...What it takes to get into a General Surgery Residency . . . . By Shirin Towfigh, MD -----------------------------------------------------------------------------------------------------------A word to the wise: Only those who cannot envision doing anything else with their lives should choose surgery. If you can find happiness in any other career, then do not choose surgery. A few statements I stand by (let’s get rid of some myths): 1. It is never too late to choose surgery as a career. Many do not choose until the end of their third year. 2. Though most students who know they are interested in surgery do it as their last rotation in Year III, whether you do surgery first or last has historically had no effect on your grade or outcome. 3. If you are savvy in your rank list, you will likely match in a program. Most don’t match because they did not rank enough programs (or the right programs). Be honest about your prospects and have a mentor. 4. The majority of general surgery programs are very good. You will graduate being a good surgeon and you will get a good fellowship or a job. Now, the facts (from NRMP book, found lying around in the KSOM Student Affairs Office): In 2004: - 1,042 of 1,044 general surgery spots were filled. The remaining 2 spots filled the day after the MATCH. - Of U.S. grads, 885 matched out of 1,230 applicants (72%), the rest were foreign grads. Note that the national average for all specialties is a 93% match rate. - The average student ranked 12.4 programs...
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...Robotic Surgery Deborah Martin, ROBOTIC SURGERY ༉ Introduction ༉ Advantages & Disadvantages ༉ How Robotic Surgery Works ༉ Conclusion Robotic Surgery Mostly paying consideration on reducing the invasiveness of the surgical procedure Robotic Surgery • Computer supported surgery • Surgeon operates the machine to do the operation • Surgeon uses one or more technique to control the instrument • While operate the operation the Surgeon uses remote or directly the computer to manage those instrument AESOP Endoscope Positioner robotic system ༉ Computer Motion, Inc developed the AESOP Endoscope Positioner robotic system and in 1993 this became the first robot approved by the FDA for surgery. ༉ AESOP Endoscope Positioner is a voiceactivated robotic system for endoscopic surgery. ZEUS® Surgical System ༉ Computer Motion, Inc introduced the ZEUS® Surgical System in 1998. ༉ ZEUS® Surgical System consists of : ༉ Surgeon control console ༉ Three table mounted robotic arms Da Vinci Surgical system ༉ ༉ ༉ ༉ ༉ Intuitive Surgery, Inc. created the da Vinci Surgical system and approved in 1997 by FDA. July 2000 it become the first laparoscopic surgical robotic. The da Vinci system consists of: A Surgeon console A patient side cart Four robotic arms (the three arms of the da Vinci system holds the operation instruments and the fourth arm has a camera with two lenses...
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...ranging from the history and development of robots that can be found in surgical rooms, political concerns regarding the Food and Drug Administration and their requirements to approve use of these robots, the legal aspect of robotic technology on how to determine which party is held liable in case of accidents or malfunctions that can lead to injury and a legal case that shows the difficulty to prove fault against a manufacturer. Also discussed will be the economic ramifications on our society, psychological, sociological, cultural, moral and ethical impacts on human life, in particular the patients that undergo surgery involving a robotic surgical system, and the environmental impacts of robotics in surgery. It is our hope that through this research paper that we are able to explain to and educate our readers on the impacts of Robotic Surgery as this type of surgery is becoming more popular with doctors in order to...
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...Robotic Surgery Review Related Literature Twenty-five years have passed since the first successful minimally invasive surgical procedure and laparoscopic general surgery has grown exponentially with particular regard to certain pathologies and now, besides cholecystectomy , it is considered to be the gold standard for surgery of the oesophagogastric junction, adrenal glands, distal pancreas, and spleen. The expanding role of laparoscopic surgery is closely associated with technological advances, including the advent of flexible fibreoptic instruments and improved laparoscopic haemostatic devices such as clips, endoscopic staplers, and energy-induced forceps (electrical based and ultrasonic based). The most recent innovation in this field has been robotic-assisted technology. Multiple large study series have clearly demonstrated superior outcomes with laparoscopic versus conventional open surgery; the benefits of laparoscopy include decreased postoperative pain, morbidity, and length of hospital stay (LOS), improved cosmesis, and overall cost-effectiveness. Nevertheless, the operative complexity that can be achieved with this kind of minimally invasive surgery has slowed the broad adoption of laparoscopy especially in the most challenging hepatobiliary surgery due to the complex vascular and biliary anatomy of the liver, propensity for bleeding, parenchymal friability, and extremely difficult surgical exposure. Considering the limitations of the laparoscopic technique, it is...
