Medical Service and Robotics in 21st Century. Robotic devices for advanced endoscopic surgical procedures. An overview.

摘要

The advent of endoscopic techniques had considerable influence on surgery in many clinical areas. This paper intends to describe an overview about robotics technologies facilitating endoscopic surgery.A major enhancement for endoscopic techniques is the introduction of robotic technology to design assisting devices for solo-surgery and manipulators for microsurgical instrumentation to provide the surgeon with ad-ditional degrees of freedom of instrumentation. In 1996 a first prototype of an endoscopic manipulator system, named ARTEMIS, could be used in experimental applications. Master slave systems consist of a user station (master) and an instrument station (slave) . The surgeon sits at a console which integrates endoscopic monitors, communication facilities and two master devices to control the slave arms which are mounted to the operating table. Systems developed by industry quickly gained the interest of the surgical community and are today employed at several specialised centers around the world in clinical use, mainly in the area of cardiac surgery. The combination of telecomunication technology with robotic instruments will open new frontiers, such as teleconsulting, teleassistance and telemanipulation.With the increasing complexity of endoscopic surgery in the various clinical specialties, such as general, cardiac or other fields of surgery, came the demand for more sophisticated instrumentation. Robotics was soon identified as a major pacemaker towards the technological future of minimally invasive surgery. The first steps in the use of robotics for increasing instrument functions were made in the area of endoscope guidance, where robotic instrument holders got used to direct the endoscope during the operation [1] [3] . Robotic endoscope holders demonstrated to be efficient and safe in clinical use and are today accepted as assisting devices among endoscopic surgeons [4] . The field of robotics for enhancing surgical instrumentation did not emerge so fast as the former because of its technical complexity and safety concerns linked to the use of robotic devices for surgical operations.