A recent Food and Drug Administration approval of a voice-activated, surgeon-controlled robotic arm will likely pave the way for robots in the operating theater, and may even lead to robot-assisted heart surgery.
"When a surgeon makes an order, any order, it will be carried out by a robot," predicts Steve Wilson, vice president of Computer Motion, makers of the AESOP 3000, or Automated Endoscopic System for Optimal Positioning.
The AESOP 3000 can precisely maneuver and position an endoscope, the optical tube connected to a medical video camera and light source that is now the standard hardware in many knee and joint operations. Until recently, however, surgeons have been reluctant to enter the human chest cavity with endoscopes, cutters, and cauterizers due to the small size of the arteries there.
A robotic arm, however, can be held much more steadily than the human hand. The AESOP 3000 will now allow surgeons to perform minimally invasive heart surgery procedures with voice commands and see their progress on a computer or video monitor at 15 times the current magnification and resolution, Wilson said.
Tests of these procedures, including heart valve replacement and internal mammary artery harvesting, was completed at cardiac centers last month.
In the coming weeks, Computer Motion plans to introduce a three-armed robot, called the Zeus, which will serve as a surgical assistant in operating rooms, reducing the need for residents to assist surgeons. Farther out still, the company plans to introduce Hermes, another product that the company claims will automate everything in the operating room.
But Computer Motion will not have its lead for long.
Surgeons at the East Carolina University School of Medicine are also testing minimally-invasive techniques for cardiac surgery. Dr. Randolph Chitwood and colleagues are investigating new technologies such as robotics and virtual surgery.
Rensselaer Polytechnic Institute's Center for Advanced Technology in Automation, Robotics, and Manufacturing is working on similar a robotic surgery project with Albany Medical Center, said spokeswoman Sheila Nason.
Integrated Surgical Systems makes a robotic surgical device for hip surgery used by more than a dozen health care institutions in Germany. The device is being reviewed for use in the United States, said spokesman Frank Thorsberg.
At least one surgeon is looking forward to greater command of robotics in the OR.
"The thoracic cavity is a new and significant frontier for endoscopic procedures," said Dr. Randall Wolf, a cardiothoracic surgeon in minimally invasive procedures at Christ Hospital in Cincinnati.
"These procedures effectively provide the surgeon with a third arm, returning direct control of the optical field to the surgeon and providing a motionless image from which to operate," he said. "Voice control goes the next step, making the use of the robot seamless and perfectly natural."
