Robotic surgery: potentials, barriers, and limitations

SummaryBACKGROUND: The advent of laparoscopic surgery has created the room for the introduction of computer and robotic technologies in surgery. Robotic and computer technologies can be used to enhance dexterity, digitize gestures and video signals, and compress information that can be transmitted over a distance. METHODS: We reviewed current literature about clinical and experimental applications of robotics-assisted surgery. In this article we give an overview of the most important advances and issues deriving from the application of robotic technologies in surgery. RESULTS: Many clinical series have documented the feasibility and safety of robot-assisted surgery for virtually any kind of operation in general surgery. However, evidence of significant clinical benefits is still lacking. Important aspects of robotic technology, such as remote surgery and integration of robotic and virtual-reality technologies have not been fully exploited. CONCLUSIONS: Robotics-assisted surgery is feasible and safe for many operations in general surgery. Further technical development, particularly in the field of remote surgery and virtual-reality technology applied to robotics, will likely boost application of robotic surgery and possibly improve both patients' care and surgical education.ZusammenfassungGRUNDLAGEN: Laparoskopische Chirurgie stellt die Voraussetzungen für die Einführung von Computer- und Robotertechnologien in der Chirurgie dar. Roboter und Computertechnologie können die Geschicklichkeit verbessern, Bewegungsabläufe und Videosignale digitalisieren und Informationen komprimieren und über weite Entfernungen übertragen. METHODIK: Literaturübersicht über experimentelle und klinische Anwendungen der Roboter-assistierten Chirurgie. ERGEBNISSE: Viele klinische Serien haben Machbarkeit und Sicherheit Roboter-assistierter Chirurgie aufgezeigt. Trotzdem fehlt die Evidenz für einen klinischen Benefit. Viele Bereiche der Roboterchirurgie werden noch nicht ausreichend ausgeschöpft, wie zum Beispiel die ferngesteuerte Operationstechnik und die Integration von Robotern und virtuellen Technologien. SCHLUSSFOLGERUNGEN: Viele Eingriffe in der Allgemeinchirurgie können heute sicher Roboter-assistiert durchgeführt werden. Zukünftige Entwicklungen, welche Roboter und ferngesteuerte Chirurgie sowie virtuelle Realität verbinden, werden die medizinische Versorgung verbessern und leichter machen.

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