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The introduction of a new technology in a consolidated field has the potential to disrupt usual practices and create a fertile ground for errors. An example is robotic surgery that is now used in most surgical specialties, pushed by technology developers and enthusiastic surgeons. To analyze the potential impact of robotic surgery on patient safety, a consortium of major European Universities started the project SAFROS whose findings are summarized and further elaborated in the three parts of this book. Part one describes safety in complex systems such as surgery, how this may disrupt the traditional surgical workflow, how safety can be monitored, and the research questions that must be posed. Part two of the book describes the main findings of this research, by identifying the risks of robotic surgery and by describing where its ancillary technologies may fail. This part addresses features and evaluation of anatomic imaging and modeling, actions in the operating room, robot monitoring and control, operator interface, and surgical training. Part three of the book draws the conclusions and offers suggestions on how to limit the risks of medical errors. One possible approach is to use automation to monitor and execute parts of an intervention, thus suggesting that robotics and artificial intelligence will be major elements of the operating room of the future.
Handbook of Robotic and Image-Guided Surgery provides state-of-the-art systems and methods for robotic and computer-assisted surgeries. In this masterpiece, contributions of 169 researchers from 19 countries have been gathered to provide 38 chapters. This handbook is 744 pages, includes 659 figures and 61 videos. It also provides basic medical knowledge for engineers and basic engineering principles for surgeons. A key strength of this text is the fusion of engineering, radiology, and surgical principles into one book. A thorough and in-depth handbook on surgical robotics and image-guided surgery which includes both fundamentals and advances in the field A comprehensive reference on robot-assisted laparoscopic, orthopedic, and head-and-neck surgeries Chapters are contributed by worldwide experts from both engineering and surgical backgrounds
Specific injuries due to poor positioning seen in robotic pelvic surgery include slips, compartment syndrome, facial oedema, injuries on pressure points, and accidental injuries caused by the robotic arms. The use of the vacuum bean-bag positioner, L-bar against the patient’s face, and inflated gloves for hand support are simple and effective techniques and should be included in the standard operating policies for robotic surgery. We recommend use of the “L” shaped safety bar against the patient’s face to ensure protection against accidental injuries caused by the robotic arms. The anti-slip bean-bag mattress is efficient to prevent slipping; it conforms to the shape of the body for stable positioning and allows extremities to lie in a natural position. Protection of pressure points of hands and elbows can be done with inflated medical gloves placed in the patient’s hands. Surgeons, anaesthetists and theatre teams are together responsible for ensuring that safety measures are in place to reduce the risk of these complications.
The first edition of Robotic Surgery was written only a decade after the introduction of robotic technology. It was the first comprehensive robotic surgery reference and represented the early pioneering look ahead to the future of surgery. Building upon its success, this successor edition serves as a complete multi-specialty sourcebook for robotic surgery. It seeks to explore an in-depth look into surgical robotics and remote technologies leading to the goal of achieving the benefits of traditional surgery with the least disruption to the normal functions of the human body. Written by experts in the field, chapters cover the fundamental principles of robotic surgery and provide clear instruction on their clinical application and long term results. Most notably, one chapter on “The Blueprint for the Establishment of a Successful Robotic Surgery Program: Lessons from Admiral Hymen R. Rickover and the Nuclear Navy” outlines the many valuable lessons from the transformative change which was brought about by the introduction of nuclear technology into the conventional navy with Safety as the singular goal of the change process. Robotics represents a monumental triumph of surgical technology. Undoubtedly, the safety of the patient will be the ultimate determinant of its success. The second edition of Robotic Surgery aims to erase the artificial boundaries of specialization based on regional anatomy and serves as a comprehensive multispecialty reference for all robot surgeons. It allows them to contemplate crossing boundaries which are historically defined by traditional open surgery.
With the increasing demand of robots for industrial and domestic use, it becomes indispensable to ensure their safety, security, and reliability. Safety, Security and Reliability of Robotic Systems: Algorithms, Applications, and Technologies provides a broad and comprehensive coverage of the evolution of robotic systems, as well as industrial statistics and future forecasts. First, it analyzes the safety-related parameters of these systems. Then, it covers security attacks and related countermeasures, and how to establish reliability in these systems. The later sections of the book then discuss various applications of these systems in modern industrial and domestic settings. By the end of this book, you will be familiarized with the theoretical frameworks, algorithms, applications, technologies, and empirical research findings on the safety, security, and reliability of robotic systems, while the book’s modular structure and comprehensive material will keep you interested and involved throughout. This book is an essential resource for students, professionals, and entrepreneurs who wish to understand the safe, secure, and reliable use of robotics in real-world applications. It is edited by two specialists in the field, with chapter contributions from an array of experts on robotics systems and applications.
Robotic Urologic Surgery, Second Edition is an updated and revised technical manual focusing on the various robotic approaches to robotic urologic surgical procedures. This book provides instructions on how to develop a successful robotics program, learn the various techniques, and improve outcomes. It also aids the reader with helpful hints to avoid pitfalls. Robotic Urologic Surgery, Second Edition includes up-to-date contributions from leading robotic urologic surgeons from around the world. The detailed body of data which this book provides is supported by schematic diagrams and anatomic photographs to illustrate the concept being discussed. Robotic Urologic Surgery, Second Edition is an essential guide for all urologists as a reference to establish a robotics program, refine their surgical technique, and provide information to patients.