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...Spinal surgeries Of all the spinal surgeries, Spinal Fusion is the most popular and most sought out treatment for back pain problems. One of the reasons for wide acceptance of Spinal Fusion procedure was may be due to the fact that the procedure doesn’t involve removal of any body part unlike Spinal Discectomy or Laminectomy. While the Fusion procedure is an improvement and better alternative over the other two for back problems, it still is a medical procedure with significant risk. The patient may lose the ability to walk in some conditions and it’s a very expensive procedure. Rate of Spinal surgeries Increase in the rate of Spinal Fusion procedure may be attributed to the incentive for hospital profits. While many hospitals setup separate spinal care units to solve all back pain problems, it still is the surgeon’s decision whether the patient needs a surgery or not. If the surgeon owns a POD, the incentive for the doctor to approve the surgery is high. Hospital profits and revenue due to spinal procedures are a prime factors that drive the increase in rate of spinal surgeries. The invention of spinal fusion procedure set the rate of spinal surgery trend line to a burgeoning growth because it’s a “relatively safer” surgery. The term “relatively safer”, if advertised can mislead the patients suffering from back pain and mask the risks involved the procedure. For most aging humans, back problems are inevitable due to the present lifestyle. Although most problems can...
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...------------------------------------------------- Robot Assisted Surgery: The Evolution of the Surgeon and the Operating Room Abstract The art of surgery has evolved significantly from the times of shaman priests in ancient Egypt and bloodletting barbers of Medieval Europe. This evolution was assisted by the development of new tools that were created as the result of some advancement in technology. These new instruments permitted the surgeons of their day to unlock new possibilities and develop new techniques, each more sophisticated than the one before. Due to the sensitive nature of surgery, moral and ethical obligations were established early on and eventually formed the basis of “The Hippocratic Oath”, which is still relevant to the modern surgeon. We are now in a place in history where robots are being used to assist with surgical procedures that were once only conceivably done by human hands. This paper seeks to detail this evolution as well as describe current and future applications of robotics in the surgery and the ethical implications inherit with this technology. This report will also attempt to identify and discuss the complex legal, political, and cultural issues that have also evolved with this science. A review of the literature was undertaken using Medline. Articles describing the history and development of surgical robots were identified as were articles reporting data on applications. This most recent development in surgical advancement has infinite potential...
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...Injuries to your joints can be extremely debilitating, and surgery is often required to repair this type of damage. Luckily, arthroscopic surgery has made it possible for your doctor to perform these procedures using much smaller incisions, which allow patients to experience a much shorter recovering time. However, if you have never undergone this type of procedure, you may benefit from the following answers to common arthroscopic surgery questions. What Should You Expect Immediately Following Arthroscopic Surgery? Arthroscopic surgery is far less invasive than traditional orthopedic surgery, but you may not know what to expect in the days immediately following this procedure. While you can expect a more rapid recovery period than traditional...
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...me. That’s what you get when you need surgery. I was in there to have my shoulder repaired. The tragic accidents continuously replay in my mind while I mindlessly lay in the bed. Surgery is unforgettable, terrifying, and painful.. Everyone probably remembers playing badminton in high school gym class. It was more to me than just another class activity. It was a game that changed my life. One day we were playing it and I went up to hit the birdie and “pop”. I suddenly drop to the ground. The pain from my shoulder dislocating was unbearable. I finally stand up and somehow I am capable of getting my shoulder back in. But I was unable to move it without screaming out in pain. The teachers help me ice it but that doesn’t help me as much as it should. Eventually my mom gets called to come pick me up and she takes me right to the hospital. Which is when the long journey began. The visit to the hospital declared nothing. We were scheduled to meet with a specialist that later ordered a MRI for me. Which then told us that my capsule was too loose and needed to have surgery to tighten it up. If I didn’t have surgery then I would continue to dislocate my shoulder. Therefore we did choose to have it done for me. Weeks later I show up to the hospital at 6:45 am. The nurses help get me changed and the iv in my arm. I can’t even remember how many different doctors came into my room to talk to me about various things. Right before my surgery was scheduled to begin they wheeled me...
