concorde career college, department of surgical technology st210
TRANSCRIPT
Biomedical Sciences: Information Technology, Electricity Concepts, Robotics, & The Future of Surgery
Concorde Career College, Department of Surgical TechnologyST210
Information Technology
Objectives
Define the term computer
List and describe the basic components of a computer system
Understand basic word processing and the use of graphics
Objectives
Access the internet to gather information
Apply basic computer skills to the educational process and to surgical case management
Demonstrate knowledge of terminology related to computer skills verbally and in the written form
Utilization of Computer Technology in the Operating Room
Scheduling Send/Receive Orders Send/Receive Medical
Records Update Pt. Chart Insurance Billing Update Surgeon’s
Preference Card Manage and Print
Instrument Count Sheets Order Supplies Complete Operative
Record Laboratory Requisitions
Utilization of Computer Technology in the Operating Room
Surgical patient scheduling software
Utilization of Computer Technology in the Operating Room
Preference Card Applications
As opposed to…
Utilization of Computer Technology in the Operating Room
…Hand written Often illegible Difficult to find Easily lost Can be taken with
the surgeon to another facility
Utilization of Computer Technology in the Central Sterile Department
Order Supplies and Instruments
Maintain Inventory Par Levels
Save and Manage Sterilization Records
Create Instrument Tray Menu Cards
Interdepartmental Equipment Transfers
Track Equipment Maintenance
Utilization of Computer Technology in the Operating Room
Supply chain maintenance and ordering software
Robotics
The use of robotics in the OR is gaining in popularity among many surgical specialties
Integrates complex computer science and mechanics
STs are often required to maintain, manage, sterilize, and manipulate this equipment
Must understand basic computer concepts in order to successfully function in the robotics-integrated OR suite
Computer Hardware
Watch the following basic computer hardware tutorial: http://www.youtube.com/watch?v=-FnnG
ouYpQQ
Computer Software
Programs that operate the computer system and its individual hardware components Operating systems Word processing Email Internet
Internet Basics
Global network connected through millions of servers
World Wide Web (www) is the most recent format for the Internet
Photo and Article Access Each has address begins http://www. Not all Web addresses contain www Ending of address identifies what type
organization publishes the information (.org, .gov, .edu, etc.)
Internet Basics
Search Engine Popular Search
Engines▪ Google, Bing, Yahoo
Uses keyword or phrases to search for subject
Usually first 20 – 30 articles directly pertain to subject
Internet Basics
Research for Homework and Projects Avoid using sites like Wikipedia that are not
peer reviewed, professional data sources Prefer scholastic search engines to general
search engines▪ Google Scholar: http://scholar.google.com/▪ iSeek: http://education.iseek.com/iseek/home.page▪ Library of Congress: http://www.loc.gov/index.html▪ Google Books: http://books.google.com/▪ Science.gov: http://www.science.gov/
Activity
AST Website & Discussion Board http://www.ast.org/
Visit the state assembly▪ http://www.ast.org/state_assemblies/index.as
px
Electricity Concepts
Objectives
Define the term electricity. Understand the basic principles of
electricity. List and describe the types of
electrical current.
Objectives
List and describe the basic components of an electrical receptacle.
Analyze the relationship between magnetism and electricity.
Identify basic electrical equipment utilized in the surgical environment.
Objectives
Apply knowledge of electricity to safe practice in the surgical environment.
Demonstrate knowledge of terminology related to electricity verbally and in the written form.
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Electricity – Uses in the OR
Electrosurgery X-ray Endoscopes Lasers Robotics
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Atoms, Electrons, and Matter
Matter is anything that has mass and occupies space
All matter consists of atoms
Volume is the amount of space occupied by an object.
Protons – Inside nucleus and positively charged
Neutrons – Inside nucleus; neutral particles
Electrons – Revolve around the nucleus; negatively charged particles
Atoms are composed of small particles: Protons Neutrons Electrons
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Electron Theory
Electrons revolve around the nucleus in paths called shells or orbits
Electrons that are located closer to the nucleus demonstrate a stronger attraction the nucleus; electrons moving in the outer orbits are less attracted.
In certain atoms, if these outer electrons are exposed to light, heat, or electric energy, they will speed up and leave the atom
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Electricity
These outer electrons are known as free electrons
The movement of free electrons creates electric current
The term electricity describes the free electrons moving or flowing from the ring of one atom to another
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Conductors
Materials that allow the flow of free electrons
Examples: silver, iron, saltwater, copper
Copper is the commonly used because it’s the most economical
Examples of OR devices that use copper: OR lights, power drills, ESU
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Conductors
Because water is a conductor of electricity, the amount of humidity in the air is important
High humidity often results in static charge leakage
Low humidity results in the formation of sparks
Humidity in the OR is maintained between 50% and 55%
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Insulators
Materials that inhibit the flow of free electrons
Insulators are simply poor conductors
Conductors are wrapped in insulation to prevent leakage of electrons while the current flows to the device that will use it.
