Robots have been working for us for the past 50 years. They have been used in industrial applications such as automobile manufacturing doing some of the more dangerous and repetitive work such as welding or lifting heavy car parts. The Tesla automotive plants have a significant amount of robots, therefore, speeding production and decreasing costs. Robotic application in healthcare especially in surgery is a more recent event. Robots are increasingly being used in varied ways in surgery. They are very helpful since they can lead to increased precision in performing delicate surgeries.
Perhaps the best-known surgical robot is the DaVinci surgical robot. This robot is used as an extension of the surgeon in performing very delicate surgeries in the abdomen and pelvis. In this application, the robot is positioned over the patient and the surgeon sits in a console and remotely controls the robot. In this console, the surgeon can view what the robot is doing through specialized cameras which are inserted into the patient’s body. Since the robot can work through very small incisions called portals the surgical trauma to the patient’s body is minimized leading to less surgical pain and a faster recovery for the patient.
This kind of robotic use is very different from the robots used in manufacturing. The DaVinci robot is not automated meaning it does not operate independently with a set of instructions like the robots in the Telsa plant or the robots in an Amazon warehouse. The DaVinci robot is more of an extension of the surgeon’s hands and is controlled at all times by the surgeon.
The robots used in spinal surgery are a hybrid of the independent robots used in the automotive plants (Telsa, GM, Ford) or in the Amazon warehouse and the DaVinci. The spinal surgery robot is semi-autonomous in that it can carry out some pre-determined instructions and then act as an extension of the surgeon’s hands.
Spine surgery often includes placing specialized instruments into the spine while avoiding causing injuries to the spine and the nerves which are in it. Some of these specialized instruments or implants are meant to provide support for the spine and required very precise placement.
With spinal robots such as the Mazor or Excelsius GPS very detailed images of the spine from a CT scan are fed into the robot. These images are then used as a guide for the robot to navigate around the spine and allow the robot to find the best path or location to place these specialized instrumentations into the spine. When the robot is doing this it is acting semi-autonomous based on the set of instructions that the surgeon programs into the robot. Once the robot finds the best route to place the instrumentations it then becomes a guide to help the surgeon in placing the instrumentations. The surgeon then uses the robot’s guide to place a portal or small incision in the skin above the spine and uses this same portal to place the instrumentations. In this role, the robot is acting as an extension of the surgeon in the same way the DaVinci robot does.
In spinal surgery, the current benefits of the robot are:
- to decrease the time of surgery since it can find the best and quickest way to place instrumentation
- decrease the size of the surgical incision and therefore the post-op pain since the surgeon can now work through the very small incisions.