A Role for BMETs in Supporting Robot-Assisted Surgery

Abstract

This is one of those areas in which biomedical equipment technicians (BMETs) are limited in what they can do. So, get your hands on as much information as possible and educate yourself at every opportunity.As part of that, I'll devote this column to a quick overview of robot-assisted surgery, a term used to describe the use of a robotic system to aid and enhance a surgical procedure. With such surgery, the surgeon does not directly move the instruments. Instead, the surgeon moves a computerized joystick-like device and then the robot moves the instrument. The surgeon conceivably could be anywhere in the world and perform the surgery. Some robots have articulating wrists instead of the joystick-type device. This allows for more precise movement and more human-like manipulation. Some robots are able to sense the surgeon's hand movements and translate them into micro-movements, enabling the surgeon to manipulate tiny instruments. The ability to provide a three-dimensional, high-definition image gives a more realistic view of the surgical field. All of these things allow the patient to have a surgery that is performed with greater precision, decreased blood loss, smaller incisions, and quicker healing time.From the BMET's point of view, the system usually consists of a video tower, the robot, and the viewing device for the surgeon. The video tower has your usual equipment, such as a light source, video controller, and some sort of electrosurgical device. The tower can be as robust as needed for the surgeon. If the company that makes your device offers online, on-site, or manufacturer-based training, I suggest you take as much of it as possible. Training is always an asset in your toolbox. The online training that I took was very effective. It was very biomed specific, and the knowledge I gained about the device has allowed me to communicate more effectively with the team.Terms such as docking, undocking, locking, driving, assembling, and disassembling are all good to know. Docking refers to positioning the robotic arms over the patient in the surgical field. Undocking refers to removing the robotic arms away from the surgical field. Locking describes the act of securing the instruments and robotic arms in place for use. Driving is the word used when talking about moving the robotic arm.Assembling the arms and the other devices around the room is a surgeonspecific procedure. Prior to the first use of the robotic system, the team will need to practice and see where the equipment needs to be. The BMET will need to assist in ensuring that dedicated power and information technology connections are available. Most “robots” can be fully integrated with room video integration systems.What about the legal issues? Most companies will provide documentation about the use and limits of the robotic device. I would caution BMETs to remember that we repair equipment and that we don't have law degrees. Leave the bigger decisions about use to the clinicians and legal departments. Our role is to support the use of these robotic devices, and, as part of that, we need to educate ourselves about how they work and their role in healthcare technology.Most surgical departments will perform several walkthroughs of cases. Take your role in these practices seriously. Train as if it is the real thing. If the equipment needs to be connected to dedicated power, make sure the connection works in the practice session. Leave nothing to chance. Keep learning, and always be an advocate for safety.