Navigating the Future: Understanding Smart Handheld Robotic Systems in Laparoscopic Surgery

Introduction

Providing effective treatment and enriching lives are the core goals of every surgical intervention. Technological advancements facilitate these goals through constantly evolving healthcare. The role of technological development in surgery is to optimize and enhance the capabilities and expertise of surgeons, expedite surgical functions and procedures, ensure positive outcomes, and enable quality patient care. 

The contributions of surgeons to every surgery's successful outcomes are undeniably remarkable. They are invested physically, mentally, and intellectually in the surgeries and constantly work towards balancing these variables for successful surgical and patient outcomes. When surgeons collaborate with automation and augmentation, they can work with more precision, accuracy, and deliver better results, benefiting the patient.

One such evolution in surgery has been Minimally Invasive Surgery (MIS). This MIS is done laparoscopically, ruling out the need for invasiveness in surgeries to gain access to the surgical site. Furthermore, the deployment of robot assistance in laparoscopic surgery has provided for greater surgical precision and accuracy in complex operations, using on-screen visualization, immersive and 3-D imaging, dexterous surgical devices, and highly articulated instrument tips. Smart handheld robotic system is the latest addition to the list of technological advancements in laparoscopic surgeries.

To know how the latest and smart handheld robotic system works and the benefits it entails in surgical outcomes, continue reading this blog.

Benefits of Laparoscopic Surgery and Robot-Assistance

The well-known benefits of laparoscopic surgery include:

• Minimal invasiveness
• Less tissue scarring and lesions
• Faster healing and recovery
• Less pain
• Shorter postoperative hospitalization
• Faster return to normalcy

The above benefits add further exponential value by introducing robot-assisted technology in surgeries. The role of robot assistance in surgical performance is evident in the surgeons' enhanced capabilities, augmenting their expertise in performing complex operations with precision, accuracy, and efficiency.

Robots take care of the mental, physical, and technical variables that may restrict and/or affect surgical performance. Robots help reduce potential human errors and enhance surgical efficacy and performance as they are fatigue and stress-resistant, insusceptible to emotional responses, dexterity and scalable motion, and high on maneuvering complex movements for accessing hard-to-reach surgical sites. 

Challenges of Laparoscopic and Robot-Assisted Surgeries

Though minimally invasiveness and robot-assisted surgeries have been transformative in enhancing surgical outcomes and patient care, they face challenges.

Challenges with Laparoscopic Instruments

The laparoscopic surgery tools have narrow shafts, various tips, and multiple handle styles to maneuver the surgery. They are used with a laparoscope and provide ergonomic rotation and tissue handling during the surgery. Some of the laparoscopic surgery tools are needle drivers, trocars, and bowel grasper.

The lesser the invasive access, the greater the difficulty with controlling the surgical instruments while operating for the surgeons. They need proximity to the instruments when accessing the inner body through smaller incisions. This restricts the movement of the instruments, surgeons' skill, and angulation of the surgical instruments, requiring the surgeons to perform repeated procedures in restricted posture and uncomfortable body positioning for a longer time. Long-term adherence to such postures and movements affects their performance and body posture, muscular and physical wellbeing.

Challenges with Robotics in Laparoscopic Surgery

Robotic platforms require large-scale capital, machinery, time, space, and infrastructure investment, involving huge financial and maintenance costs. These platforms lack mobility and easy accessibility due to their size and scale of operation. The operating console and robotic arm lack proximity to the surgical site, and managing the large workflow setup of the robotic platform is challenging.

Need for Smart Alternative Surgical Instruments

The need for smart handheld robotic systems was felt in light of the challenges of conventional surgical instruments and robotic platforms assisting surgeries. Conventional laparoscopic instruments possessed straight, rigid tips that restricted their movement and functionality. The end effectors of instruments in robotic surgery possess dexterity, enabling effective surgical maneuvering. There arose a need to provide an instrument that would be flexible and dexterous, like instruments in robotic surgery, while ensuring less capital investment and affordable alternatives that would fit the setup of laparoscopic surgery.

Advent of New Handheld Devices

The 2D images of the laparoscope and the limited range of motion of the conventional instruments led to the introduction of robot assistance in these surgeries. In robotic surgery, the surgeon controls the instruments while sitting on the console with the help of high-definition and 3D images.

The new handheld devices introduced in the market work towards bridging the gap between laparoscopic surgery using conventional and robotic surgical instruments. Handheld surgical systems are motorized and driven by software which ensures the following points. 

• Optimal fitting in the surgeon's hand for smooth maneuvering and controlling the operation.
• Ergonomic comfort, ease, and flexibility to surgeons while reaching inner areas of surgical sites.
• Efficient articulation, thus mitigating the operational challenges of the surgeons.
• Personalized and tailored designs that imitate the surgeon's natural hand motions, thus enabling them to perform with ease and efficacy.
• Lightweight and easy handling for high mobility and agility.
• Minimum setup that adjusts to the existing laparoscopic workflow without disturbing it.
• Cost-effectiveness while integrating the advantages of the robotic platform by modifying and minimizing the device sizes.

HANDX® from Meril

HANDX® from Meril is a handheld solution for surgeons that combines the advantages of robotics with the benefits of handheld instruments. FDA-cleared and CE-marked (MDA), HANDX® is a robust yet compact and lightweight device that is easy to use and a powerful tool for surgeons in MIS practice.

It is a simplified, modular, and cost-effective platform ensuring suitability for hospital setup, no workflow disruption and maintenance, as a flexible economic model. The device facilitates complex MIS maneuvering, allowing efficient articulation and smooth access to technically challenging areas. HANDX® is suitable for varied surgical approaches. The device comes in various working lengths and end effector lengths.

Conclusion

The new robotized handheld devices combine the advantages of conventional and robotic surgical instruments, thus navigating the future of laparoscopic surgery toward optimal surgical efficiency, accuracy, and precision with surgical ergonomics. These devices enable the surgeons' ease, comfort, agility, and effectiveness on the operating table and help them perform complex surgeries optimally.

References

https://hospitalprofessionalnews.ie/2023/09/25/handheld-robotic-systems-for-minimally-invasivesurgery/#:~:text=HandX%E2%84%A2%20by%20Human%20Xtensions,set%2Dups%20and%20indeed%20pricing.

https://www.intechopen.com/chapters/59483

https://blog.engineering.vanderbilt.edu/the-future-of-surgery-augmentation-and-automation-in-healthcare#:~:text=Robot%2Dassisted%20surgeries%20(RAS),beyond%20what%20the%20body%20allows

https://www.merillife.com/medical-devices/endosurgery/robotics/handheld-robotics-system/handx