addition, scientists and engineers are experimenting with robots that allow multiple surgeons to work on a single patient at once and robots that simulate a sense of touch for the surgeon.

Robotic surgery has allowed surgeons to conduct procedures over large distances. In 2001, a surgeon in New York used robotic technology to successfully operate on a patient in France. As this technology becomes more common, surgeons will be able to operate on patients throughout the world without having to leave their home hospitals. The United States Department of Defense has plans to create a remote surgical station for wounded soldiers in war zones by 2025. Eventually, surgeons hope to conduct emergency operations on patients in outer space.

Bibliography

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Carr, Katie. "Study Questions Safety of Popular Robotic Surgical Device." Coordinated Science Lab. University of Illinois at Urbana-Champaign. 3 Apr. 2014. Web. 10 Feb. 2015. http://csl.illinois.edu/news/study-questions-safety-popular-robotic-surgical-device

Eveleth, Rose. "The Surgeon Who Operates from 400km Away." BBC Future. BBC. 16 May 2014. Web. 11 Feb. 2015. http://www.bbc.com/future/story/20140516-i-operate-on-people-400km-away

Greenberg, Herb. "Patients Scarred After Robotic Surgery." CNBC. CNBC LLC. 19 Apr. 2013. Web. 10 Feb. 2014. http://www.cnbc.com/id/100652694#

Greenemeier, Larry. "Robotic Surgery Opens Up." Scientific American. Nature America, Inc. 11 Feb. 2014. Web. 10 Feb. 2015. http://www.scientificamerican.com/article/robotic-surgery-opens-up/

Lanfranco, Anthony R., et al. "Robotic Surgery: A Current Perspective." Annals of Surgery. Medscape. 2004. Web. 10 Feb. 2015. http://www.medscape.com/viewarticle/466691_8

Moylan, Tom. "Da Vinci Surgical Robot Maker Reserves $67M to Settle Product Liability Claims." LexisNexis. Reed Elsevier. 9 Apr. 2014. Web. 10 Feb. 2015. http://www.lexisnexis.com/legalnewsroom/litigation/b/litigation-blog/archive/2014/04/09/da-vinci-surgical-robot-maker-reserves-67m-to-settle-product-liability-claims.aspx