Examples of insulators in the OR are the plastic and rubber casings that cover the ESU cords
Electrical Charge
Can be either negative or positive. Like charges repel each other, unlike
charges attract each other. 2 negative charges or 2 positive charges
will repel each other.▪ ***Opposites attract***▪ (magnets)
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Electrical Current
Electric current is movement of the electrical charge
The electrical current travels through conductors by movement of the free electrons that migrate from atom to atom inside the conductor
Volts
Electrical potential Voltage: The force or push that moves
free electrons from one atom to another.
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Resistance
Restricting the flow of the current Measured in ohms
Opposing or counteracting force
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Power, Load , and Switch
Power – the rate at which work is done (ex- battery) Power is measured in watts (W)
Load – the device that uses the energy (ex- flashlight bulb)
Switch – device that opens or closes a circuit and controls the flow of electricity (ex- between the battery and flashlight)
Hot Wire and Neutral Wire
Hot Wire: supplies electrical current in a circuit TO a device.
Neutral Wire: AKA ground wire, carries electrical current in a circuit AWAY from a device.
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Wall Outlets
Plugs used in surgery have 3 prongs. Components: ▪ First prong (positive)▪ Second prong (negative)▪ Third prong (ground)
If electrical short occurs, the electrical current will flow through the grounded plug to reduce the risk of current passing through surgical team or patient. Must never be removed to fit in a 2 prong plug.
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Direct and Alternating Current
Direct (DC): electrical current that flows in one direction. Batteries
Alternating (AC): electrical current that reverses direction periodically. A complete cycle moves in one direction and then reverses its course. Electrosurgery
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Electrosurgical Unit (ESU) Circuit Generator (power source) Active electrode (electrosurgical pencil)
Delivers the electric current to the surgical site through the tissue, the energy is converted from electrical to thermal.
Patient Dispersive electrode/inactive electrode
(grounding pad) Electric current is channeled back to the
generator via the grounding pad Placing the grounding pad p 112
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Monopolar/Bipolar
Monopolar Most common Coagulation or
cutting, or blend Large areas Grounding pad
needed
Bipolar Less frequent Only coagulation Delicate procedures Areas of moisture Grounding pad not
needed
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Accessories to Electrosurgery
Harmonic scalpel Ultrasonic energy Cut and coagulate Surrounding tissue suffers less thermal
damage (charring) A grounding pad is not necessary ▪ No electricity
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Advantages of Electrosurgery
Reduced blood loss Saves time Cutting current also burns tissue
reducing the need to stop and control bleeding
Cutting current seals small spaces in the tissue and lymphatic vessels
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Dangers of ESU
Electrical burns Patient and surgical team▪ Resonant frequency (RF) capacitive coupling:
AC travels from active electrode, across insulation and into skin.▪ EX: surgeon clamps hemostat to bleeding vessel
▪ Dielectric Breakdown: occurs when high voltage breaks down insulating material (gloves) causing a hole and possibly burning the individual.
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Laser Light
Different from ordinary light Monochromatic Coherent Collimated Its color will decide how it will react
with various tissues Red laser light is absorbed by red-
pigmented tissue Photon: a particle of LASER light
energy
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Laser
Fluence Spot size, watts, time
Four interactions of laser with tissue Absorption, transmission. reflection, or
scattering
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Parts of a Laser System
Energy pump (excitation source) responsible for delivering the energy to the laser head to produce laser light - can be from any energy form (media)
Laser head – active medium that produces the laser energy. Lasers are named according to active medium. Mirrors are positioned at both ends of laser head. Laser energy is reflected off mirrors.
Ancillary components – includes the console, cooling system and vacuum pump
Control panel – controls for operating the system; includes wattage, duration, and mode
Delivery system – transports the laser energy from the laser head to the tissue. Ex – articulated arm, fiber, fixed optical array
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Lasers Carbon Dioxide Argon Nd:YAG Holmium: YAG **YAG=pulsed beam
CO2
Most frequently used Invisible beam
Helium-neon laser beam is transmitted with the Co2 laser to aid in aiming (red color)
Permits precise cutting and coagulating Absorbed by cellular water content (not
dependent on tissue color or consistency) Not effective for use where the laser light needs
to be transmitted through clear fluids. Delivered through an articulated arm w/ mirrors
positioned at the articulations.
