Surgical Robots Could Be Used For Long-Distance Regional Anesthesia

A new study demonstrates that the da Vinci surgical robot could allow expert anesthesiologists to perform complex regional anesthesia procedures from remote locations.

Researchers at the University of Florida (Gainesville, USA) performed a series of simulations to evaluate the feasibility of performing robot-assisted regional anesthesia procedures using the da Vinci multipurpose surgical robotic system, a product of Intuitive Surgical (Sunnyvale, CA, USA). The system, which consists of four robotic arms, a high-definition stereoscopic camera, and an operator console, is widely used to perform various types of robot-assisted surgical procedures. The simulated anesthetic procedures in the study were performed using an ultrasound (US) phantom that displayed what the anesthesiologist would see when performing US-guided procedures.

After initial placement of the US probe, the anesthesiologist was able to carry out successfully a simulated nerve block procedure, including identifying nerve structures, picking up the needle and positioning it at targeted nerve, and performing the injection. The robotic system was then used to attempt a more technically advanced regional anesthesia procedure: placing a perineural catheter for continuous nerve block. Although some steps had to be performed manually, most of steps of this complex catheter placement procedure were successfully performed by the da Vinci operator. The study describing the simulations was published in the September 2010 issue of Anesthesia & Analgesia.

"Both single-injection and perineural catheter techniques were successfully performed by an operator who was not physically present at the bedside,” concluded lead author Patrick J. Tighe, M.D., and colleagues of the department of anesthesia. "The simulation proved that robotic-assisted regional anesthesia is feasible using existing clinical equipment.”

"There are too few skilled regional anesthesiologists to meet the demand,” commented Steven Shafer, M.D., of Columbia University (New York, NY, USA), editor-in-chief of Anesthesia & Analgesia. "This technology is in its infancy. If future studies show that it is practical, one highly trained anesthesiologist could provide dozens of specialized nerve blocks to patients around the world in a single day. There would still be a requirement for a local anesthesiologist to look after the patient, handle any complications, and provide backup anesthesia in case the block fails.”

Related Links:
University of Florida
Intuitive Surgical