MIS

• Minimally Invasive Surgery

• Minimally invasive surgery typically involves performing
surgical procedures through small incisions. Minimally
invasive surgery included laparoscopic surgery, where
instruments are passed into the body through these small
incisions to perform the surgical procedure.
• Surgeons use MIS techniques and technology to cause as
little trauma as possible during procedure. Smaller cuts
reduce potential for pain, complications and recovery time.
Healthcare providers perform many common procedures
today using minimally invasive surgery techniques.
 What tools or equipment are used in
minimally invasive surgery?
• Endoscopes. Endoscopes are long, narrow tubes with a lighted video
camera at the end.
• Imaging equipment. Monitors project video from the endoscope during surgery. Surgeons
often use other imaging technology to locate the surgical site, such as ultrasound ….
• Trocars. Trocars are tubes that the surgical team places within your keyhole incisions
(ports). They place the other surgical instruments, including endoscopes, through the
trocars.
• Insufflators. Insufflators deliver low-pressure carbon dioxide gas through a tube into
patient body cavity. Surgeons use insufflators when they need to inflate patient cavity for
visibility and access.
• Balloons. When surgeons don’t want or need to inflate patient entire body cavity, they
might use an inflatable balloon to make space to operate just where they need it. They
place the balloon at the end of a trocar, endoscope or catheter and inflate it by pumping
gas through the tube.
• Surgical instruments. Minimally invasive surgical instruments are long and narrow to
operate within narrow spaces. Surgeons manipulate them through trocars, endoscopes or
catheters.
• Potential benefits include:
• Reduced trauma.
• Reduced blood loss.
• Reduced risk of surgical complications.
• Reduced risk of infection.
• Reduced scarring.
• Reduced hospital stay.
• Reduced recovery time.
• Reduced pain and need for medication.
• May not require general anesthesia.
• May make surgery possible for some people where it wasn’t
otherwise.
• Potential disadvantages include:
• Requires special training and equipment.
• May not be available locally.
• May be more expensive.
• Operations may take longer.
• May not work in an emergency setting.
• Gas insufflation poses cardiopulmonary risks
for some people.
• Improved control and dexterity is one of the
main benefits of robotic technologies for MIS.
Mechatronically enhanced surgical
instruments have been designed to
compensate for the loss of wrist articulation
caused by the traditional approach
• Haptic virtual fixtures are software-generated force
and position signals applied to human operators
via robotic devices. Virtual fixtures help humans
perform robot-assisted manipulation tasks by
limiting movement into restricted regions and/or
influencing movement along desired paths. By
capitalizing on the accuracy of robotic systems,
while maintaining a degree of operator control,
human-machine systems with virtual flxtures can
achieve safer and faster operation.
• Virtual fixtures show great promise for tasks that require better-than human levels of
accuracy and precision, but also require the intelligence provided by a human directly
in the control loop. Human-machine manipulation systems make up for many of the
shortcomings of autonomous robots (e.g., limitations in artificial intelligence, sensor-
data interpretation, and environment modeling), but the performance of such
systems is still fundamentally constrained by human capabilities. Virtual fixtures, on
the other hand, provide an excellent balance between autonomy and direct human
control. Virtual fixtures can act as safety constraints by keeping the manipulator from
entering into potentially dangerous regions of the workspace, or as macros that assist
a human user in carrying out a structured task. Applications for virtual fixtures include
robot-assisted surgery, difficult assembly tasks, and inspection and manipulation tasks
in dangerous environments. Virtual fixtures can be applied to two types of human-
machine robotic manipulation systems: cooperative manipulators and
telemanipulators. In cooperative manipulation, the human uses a robotic device to
directly manipulate an environment. In telemanipulation, a human operator
manipulates a master robotic device, and a remote slave robot manipulates an
environment while following the commands of the master.
• What is the main perceptual differences between humans and
robots in medical surgery
• It depend on the ability of processing qualitative and quantitative
information. Robots can integrate a large amount of quantitative
data precisely through different sensors, thus being able to perform
and repeat repetitive tasks with good stability and positional
accuracy. On the other hand, surgeons are superior in combining
diverse sources of qualitative information for making difficult
decisions. Such skills are critical to the success of any surgical
intervention, but existing surgical robots are still limited to simple
procedures under the direct control of surgeons. Unlike industrial
automation, robotic systems for surgery must be considered as a
‘surgeon’s extender’ rather than a ‘surgeon’s replacement’