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1、CHAPTER17EMERGINGTECHNOLOGYINSURGERY:INFORMATICS,ROBOTICS,ANDELECTRONICSGeraldM.FriedMINIMALLYINVASIVESURGERYminimallyinvasivesurgeryAccessinginternalbodycavities,suchasthechest,abdomen,catheter-basedtherapiesandpelvis,requiresanincision.Thesizeoftheincisionisdeter-image-gui
2、dedablativetherapiesminedbytheneedofthesurgeontoseeandmanipulatetheminimallyinvasiveroboticsurgerytargettissues.Ifresectionisrequired,theincisionsizemusttakeflexibleendoscopeasasurgicalplatformintoaccountthedimensionsofthetissuestoberemoved.Insimulationforsurgicaltrainingand
3、operativeplanningsomecases,thoroughhistologicexaminationoftheremovedconclusiontissueisnotcritical(e.g.,splenectomyforidiopathicthrombo-cytopenicpurpura[ITP],hysterectomyforfibroids)andtheresectedorganmaybepulverizedormorcellatedtoeaseitsTherehasbeenadramaticchangeinsurgicalc
4、areoverthepastremovalthroughasmallincision.Inothercases,suchascolec-20yearswiththeintroductionofdigitization,miniaturization,tomyforcancer,itisimportanttoexaminetheremovedtissuesimprovedoptics,novelimagingtechniques,andcomputerizedaccuratelyforstagingandgradingpurposesandtoe
5、nsurethatinformationsystemsintheoperatingroom(Fig.17-1).Whereastheresectionmarginsarefreeofdisease.Inthelattercases,thesurgeryhastraditionallyrequiredlargeincisionslargeenoughtoincisionmustbesufficienttoavoidcompromisingtheaccuracyallowthesurgeontointroducehisorherhandsintot
6、hepatient’softhepathologicexamination.Thegoalofminimalaccessbodyandallowsufficientlighttoseethestructuresbeingoper-surgeryistodiminishthetraumaofaccesswithoutcompromis-atedon,innovationshavestimulatedaradicalchangeinhowingtheoverallgoalofthesurgicalprocedure(Fig.17-2).surgic
7、alproceduresareperformed.ManysurgicalproceduresThecosttothepatientofthisaccessincisionismultifacto-havebecomeimage-guided.Thesecanbedonebymanipulatingrial.Generally,largerincisionsareassociatedwithmorepostop-instrumentsfromoutsidethepatientwhiledirectingthembyerativepain,lon
8、gerrecoveryperiods,aperiodofphysicallookingatdisplaysofdirectimagesofthetar
