History and Future of Robotic Colorectal Surgery
The first prototype robots were developed in the mid-1990s to overcome the disadvantages of laparoscopic surgery, mainly the 2D plane, the rigidness instruments, and the limited degrees of freedom. Current robotic platforms mitigate these disadvantages by
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History and Future of Robotic Colorectal Surgery Joshua MacDavid and Garrett Friedman
Introduction
Jacobaeus (1879–1937), was credited with performing the first laparoscopic intervention in humans in 1910 where he Medical innovation has always been a curiosity of our society. created pneumoperitoneum and evacuated ascites [4]. This Two hundred and eleven years ago, Philipp Bozzini (1773– technology made its way to the United States in 1911, by 1809) began the era of modern endoscopy with his invention Bertram Bernheim. Further advances in laparoscopy were of the Lichtleiter, a 35-cm-tall device that housed a series of made by Heinz Kalk, a German gastroenterologist who mirrors that reflected candlelight for looking into the bladder developed the first forward viewing scope in 1929 and and rectum [1]. It took seven more decades before Max Nitze described several new techniques, including liver biopsy. In (1848–1906), a German urologist, developed a clinically 1933, the first laparoscopic lysis of adhesions using electrousable cystoscope that was eventually used as the first laparo- cautery was performed by gynecologist Karl Fervers [2]. scope [2]. It took another 80 years until the first laparoscopic From the mid-1950s until the mid-1970s, laparoscopy was appendectomy was performed in 1980 [3]. The first prototype widely rejected by the scientific community and was even robots were created in the mid-1990s and have not achieved banned in Germany from 1956 to 1961 [5]. Concerns were widespread usage until this past decade. Currently we are in raised from the increased risk of pregnancy with tubal ligathe robotic era of minimally invasive surgery, which has gone tion performed laparoscopically and the increased incidence from concepts resembling those in science fiction novels to of bowel injuries [2]. reality at seemingly increasing rates. This chapter outlines a In 1980, the first laparoscopic appendectomy was perbrief history of minimally invasive surgery with special formed by Kurt Semm (1927–2003), a German gynecoloemphasis on laparoscopic and robotic innovations, along with gist. Dr. Semm is often referred to as the father of modern the current and up and coming robotic platforms. laparoscopy, given the multiple laparoscopic techniques and devices he was involved with creating including the suction irrigator, auto insufflation, and intracorporeal knot-tying devices [3, 6]. Jacobs et al. reported the first laparoscopic Laparoscopy colon resections. In their cohort of 20 patients, 9 patients Around the turn of the twentieth century was when laparos- underwent a right hemicolectomy, 8 underwent a sigmoid copy was used to visualize intra-abdominal contents, adopt- colectomy, and the other 3 patients underwent either a low ing instruments similar to those in endoscopy. In 1901, anterior resection, Hartmann’s procedure, or an abdominoGeorge Kelling (1866–1945), a German surgeon, used perineal resection. Though their study was not a controlled Nitze’s cystoscope to examine the intra-abdominal contents trial, it ma
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