ANAHEIM, CA (UroToday.com) - Dr. Richard Satava presented a State-of -the-Art lecture "The Surgical Revolution in Minimal Access Surgery- The Robotic Connection" at the Sunday Plenary session of the AUA in Anaheim, May 20, 2007.

Dr. Satava, Professor of Surgery, University of Washington discussed that robots are 12-15 times faster and function with greater precision than humans. Robots can work around the clock without taking coffee breaks, he said. Information is a basis for surgery in the new age. "Holomer" is a total body scan to guide intra-operative navigation during surgery. A surgeon could then use this to perform a virtual operation on a patient prior to the real operation. A robot is an information machine, rather than a machine, he said. Thinking as such will permit greater integration into our healthcare system. The surgeon is then an information manager, and can integrate all aspects of the care to include preoperative planning, surgical approaches, etc. The robot can give 1mm accuracy using a virtual robot to practice an operation ahead of time on a virtual patient.

High intensity ultrasound can be used during surgery or can also be extrapolated to extra-corporeal systems to avoid surgery in some scenarios. This type of technology is being utilized in the military. Combined with telemedicine, electronic medical records, etc the patient benefits by an empowered information system. Military helicopters being developed are unmanned and can remotely evacuate military personnel. A robotic scrub nurse he showed can more quickly and accurately serve a surgeon freeing up nurses for more important activities. He showed a prototype of this. He also showed an OR that is entirely run without humans present. The tool changing nurse, scrub nurse, and da Vinci robot all communicate to provide the surgical care. All this is orchestrated by a surgeon, who is at the central console. For example to change a tool on the da Vinci, it takes the robot only 5-7 seconds

By 2025, congress has planned to have all fighter aircraft unmanned and fly them from remote sites. He showed a video of a virtual rescue and evacuation of a solder to a Bradley vehicle outfitted entirely robotically to treat the patient. All the technologies used in such a system are already present in the military arena and just need to be adapted to medicine. Finally he showed a biomimetic micro-robot that is inserted inside a patients' abdomen and performs operative tasks. Other aspects he touched upon included new lasers, tissue engineering, and hypothetically operating on a cells' genetic material as opposed to operating on tissue (intracellular surgery, as he referred to it).

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Written by Christopher P. Evans, MD, a Contributing Editor with UroToday.

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