Computer-assisted surgery

This can be conducted through a number of medical imaging technologies including CT, MRI, x-rays, ultrasound plus many more.

It is possible to employ a number of scanning methods, with the datasets combined through data fusion techniques.

The final objective is the creation of a 3D dataset that reproduces the exact geometrical situation of the normal and pathological tissues and structures of that region.

Of the available scanning methods, the CT is preferred,[1] because MRI data sets are known to have volumetric deformations that may lead to inaccuracies.

Image analysis involves the manipulation of the patients 3D model to extract relevant information from the data.

Robotic surgery can be divided into three types, depending on the degree of surgeon interaction during the procedure: supervisory-controlled, telesurgical, and shared-control.

[2] In a supervisory-controlled system, the procedure is executed solely by the robot, which will perform the pre-programmed actions.

With shared-control systems, the surgeon carries out the procedure with the use of a robot that offers steady-hand manipulations of the instrument.

In most robots, the working mode can be chosen for each separate intervention, depending on the surgical complexity and the particularities of the case.

This allowed a greater development in brain microsurgery (compensating surgeon’s physiological tremor by 10-fold), increased accuracy and precision of the intervention.

It also opened a new gate to minimally invasive brain surgery, furthermore reducing the risk of post-surgical morbidity by avoiding accidental damage to adjacent centers.

Current navigation systems available include Medtronic StealthStation, BrainLab, 7D Surgical, Stryker, and Zeta Surgical Zeta; current robotics systems available include Mazor Renaissance, MazorX, Globus Excelsius GPS, and Brainlab Cirq.

[5] Static utilises prefabricated guides to direct osteotomy and implant placement,[6] dynamic is based or real time tracking of the drills position through optical technology[7] while robotic includes implant placement by autonomous robotic arm.

[citation needed] Using cone beam computed tomography, the patient and the existing prosthesis are being scanned.

Glass pearls of defined diameter are placed in the prosthesis and used as reference points for the upcoming planning.

The surgeon, using special developed software, plans the implants based on prosthetic concepts considering the anatomic morphology.

[citation needed] The dental technician, using the data resulting from the previous scans, manufactures a model representing the situation after the implant placement.

[citation needed] With the aid of a registration template, the abutments can be attached and connected to the implants at the defined position.

Using 3D imaging during the planning phase, the communication between the surgeon, dentist and dental technician is highly supported and any problems can easily detected and eliminated.

Image-guided surgery and CAS in ENT commonly consists of navigating preoperative image data such as CT or cone beam CT to assist with locating or avoiding anatomically important structures such as the optic nerve or the opening to the frontal sinus.

[10] The application of robotic surgery is widespread in orthopedics, especially in routine interventions, like total hip replacement[11] or pedicle screw insertion during spinal fusion.

Laparoscopy in abdominal and gynecologic surgery is one of the beneficiaries, allowing surgical robots to perform routine operations, like cholecystectomies, or even hysterectomies.

In cardiac surgery, shared control systems can perform mitral valve replacement or ventricular pacing by small thoracotomies.

In urology, surgical robots contributed in laparoscopic approaches for pyeloplasty or nephrectomy or prostatic interventions.

During the procedure, real time X-ray is used to accurately position the device before delivering radiation beam.

During the operation, the computer guidance improves the geometrical accuracy of the surgical gestures and also reduce the redundancy of the surgeon’s acts.