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Details of A robot surgeon

In future it will carry out 50% of the participations in laparoscopia

' robot' in place of the hands of the surgeon, in order to operate the patients in more and more precise and above all little invasive way. It is the new adopted technological solution for many types of operations already in 20 Italian hospitals, between which that one of Spoleto directed from professor the Luciano Casciola and that, in near future, it is hoped could arrive to being employed in order to carry out approximately the half of the participations of laparoscopica general surgery. And it will see to grow also its ' incarichi' in thoracic surgery and cardiochirurgia. The participations for which the robot-surgeon mainly it is indicated are operations to the milza and the pancreas, disease from gastroesofageo reflux, tumor of the low rectum and the prostate, where it avoids the appearance of complicanze of sexual and urologico type first inevitables.

"the surgery robotics can defined the evolution of that laparoscopica, that is of the videochirurgia - Luciano Casciola explains - of which it has maintained and contributed to emphasize the advantages. The instruments of the laparoscopica technique, in fact, currently ' have given tutto' what they had to give and are not possible to improve them ulteriorly. While with the robotics today we are in a position to realizing desires of patients and surgeons: not ' aprire' more the belly and, to the contempo, to operate arriving in depth and points that before were unthinkable, without to bring damages to the organism ". The three-dimensional vision is an other advantage carried from the introduction of the ' robot-chirurgo': before, with the laparoscopia ' classica', from the monitor it could be only enjoyed a bidimensional image and therefore ' piatta'. "Today - the expert emphasizes - we have a depth of field and a greater blowup of image, therefore the doctor is facilitated in covering ' roads impervie'.

Moreover, the vision turns out extremely stable: if before the quality and the firmness of the images depended on the hand of an assistant, currently with the robot this problem it comes annulled, with the ulterior advantage to demand little dispendio than energies from part of equipe the doctor. And in more we have obtained the great result of the elimination of ' tremore', inevitable when to operate they are the hands of the man ". The robot, finally, being a ' machine instancabile', could favorably be used in the future in order to pull down the lists of waited for: "if today we have of the physical limits for which after hours and hours of it knows it operating we are exausted and we must stop - Casciola emphasizes - the robot can continue to work alone, under the control of the operator to the consul".

Beside these numerous positive factors you, there is only an aspect negative: the sensibility ' not perfetta' of the ' surgeon automatico', "than naturally does not have ' tocco' of the specialist for which, as an example, if sewing one hurt the thread is broken off, not if it notices some". But draft of solvable disadvantages thanks to the constant control of the operator to the commando of the machine. "It is possible to preview that, to forehead of a 30-40% of participations of laparoscopica general surgery it carries out to you with the robot today - assumes the surgeon - in the future one beyond the half of the operations it will happen with the aid of this advanced technology. In future there will be limits that the laparoscopia will not be able to exceed, but the robot surgeon will be in a position to making it ".

With the robot an ulterior sharpening of the operating technique to all advantage of the quality of the surgical action is come true: seated the consul, the specialist work using two ' directly posizionate arms meccaniche' under a visual display unit of the magnified operating field 3D. The tips of the instruments visualized on the display are aligned with the arms in order to assure to the instrument natural and expectable movements. The surgeon, therefore, maintains the guideline testa/occhi and the practical sensibility della ' to sky aperto' and its gestures come are converted on the credit side moment in movements minimally invaded to you, concurring to approach through small recordings without to renounce alla skill, alla precision and ai instinctive movements della classic surgery. At the same time, the ' tremito' natural one of the hand of the doctor comes eliminated from an electronic filter that assures a control of the stable and expectable instrument.

Been born in order to answer to the requirement to take part surgical in contexts it acclimatizes them particularly difficult (es. the battlefields), in which the employment of the satellite is previewed quite, the robotico system has open new horizons to the surgery, concurring to simplify puts into effect them them short, sure minium-invasive procedures rendering them and of ruotine for the patient. Currently operations are carried out also at a distance, extremely complex treatments that can be only entrusted particularly skillful and expert surgeons. In 2001 it has already been executed the first connection ' transoceanico' between New York and Strasburgo and have been executed some you leave of an participation with the aid of this instrument: the surgeon to Strasburgo made it to move in the United States for via satellitare. And it is of little days ago the news of the man of 34 years ' comodamente' ricoverato to the Saint Raffaele of Milan, acts to the heart from a university professor of Boston.

The first instrument available in Italy is called From Wins^TM and has been christened with this name from its creators Americans in order to emphasize the genius of their new model. ' From Vinci', been born in the zone technologically more advanced the world, the Silicon Valley, it is a machine that allows to make also participations of cardiochirurgia without opening the thorax: through three forellini hardly a centimeter one made in the intercostal spaces, comes inserted one very small television camera in fiber optic of eight millimeters, that it can move on 360 degrees on the three aces of the space (can see is of forehead that to 30 degrees up and low); from the others two forellini the mechanical arms with to the appendix two very small hands enter that have seven degrees of freedom (therefore are like if it were a hand with a wrist that can turn of 360 degrees, rather than of 180 like that human). They are they then that they operate and they take part.