Robot Assisted Pulmonary Resection

The term ‘robot’ originates from the Slavonic term ‘robota’ which means forced labor but was made famous by the 1921 Czech play Rossum's Universal Robots (RUR) written by Karel Capek [1]. Thus, the robotic systems used in surgery today are not true robots because they lack independent motions or preprogrammed actions but are more accurately described as computer-enhanced telemanipulator systems. The concept for the modern day system first began in the mid 1980s with Scott Fisher, PhD at the National Aeronautics and Space Administration (NASA) Ames Research Center (Palo Alto, CA, USA.), and Joseph Rosen, MD (Department of Plastic Surgery, Stanford University, Palo Alto) who conceived the notion of combining virtual reality with surgical robotics or telepresence surgery. The idea of telepresence surgery was implemented by the Department of Defense of the U.S. military when analysis of the casualties of the Vietnam War revealed a large percentage of soldiers dying of wounds that were deemed survivable by today’s technology. Thus, an advanced biomedical technical program was implemented to develop a military vehicle (Medical Forward Advanced Surgical Treatment [MEDFAST]) with a surgical station that was controlled by a surgeon at the telesurgery unit in a nearby hospital. The idea was to perform damage control surgery “in the field” via the robot while transporting the solider to the hospital for more definitive care. Although telesurgery in the battlefield never was implemented mainly due to the change in warfare from open areas to closed urban terrain which was ill fit for the MEDFAST, the system was revamped and commercialized as the da Vinci surgical system (Intuitive Surgery, Sunnyvale, CA, USA), the present day’s robotic system. This system offers a high resolution 3 dimensional (3D) visual field and EndoWrist instruments, which provide 7° of freedom, 90° of articulation, and tremor reduction.