This book describes the current state of robotics in plastic and reconstructive surgery. It examines existing clinical applications, emerging and future applications and evolving technological platforms. Concise yet comprehensive, this book is organized into four sections. It begins with an introduction to robotic microsurgical training and robotic skills assessment, including crowd-sourced evaluation in surgery. Section two explores a variety of robotic clinical application, including robotic breast reconstruction, robotic mastectomy, robotic cleft palate surgery and robotic microsurgery in a urologic private practice. Following this, section three addresses the opportunities and challenges an interested surgeon might face when considering incorporating this technology into their practice. To close, the final section discusses new microsurgical robotic platforms and the potential directions this technology may take in the future. Supplemented with high quality videos and images, Robotics in Plastic and Reconstructive Surgery is an invaluable resource for both plastic surgeons and multi-specialty micro-surgeons.
This book presents a practical approach to patient safety issues with a focus on evolution and understanding the key concepts in health care and turning them into implementable actions. With its contemporary approach and lucid presentation, this book is a valuable resource for practicing doctors in medicine and surgery to treat their patients with care, diligence and vigilance and contribute to a safer practice in health care.
Confronted with worldwide evidence of substantial public health harm due to inadequate patient safety, the World Health Assembly (WHA) in 2002 adopted a resolution (WHA55.18) urging countries to strengthen the safety of health care and monitoring systems. The resolution also requested that WHO take a lead in setting global norms and standards and supporting country efforts in preparing patient safety policies and practices. In May 2004, the WHA approved the creation of an international alliance to improve patient safety globally; WHO Patient Safety was launched the following October. For the first time, heads of agencies, policy-makers and patient groups from around the world came together to advance attainment of the goal of "First, do no harm" and to reduce the adverse consequences of unsafe health care. The purpose of WHO Patient Safety is to facilitate patient safety policy and practice. It is concentrating its actions on focused safety campaigns called Global Patient Safety Challenges, coordinating Patients for Patient Safety, developing a standard taxonomy, designing tools for research policy and assessment, identifying solutions for patient safety, and developing reporting and learning initiatives aimed at producing 'best practice' guidelines. Together these efforts could save millions of lives by improving basic health care and halting the diversion of resources from other productive uses. The Global Patient Safety Challenge, brings together the expertise of specialists to improve the safety of care. The area chosen for the first Challenge in 2005-2006, was infection associated with health care. This campaign established simple, clear standards for hand hygiene, an educational campaign and WHO's first Guidelines on Hand Hygiene in Health Care. The problem area selected for the second Global Patient Safety Challenge, in 2007-2008, was the safety of surgical care. Preparation of these Guidelines for Safe Surgery followed the steps recommended by WHO. The groundwork for the project began in autumn 2006 and included an international consultation meeting held in January 2007 attended by experts from around the world. Following this meeting, expert working groups were created to systematically review the available scientific evidence, to write the guidelines document and to facilitate discussion among the working group members in order to formulate the recommendations. A steering group consisting of the Programme Lead, project team members and the chairs of the four working groups, signed off on the content and recommendations in the guidelines document. Nearly 100 international experts contributed to the document (see end). The guidelines were pilot tested in each of the six WHO regions--an essential part of the Challenge--to obtain local information on the resources required to comply with the recommendations and information on the feasibility, validity, reliability and cost-effectiveness of the interventions.
Minimally invasive surgery has impacted the outcomes of surgery more than any technology since the development of sterile technique. The hard science has demonstrated that decrease in wound complications and recovery time has created the biggest gap with open approaches to surgery. The total economic benefit may be unfathomable when looked at comprehensively. Integral to the rise of minimal access and therapeutic techniques in surgery has been the growth of technological improvements over time. Beginning with insufflators, videoscopy, and energy devices, that evolution has continued into the development of tele-surgical devices that feature full articulation of instruments, high-resolution 3-D optics, and computer assisted movement. This has come with controversy – as the dominant manufacturer of robotic assisted devices, Intuitive Surgical, and their generations of da Vinci surgical platforms, holds enough market share to spur cries of monopoly and financial excess. However, with over 3000 world-wide systems in use, and over 6000 peer-reviewed research articles, the impact of robotic surgery cannot be ignored. The current state of data suggests equivalency in most procedures with regard to traditional outcome measures, equal or somewhat elevated costs, with specific areas of superiority. The first section of this textbook, Surgical Robots, covers the history, economics, training, and medico-legal aspects of robotic surgery that will be of interest to students, residents, fellows, surgical staff, and administrators or public health specialists who seek to gain a comprehensive background on robotic surgery, or justification for purchasing a robotic system for their institution. Surgeons will also find this background valuable to their practice, to give context to their procedures so they can better counsel their patients, help with advocating for robotic platform purchases, and proactively prepare themselves for medico-legal issues. The chapter on legal issues will have specific instances of robotic surgery-related lawsuits and their outcomes, a first for robotic surgery texts. The second section of this textbook, Robotic Procedures, will contain a comprehensive catalogue of procedures that have been performed robotically in general surgery, gynecology, urology, plastic surgery, cardiothoracic, and otolaryngology. Each author will cover the existing literature, preoperative planning, room and patient setup, steps of the procedure, and postoperative care. Standardized room maps and port placement will help the student, resident, fellow, surgeon or OR Staff to quickly reference these before cases. Each chapter will also cover the specific equipment needs and expected complexity of the procedures, allowing administrators to better gauge how to prepare for, or ration, use or their robotic resources. The final section, Future of Robotics, will give the entire scope of audience a look into what exciting advancements in the field are on the horizon. This textbook is a complete resource for robotic-assisted minimally invasive surgery, covering the history, current state, technical and clinical aspects, and future considerations that may be of interest to any who has a role, stake, or curiosity regarding robotic surgery.