1. Flexible Robotics Presented by: Autum Artz

2. Objectives: Understand Flexible Robotics and the growth of tele-surgical devices. Describe and evaluate hardware and software used in flexible robotics. Assess the role and functions of the robotics nurse specialists. Examine and understand ethical dilemmas in regards to flexible robotics. Describe advantages and disadvantages of flexible robotics in the health field and in nursing.

3. What is flexible robotics? Medical robotic technology, that has transformed surgical procedures, using smaller incisions with a telesurgical device with shared control from the surgeon and the robotic system.

4. Information System Used: Medical/Clinical Information system Used clinically by medical professionals

5. Information System Review: Clinical information system Used by Physicians and nurses Purpose to diagnose and treat operatively Configuration-stand alone workstation Perioperative nursing dataset classification system Excellent information system and tool on many levels, highly recommended

6. Uses: Cardiac Revascularization Gastric Bypass Radical Prostatectomy Hysterectomy Cardiac Tissue Ablation Epicardial Pacemaker Lead Placement

7. Hardware and software used: Fiber optic instruments Small video cameras Joysticks to perform surgical tasks Telemanipulation to guide robotic arms Three dimensional images vs. two dimensional

8. Usability: The equipment is ergonomically appealing: There is great ease of learning, using, and remembering how to manage The system. The hardware and software work well together and each part has a specific Role which enables the others parts to perform with ease.

9. Davinci Robot Vs. Zeus Robot Davinci is made by Intuitive Surgical Inc. First used July 2000. Used for cutting and suturing. Ergonomic interface surgeon uses hand movements and foot petals. 4 interactive arms with endowrist action. 3 dimensional image of surgical sites. Zeus is made by Computer Motion Inc. First used October 2001. Used for grasping, holding, and moving things out of the way. 3 robotic arms. One arm voice activated to hold endoscope. Surgeon wears glasses to create 3 dimensional image.

10. Nurse Informaticist Role: Assists intra operatively with all robotic procedures. Brings observations and concerns to proper staff members to seek resolution. Orients and trains nurse personnel and students. Keeps database of types of procedures and times, assists with research. Acts as liason with institution and manufacturer. Builds comprehensive picture of how, why, and when to use system.

11. Ethical Dilemmas: Waste of resources, procedures can be done with simple microscope already. Cost is significantly more. Surgeon is not at patient bedside but at computer during procedure.

12. Advantages: Robot allows for more efficient use of Instruments. 60% less blood loss. No tremor with robot. Allows for 3 dimensional view instead of 2 dimensional. Decreased length of stay. Use of multiple arms.

13. Disadvantages: Has limitations. Not useful for very complicated resections. Technical difficulty. Learning curve for surgeons, takes at least 12-18 surgeries to feel confident. Cost. Length of surgery is longer.

14. Competencies Turning equipment on Cleaning equipment Changing out equipment Patient care Knowledge of hardware and software

15. Summary Physicians are not scrubbed Physicians are not at the bedside Alternative surgery to open procedures Many advantages Nurses play an intricate role Multiple patient care benefits

16. References: Bonsor, Kevin, and Jonathan Strickland. "HowStuffWorks "Shared-control Robotic Surgery Systems"" Howstuffworks "Science" How Stuff Works, Inc., 30 Oct. 2008. Web. 02 June 2010.. Francis, Paula. "The Evolution of Robotics in Surgery and Implementing a Perioperative Robotics Nurse Specialist Role." Elsevier. AORN, Mar. 2006. Web. 04 June 2010.. "Intuitive Surgical, Inc. - Da Vinci Surgical System." Intuitive Surgical, Inc., 2005. Web. 03 June 2010.. University of Florida. "Urologists Use Robot to Shave Time off Vasectomy Reversal, Raise Sperm Counts." Science Daily: News & Articles in Science, Health, Environment & Technology. Science Daily, 8 Jan. 2010. Web. 04 June 2010.. All pictures taken from intuitivesurgical.com