Intraluminal robotics: a new dawn in minimally invasive surgery?

摘要

The urological community has traditionally been quick to embrace and develop new technology to improve surgical techniques. This had led to virtually every urological operation being performed by minimally invasive surgery with well-documented advantages.Whilst laparoscopy is clearly established as the standard-bearer of minimally invasive techniques, it does have limitations. Surgical dexterity, as measured by degrees of freedom, is limited by the fulcrum effect of the entry ports. Visual feedback is limited by a two-dimensional image and constrained by the entry ports. Robotic assistance allows for unprecedented control and precision of surgical instruments. It has been shown to enhance dexterity by nearly 50% as compared with laparoscopic surgery , There are two types of surgical robotics that are well established, telemanipulators and robotic camera holders. Despite the obvious progress, there are limitations to both of these methods. TelemanipuLaton requires large external machines that are still constrained technically by the use of long tools, and limited financially by high cost. The robotic camera holder is much more affordable and eliminates the problems of the camera assistant, but there still exist the limitations of standard laparoscopic surgery. 'Internalization' of instrumentation by miniaturization is one fascinating way of addressing the problems of present day minimally invasive surgery and is possibly the most exciting development in robotics.