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...Subject- Robotic surgery ROBOTIC SURGERY * * Our society is based around innovations and technical changes; a new invention becomes an innovation if it is put to market with a good business model, and a clear marketing campaign, a new invention not put to market is not an innovation. Many inventions do not succeed due to the lack of market research. Successful innovations often disrupt an established technology, meaning that the established technology becomes obsolete, or much less used, and it us the disruptive innovation which takes over. In this paper we will see how Robotic surgery disrupts the traditional human surgery process. Robotic surgery offers small incisions, instruments that bend further than the human wrist, and an enhanced view due to its magnified 3D high-definition. It is highly beneficial due to its reduced chance of bleeding and infection, fewer post-operative complications and a faster recovery. The only commercialized robot in robotic surgery is the Da Vinci surgical robot, which is a production of Intuitive Surgical. The medical domain has already accepted a lot of innovations, it is a domain that has greatly evolved, our health being one of the most important things in life, a lot of research is made around it, and the government is often part in its funding’s. The most revolutionary innovation in the health care center is robotic surgery, which now looks to disrupt the human procedure of surgery, and replace it with robotic surgery. Robotic surgery...
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...Robotic Surgery Table of Contents Introduction 3 Historical Development of Robotics 4 Political and Legal Influences 6 Economic Considerations 8 Technology in Today’s Culture 10 Environmental Concerns 12 Moral and Ethical Implications 13 Psychological and Sociological Effects 17 Conclusion 18 References 20 Introduction Robotic surgery, or computer-assisted surgery, is the term used to describe the technology of using robotic systems to aid in surgical procedures. It was developed to help surgeons and medical health professionals overcome the human limitations of minimally-invasive surgery and enhance the abilities of the surgeons performing these procedures. It has many benefits to not only surgeons and medical facilities but for the patients as well. After years of development, training, and global awareness of the technology, medical manufacturers of the robots, surgeons, and medical professionals hope the technologies benefits will outweigh and overcome the environmental, financial, legal and ethical controversies. Dr. James McEwen, Dr. Brian Day and a team of engineering students, developed the very first surgical robot in 1983. It was used on March 12, 1984 for an orthopedic surgical procedure in Vancouver, Canada. Over sixty minimally invasive joint surgeries were performed in the first 12 months after the first successful surgery. After this, several other robotic devices were developed. A surgical scrub nurse was created...
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...have artificial intelligence. Some, like Honda's ASIMO (Fig 1) robot, will resemble the human form. They may eventually become self-aware and conscious, and be able to do anything that a human can. When we talk about robots doing the tasks of humans, we often talk about the future, but robotic surgery is already a reality. Doctors around the world are using sophisticated robots to perform surgical procedures on patients. While robotic surgery systems are still relatively uncommon, several hospitals around the world have bought robotic surgical systems. These systems have the potential to improve the safety and effectiveness of surgeries. But the systems also have some drawbacks. It's still a relatively young science and it's very expensive. Some hospitals may be holding back on adopting the technology. Robotic surgery is the use of robots in performing surgery. Three major advances aided by surgical robots have been remote surgery, minimally invasive surgery and unmanned surgery. 1.1 History In 1985 a robot, the PUMA 560, was used to place a needle for a brain biopsy using CT guidance. In 1988, the PROBOT, developed at Imperial College London, was used to perform prostatic surgery. The ROBODOC from Integrated Surgical Systems was introduced in 1992 to mill out precise fittings in the femur for hip replacement. Further...
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...LASEK surgery annually in Korea for convenience and better first impression. However, there still exist people who hesitate to get surgery because they don’t know well about the LASIK and LASEK. Therefore, it will be very helpful to read this article in that it includes information about procedure and some important matters to consider. First of all, people need to know about the procedure of LASIK and LASEK in order to relieve fear of the surgeries. Both of LASIK and LASEK are based on a principle. Surgeons can adjust the convexity of cornea by cutting sharply the cornea to make eye focus right. Patients don’t need to worry as surgeons will cut cornea by specialized laser. The most important different point is existence of corneal flap. The corneal flap is a part of cornea that is cut by surgeon. In other words, in LASIK, surgeon makes the corneal flap. After the laser reshapes the cornea, the flap is then laid back in place in LASIK, covering the area where the corneal tissue was removed. Then the cornea is allowed to heal naturally. In contrast, only the ultra-thin epithelial "flap" is peeled exposing the cornea for laser reshaping. After the laser treatment is finished a bandage contact lens will be placed on the eye. Next, preliminary patients might be also curious about how to recover and what is important after surgery. Similarly in both surgeries, doctor will have patients rest for a bit, and typically they can return home right. Most people who get LASIK surgery tend...
