Japanese Journal of Clinical Oncology 34:227-237 (2004)
© 2004 Foundation for Promotion of Cancer Research
Robotic Surgery and Cancer: the Present State, Problems and Future Vision
1 Department of Disaster and Emergency Medicine, Graduate School of Medical Sciences and 2 Center for Integration of Advanced Medicine, Life Science and Innovative Technology (CAMIT), Kyushu University, Fukuoka, Japan
In the 1990s, laparoscopic surgery entirely changed the traditional style of surgical operations. Laparoscopic cholecystectomy has spread rapidly and is now established as the standard treatment. However, besides cholecystectomy, endoscopic procedures are still not applied so widely to a variety of surgical operations. This is because laparoscopic techniques, such as suturing or ligation, make it difficult for surgeons to perform other kinds of operations and thus greatly increase their mental and physical stress. It is necessary to introduce various advanced technologies such as: surgical robots, three dimensional (3D) images, computer graphics (CG), computer simulation technology and others. Surgical robots, including the AESOP, da Vinci and ZEUS systems, provide surgeons with technologically advanced vision and hand skills. As a result, such systems are expected to revolutionize the field of surgery. However, there have so far been few studies which discuss the indications of robotic surgery for tumors/cancer. Therefore, herein we review various studies published in English to focus on the application of robotic surgery to tumors/cancer.
We point out that there are several problems to be solved for robot surgery: i) price of surgical robots, ii) training systems for surgeon, iii) coverage by medical insurance, iv) downsizing and v) navigation system. In conclusion, we believe that, in the near future as robotic technology continues to develop, almost all kinds of endoscopic surgery will be performed by this technology. It will replace traditional surgery not only in the treatment of benign diseases but also in malignant illnesses.
+ For reprints and all correspondence: Makoto Hashizume, Department of Disaster and Emergency Medicine, Graduate School of Medical Sciences, Kyushu University, 3–1–1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. E-mail: mhashi{at}dem.med.kyushu-u.ac.jp
Abbreviations: 3D, three dimensional; CG, computer graphics; CAD, computer-aided design; CAM, computer-aided manufacturing; AESOP, automated endoscope system for optimal positioning; IORT, intraoperative radiotherapy; CT, computed tomography; MR, magnetic resonance; MRI, magnetic resonance imaging; FUS, focused ultrasound surgery; CAMIT, Center for Integration of Advanced Medicine, Life Science and Innovative Technology; MIS, minimally invasive surgery; PUMA, programmable universal manipulation arm; LIMA, left internal mammary arteries; LAD, left anterior descending