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CO2
Laser Bronchoscopy Dermatologic
Pigmented lesions Shallow Tumors
GYN HPV BX for abnormal PAP
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Argon
Produces a blue or green light Plasma tube that contains argon
$$$ Laser energy is converted to heat
when absorbed, produces coagulation and vaporization.
Can travel through clear fluids and tissues, absorbed in tissue by hemoglobin or melanin.
Used in treatment for the eye 50
Nd: YAG
Consists of crystal laced with neodymium.
Invisible beam: requires helium-neon laser aiming beam
Absorbed by darker tissue Can be transmitted through clear
fluids. Used to vaporize bladder tumors Delivered through non contact or
contract fiber delivery system. 52
Nd:YAG
TURP Urethral Strictures Bladder Tumors Hysteroscopy
Uterine polyps fibroids
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Holium: YAG
Discharges a pulsed beam Travels through flexible fiber Can be transmitted through clear
fluids Used in arthroscopic procedures
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Holmium: YAG
LASIK Lithotripsy
-Tripsy: crushing Lith/o:stone
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Active Media
Gas: Co2 , Helium Neon, Krypton, Argon and Excimer
Solid: KTP and Nd:YAG. (Most power output)
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Robotics
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Robotic Surgery
Objectives
Define the term robot.
Provide a timeline of the events leading up to the use of robots in the surgical environment.
List the advantages and disadvantages to the use of robots in the surgical environment.
Objectives
Describe the principles of geometry that relate to robotics.
Identify the basic components of the surgical robot and describe the function of each.
Objectives
Describe the mechanisms by which the surgical robot operates.
Apply knowledge of robotics to safe practice in the surgical environment.
Demonstrate knowledge of terminology related to robotics verbally and in the written form.
Definition
A robot is a machine designed to operate in a seemingly human way, with speed and precision. There are as many different types of robots as there are tasks for them to perform.
Definition
Robotics is a branch of engineering that involves the conception, design, manufacture, and operation of robots. This field overlaps with electronics, computer science, artificial intelligence, mechatronics, nanotechnology, and bioengineering.
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Why Robotic Surgery?
Improve surgical patient care Overcome human limitations Reliable Complex
History
First generation robots are simple machines capable of performing precise repetitive motions at high speeds.
History
First Generation Robot
No artificial intelligence (AI)
Require constant oversight
History
Second generation robots incorporate a level of artificial intelligence.
History
Second Generation Robot
Requires occasional monitoring
AI (computer chip) Tactile sensors Auditory
capabilities Visual abilities
History
Third generation robots are autonomous.
History
Third generation robot
Mars Rover Spirit
Works independently (without supervision)
Controlled by a central computer
History
Fourth generation robots are not yet developed.
History
Fourth generation robot
Predicted to have ability to:
Learn Reproduce Evolve
Robotics
Delta (Berlin, Germany) Robotic
Surgical Microscope
Advantages Vs. Disadvantages
Advantages Decreased hospital stay/reduced
overall cost Reduced tremor Expert surgeon available even if not
in geographic area Reduced risk of transfer of disease
Disadvantages Initial cost of equipment is great Actual operating time may be
increased especially during learning curve
Technical difficulties
Geometry
Study of figures in a space of a given number of dimensions and of a given type.
Cartesian Geometry
René Descartes (1637) introduced the use of coordinates for describing plane curves, the axes were omitted, and only positive values of the x- and the y-coordinates were considered, since they were defined as distances between points. For an ellipse this meant that, instead of the full picture which we would plot nowadays, Descartes drew only the upper half.
Geometrical Terms
Point Ray or plane X axis or plane (horizontal) Y axis or plane (vertical) Origin (intersection) Angle Z axis or plane (third dimension) Slope Curvilinear
Robotic Components
Five Basic Components of the Surgical Robot
Controller (Hermes) Arm (AESOP – voice controlled) Drive (Zeus – Motor) End Effector (Instruments) Sensor (AI)
Socrates – Telecommunication system
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Robotic Arm
End Effector
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DA VINCI ROBOT SYSTEM
DA VINCI ROBOT SYSTEM
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Coming Technologies
NOTES Anesthesia Robots
NOTES
Natural Orifice Transluminal Endoscopic Surgery
NOTES
Anesthesia Robots
Closed-loop anesthesia systems McSleepy
Fully Robotic Surgery
McSleepy meets DaVinci
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What are your responsibilities?
Surgical technologists will be responsible for: Setting up the robot Running the computer
programs Operating equipment
during the surgical procedure