Table Of ContentKeith Chae Kim
Editor
Robotics in
General Surgery
123
Robotics in General Surgery
Keith Chae K im
Editor
Robotics in General
Surgery
Editor
Keith Chae Kim, M.D., F.A.C.S.
Metabolic Medicine and Surgery Institute
Florida Hospital Celebration Health
Celebration , FL , USA
ISBN 978-1-4614-8738-8 ISBN 978-1-4614-8739-5 (eBook)
DOI 10.1007/978-1-4614-8739-5
Springer New York Heidelberg Dordrecht London
Library of Congress Control Number: 2013949142
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There are many people who have been instrumental in the
publication of this book and others who have been essential
in creating the circumstances that led me to embrace robotic
surgery. Thank you.
I dedicate this book to Ella, Alex, Jennifer, John, Cathy,
Sofi a, and Young, and especially to my parents, Sun Tok Kim,
my mother, and Kwi Hyon Kim, my father, who have taught me
through their actions that hard work and perseverance
have no equal.
Pref ace
Robotic surgery will prove to be the most signifi cant advance in surgery for
this generation of surgeons and the next few generations to come. The current
platform, the da Vinci system, is the product of an evolution from the US
Department of Defense’s efforts to produce telerobotic capabilities in order to
provide injured frontline soldiers with advanced surgical care from remote
locations to commercial efforts to provide enhanced dexterity to facilitate
complex surgeries while maintaining minimally invasive techniques. The
enhanced dexterity, based on an anthropomorphic model whereby the robotic
system is designed to mimic the human hand in its range and freedom of
movements, is fairly advanced and has allowed both average surgeons to
adopt minimally invasive techniques and skilled surgeons to push the enve-
lope in the complexity of minimally invasive procedures. The robotic
approach has permeated essentially every specialty in general surgery.
More importantly, however, the robotic platform has introduced two new
dynamics between the patient and the surgeon that will have a far greater
impact. First, the system is based on a master–slave relationship in which the
surgeon is remote from the patient and performs the operation by controlling
a patient cart slave that is docked to the patient. Second, the console repre-
sents a digital interface between the surgeon and the patient. In these aspects,
we are just starting to scratch the surface of the possibilities.
The master–slave confi guration allows for telepresence as was dramati-
cally demonstrated by Professor Marescaux and colleagues in “Operation
Lindbergh,” a transatlantic cholecystectomy. This capability will not only
have a profound impact on providing sophisticated and complex care to
remote locations from a command center but will also dramatically facili-
tate professional education and collaborative surgery. Experts will be able
to have a global presence without having to leave their operating rooms and
will be able to demonstrate surgery as well as assist or take over surgeries
being performed in remote locations by linking their console to the remote
patient cart. Additionally, the master–slave platform will eventually allow
for the manipulation of wireless “slave” components that will form the
foundation of the future of endoscopy, interventional radiology, and natural
orifi ce interventions.
The digital interface, which allows for the collection and manipulation of
data that can be used for diagnostic or interventional purposes, represents an
even greater potential. Even in the relatively early stages, imaging technology
vii
viii Preface
is being used to identify structures and provide a road map to the surgical
anatomy in real time. The future will see the digital interface between patient
and surgeon evolve to facilitate image-guided surgery, computer-aided sur-
gery, as well as pre-performed surgery in simulation models that is repro-
duced by a computer-driven system on the actual patient.
This textbook, the fi rst comprehensive overview of the role of robotic sur-
gery in general surgery, is intended as a “how-to” reference of robotically
performed procedures in general surgery. Additionally, in recognition of the
importance of understanding the evolution of robotic surgery thus far, and the
impact that it will have on the future of surgery, this book provides a histori-
cal perspective of robotic surgery as well as an overview of the emerging
technology and future robotic platforms.
Celebration , Florida, USA Keith Chae Kim, M.D., F.A.C.S.
Contents
Part I Overview of the Robotic System
1 History of Robotic Surgery .......................................................... 3
Haidar Abdul-Muhsin and Vipul Patel
2 Introduction to the Robotic System ............................................. 9
Monika E. Hagen, Hubert Stein, and Myriam J. Curet
3 Overview of General Advantages, Limitations,
and Strategies ................................................................................ 17
Erik B. Wilson, Hossein Bagshahi, and Vicky D. Woodruff
Part II Surgical Techniques: Esophagus
4 Robotic Assisted Minimally Invasive Esophagectomy ............... 25
Abbas E. Abbas and Mark R. Dylewski
5 Robotic Assisted Operations for Gastroesophageal Refl ux ....... 33
Daniel H. Dunn, Eric M. Johnson, Kourtney Kemp,
Robert Ganz, Sam Leon, and Nilanjana Banerji
6 Achalasia ........................................................................................ 55
Julia Samamé, Mark R. Dylewski, Angela Echeverria,
and Carlos A. Galvani
Part III Surgical Techniques: Thoracic
7 Complete Port-Access Robotic-Assisted Lobectomy
Utilizing Three-Arm Technique Without a Transthoracic
Utility Incision ............................................................................... 69
Mark R. Dylewski, Richard Lazzaro, and Abbas E. Abbas
8 Robotic Pulmonary Resection Using a Completely Portal
Four- Arm Technique .................................................................... 85
Robert James Cerfolio and Ayesha S. Bryant
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