Robotic Surgery In Gynecology

In the decade of the ‘80s, the idea of having a military ambulance in the battlefield; equipped with a robot so that a surgeon in a hospital "Mobile Army Surgical Hospital" (MASH), located many miles away could operate a wounded soldier. In this way, saves his life by preventing blood loss and other physiological damages, avoiding disasters. The National Aeronautics and Space Administration (NASA) had a similar vision, displaying a robot operating an astronaut with acute appendicitis in a space station. By 1990’s, with the advent of laparoscopic surgery, the idea that this kind of surgery could be performed using a robot was conceived. But there were severe limitations. Many anastomosis, particularly of microscopic range, could not be performed well. These instruments are rigid tools, which can only move in two planes, in, out or turning in favor or against clockwise. However, they could not duplicate the movement of the hand and wrist of the surgeon; that is, tilt or move the instruments at different angles. In 1999 it was introduced the da Vinci Surgical System, the only commercial system for gynecological surgery. In 2005, FDA gave approval for this use. The current system consists of four components: 1. A console where the surgeon sits watches a screen and controls the instruments through digital potholders and pedals. 2. The cart with three or four arms that grip interactive ranging trocars the patient. 3. A vision system in three dimensions. 4. A computerized system algorithms that converts the movement of the fingers and hands of the surgeon to the trocars within the patient's abdomen. The potential advantages of this system are: improved depth perception in three dimensions, elimination of tremor, tele potential use in surgery, shorter hospital stays and less blood loss. The disadvantages are: high cost (more than one million dollars) in the initial acquisition of equipment, increased operating time, loss of tactile sensitivity surgeon, inability to reposition the patient, space occupied by the robot, difficult to maneuver the wizard and difficulty to train residents. Applications of robotic surgery are developing rapidly, but experience with this technology is very limited at present. <a id="