It is a method to perform medical surgeries without direct contact between the doctor and the patient during the operation, which has been made practical by giving the control of the robotic design tools to the doctors. The doctor can perform the operation at almost any distance while the patient is operated by remote control robotic surgical tools. What enables the doctor to control the surgery is a strong Internet link that is used to communicate between the doctor and the surgical instruments, monitors, and also communicate with experienced doctors. The patient undergoing surgery with robotic tools is not left alone, but a doctor's assistant is present at the place of operation to observe the problems that the doctor may not receive due to slight delays in sending the Internet.
Advantages of tele surgery
Tele surgery is done with the help of computer, so according to this issue, computer strengths can be combined with human experiences. In a special surgery, the robotic arm can reduce the effect of the natural vibration of the surgeon's hand and increase the surgeon's dexterity. It is also possible to analyze the inputs applied by the surgeon with the computer and after refining the instructions, apply them to the robotic arm. With the help of a microscope and a computer, the scope of the surgeon's movements can be changed to smaller-scale movements, and as a result, more delicate tasks that cannot normally be performed by a human agent can be performed using tiny robotic arms. In this case, less damage is done to the patient's body during surgery and his recovery happens faster.
History of telesurgery
The first aid to mountaineers through remote medicine, in 1996. And then equipping them in 1998. It was done with tools that measured the body temperature, pulse and blood oxygen level of the climbers (back-bio) . Since then, vast developments in the use of telemedicine have begun all over the world; So that it includes simple medical consultations by phone and email to sending radiology photos, MRI, CT scan, laboratory results and even tele surgery.
In 1988, a small camera was inserted into the body through small incisions and a small invasive surgery was performed. Computer robotic surgery was performed in 1996. In 2000, the FDA (US Food and Drug Administration) approved the use of robotic systems in the operating room.
In 2001, a doctor in New York operated on the gallbladder of a 68-year-old patient in Strasbourg, France. This was done by remote control of a robotic arm. The patient's recovery period was only 2 days, while in open gallbladder surgery, the recovery period lasts more than 6 days. In this surgery, two medical teams were involved (in New York and in Strasbourg) who were connected by video and high-speed fiber optic line. These two teams were 8700 miles apart. The time delay of the images received from the parties was shown on the monitor screen and its amount was less than 200 milliseconds.
The first transoceanic tele surgery in the world:
For the first time, on September 7, 2001, tele surgery was performed on a 68-year-old woman with the help of a robot. In this surgery, there was a distance of 4,000 miles (7,000 km) between the surgical team in New York and the patient at the CIVIL hospital in eastern France, which was covered by a high-speed fiber optic line. He manipulated this operation using Zeus laparoscopic robotic surgery system The operation was accepted and the gall bladder of this lady was removed. This operation lasted only 54 minutes and this 68-year-old woman went home two days after the operation and resumed her normal activities after one week. The robot used in this surgery was designed to perform the operation with the least possible invasion. Surgery using the images captured by a camera and the surgeon saw it on a screen, using a Joy stick , controlled the robot arm and performed the operation. The acceptable delay for the transmission of image coding information in such an operation is 330 msec , which in the discussed system uses ATM and RAD'S ACE-2002 technology and also NTV (Network Termination Unit).It was able to reduce the delay to 115 milliseconds.
This method not only induces a real surgical feeling in the surgeon, but also allows the surgeon to operate according to his usual methods and procedures, the surgeon does not need to learn anything new, the hand movements are fast and accurate. The visibility of the movement of the surgical equipment and the feedback of the force that enters the equipment from the tissue is transferred to the surgeon's hand with exact scaling and makes microsurgery easier even when the surgeon is next to the patient. The system uses color cameras for imaging and stereo recording of surgical sites. And the surgeon who is located at a distance sees these images through special glasses, and the surgeon holds a pair of remotely controlled manipulators that have the ability to reflect force, which is connected to a pair of effectors at the end of the path. A control in the surgical site is connected to the feedback of the image, sound and force that are transferred from the end-effectors to the surgeon, inducing the feeling of presence in the place. The surgeon's manipulator consists of two parts, the first part is the overall moving part, which is located outside the body, this part is responsible for the voluntary movement of the robot, and the second part is the controlled robot. The second part of the slaves is the milli-robot that enters the patient's body. Consequently, it must be very small and at the same time capable of a wide range of motion and relatively large forces. To meet these needs, a 2-degree-of-freedom wrist is used, which has the ability to rotate around its own axis and move in other directions.