New master arm for transurethral resection with a robot

OBJECTIVE: In 1998, we designed a robot for transurethral resection that consisted of a master arm and a slave arm that reproduced the movements of the master. We describe the innovative master arm developed in two university departments that supersedes the mere "joystick" concept to become a true, operative surgical instrument. METHODS: The new master arm was developed from a conventional resectoscope working element integrated into a robotic manipulative device and fitted with angular displacement sensors. Each sensor, part of a computer-controlled feed back system commands the position and movements of the slave arm which, in turn, move the resectoscope. The surgeon freely chooses and manages precisely within a three-dimensional surgical field four basic resectoscope maneuvers; horizontal and vertical displacement, penetration-withdrawal, and rotation; he also controls the movements and operation of the resectoscope cutting loop. Additional computer-programs provide the surgeon with an error-free, fail-safe surgical instrument that denies any movements outside the planned surgical field. RESULTS: The fact that the new easily used instrument is similar in shape and works like conventional resectoscopes greatly helps familiarization and training. Advanced technology reduces the number of errors usually associated with fatigue or inexperience of the surgeon. CONCLUSIONS: The new surgical instrument handles just like conventional instruments so surgeons do not need to change their usual operating procedures. In addition, an early-warning program detects instantly and denies inappropriate maneuvers. This facility confers peace of mind to the surgeon and ensures patient satisfaction.