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...LAS 432 Course Capstone Project Robotic Surgery (LAS 432 - 08) Robert Clark April 19, 2015 Team F Team Leader: Dylan Zinkiewicz - D# 03342318 Team Members: Alisha Young - D# 01615918 Antonice Thomas - D# 01487783 Brooke White - D# 01489597 Katherine Vega - D# 01487783 Contents Alisha Young Intro to Robotic Surgery 2 Antonice Thomas Timeline 10 Overview 15 The Future 17 Dylan Zinkiewicz Economic Talk 19 Marketing & Media Influence 24 Katherine Vega Psychological considerations and Sociological effects 29 Environmental Implications 33 Brooke White Ethics and Legal Issues 37 Conclusion 45 References 46 Intro to Robotic Surgery Robotic surgery is defined in the medical dictionary as "the performance of operative procedures with the assistance of robotic technology" ("Robotic," n.d.). Robotic surgery is an emerging technology that began its experimental phase in 1985 with the introduction of the PUMA 560 robotic arm. The first use of a robot for a surgical procedure was a neurosurgical biopsy, recorded in 1985. Following this successful surgery was the first laparoscopic surgery using the same kind of robot; the robotic arm. In 1987, a successful cholecystectomy was performed. In 1988, doctors decided to use the PUMA 560 robotic arm for a transurethral resection procedure. Finally, in 1990, the Automated Endoscopic System for Optimal Positioning (AESOP) became known as the first system to be approved by the Food and...
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...Running Head: TEAM B COURSE PROJECT Team B Course Project Final Draft April 20, 2013 Professor Aimee James DeVry University Abstract Robotic surgery is a described as when a surgeon uses robotic equipment to assist during a surgical procedure. The surgeon manipulates controls which send information to the robotic equipment, telling it what to do. This surgical technology can be used for a wide range of surgical procedures. There are multiple benefits from choosing this type of surgery, but can also cost more than laparoscopic. Robotic surgery has been discussed for over two decades. Over the last decade, it has increased in popularity and applicability. There are many economic concerns over the use of this technology such as the cost versus the applicable use. There are also concerns about the implications the use of this technology will have on the environment, as well as moral and ethical concerns. By providing background information and history of this technology, information on the use of this technology, economical, sociological, and psychological effects and concerns associated with this technology, and information on environmental implications and moral and ethical concerns of this technology, we hope to provide readers a basis to form an educated opinion on the applicability of remote and robotic surgery. Table of Contents Abstract (Jesse Edwards)…...……………………………………………….…………………….ii Introduction (Jesse Edwards)……………………………………………….……………………..1 Description...
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...Robotic Surgery October 8, 2015 Devry University The technology Robotic surgery refers to a method used to perform surgery with the help of very small surgical instruments attached to a robotic arm. The surgeon controls the robotic arm with a computer (U.S. National Library of Medicine, 2013). Robotic surgery or robotic-assisted surgery uses robots that are controlled by actual surgeons. The robots are merely for precision and accuracy during the surgery as human surgeons are prone to error due to distractions. The development also allows doctors to perform a lot more complex operations than they were able to before. It does not stop there; Robotic surgery allows for much more flexibility options, control- ability and accuracy in precision (Lanfranco, et al. 2004). The surgeon makes tiny incisions on the patient, then the blades and other surgical instruments that are attached to the robot, penetrate through the incisions. This kind of surgery has been successful in some traditional open surgical operations (Mayo Clinic, 2015). Application of general anesthesia is important during surgery because it alters the perception of the body toward a painful stimulus. General anesthesia is applied to ensure that the procedure is painless. It takes a patient to relax and submit themselves to the hands of the surgeon as the only way of healing. The anesthesia, therefore, works by reducing the anxiety that may bring complications as the patients are unconscious...
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