Medical network - on November 4, I start with the development of surgical look, begin with open surgery, the late 19th century because of the development of anesthesia, the surgeon can be very leisurely give patients do surgery, the middle of the 20th century had a laparoscopic surgery. Laparoscopic surgery advantage is minimally invasive, minimally invasive, so the doctor's eyes into the belly. Like the bladder surgery, we used some cutting equipment can put the group separation, viscera cut out, lesions, surgical site basically no bleeding, laparoscopic era, it is to enter into the 21st century into the robot assisted laparoscopic surgery. We laparoscopic surgery done good, open surgery scar greatly, the wound is very big, some places still can't reach. When we laparoscopic surgery, the original pioneering surgery is, two people to become single laparoscopic surgery, plane vision not stereoscopic vision. Other laparoscopic surgery doctor very tired.

Leonardo Da Vinci robots are now so well, its advantages can be summed up in three points, is a good time, reach, sit. Look, it is a 3 d high resolution stereoscopic vision, two eyes to see is concentrated into one field of vision, it can magnify the 10 to 15 times, the butcher can control his own view. Can also be combined with other, such as real-time ultrasound, doctors can know the blood vessels in which position. Reach, equivalent to the doctor's eyes and hands belly into the patient. We are two hands before, now has the third hand, this is used to help us do surgery. And it can imitate human activity degree of seven dimensions, can control up and down before and after the rotation. The seven degrees of freedom, we surgery, it's pretty convenient. And the equipment is small, a lot of narrow space, the original open surgery can't do it, can do now. Sit steady, the doctor do surgery, we can now sitting on a stool, not so tired. In addition we can both hands support on the shelf, with support and more stable, but also by using his hands and feet, can control the view and so on. Surgery we can do some careful operation, the machine into the my hand activity 3 centimeters, instrument inside activity 1 cm, only some trembling also can filter out, so the operation was more accurate.

Now the world's most advanced laparoscopic surgery Da Vinci robots or, turned out to be the only, have any new don't know. It has installed 3745 units, mainly in the United States, the United States more than 2000 Taiwan, Europe more than 600 Taiwan, more than 400 in Asia. From the perspective of the subject of use, mainly of obstetrics and gynecology, urology, general surgery, and thoracic surgery. From this model for increased year by year. To global since 2015 has reached 660000 units, the growth rate of 14% a year in the growth, and we can see in the United States, 90% of all prostate cancer radical surgery is made of the robot, in gynecological surgery, 80% of ovarian cancer surgery is made of the robot. So in our country, our country is relatively poor is still relatively backward, our robot in the world than less also, now we have 59, heard that recently added one has 59, do for more than 35000 cases. Now home and urology, is the subject I do robots do the most, like general surgery, cardiothoracic surgery and obstetrics and gynecology account for certain proportion.

Robots we think is very stylish, but not all can use robots to do the surgery, can in theory, but have the necessary? Where I think the advantages of the robot, good steel used in the blade, some small space is more complex surgery, need fine separation need a lot of suture surgery is more appropriate, as general surgery rectal cancer, and so on, urology bladder cancer effect a radical cure, and prostate cancer effect a radical cure, partial nephrectomy, and so on. General surgery is not necessary to use robots, it feels a bit like kill on the wheel.

Robots we use full swing, but it's not already perfect? Our answer is NO. We only know its shortcomings and the insufficiency, will continue to explore to progress. We have to start from the surgery, it is the Hand and the Work of two, is actually a manual labor. We surgeons to the pursuit of a small, want more and more fine more and more small, surgical trauma will smaller and smaller. The surgeon to do more and more careful. Robot now or imitate the surgeon's hand, and even beyond the surgeon's hands, but not limited to imitate.

I think our robot which deficiencies at present, I reduce it to these five points. One is stupid, dull, rough, less, away. But leonardo Da Vinci robot is now the most advanced robot.

Like a marionette, stupid, its operation is a doctor in the control is not itself moving. And so big a robot, we are not used to fight, is used to do surgery, should be more a little bit small. The robot we still think mobile is not very convenient to use, installed a bit of trouble. Instruments or a certain space and distance to do, also by certain restrictions.

Blunt, the main no touch, we have touch hands, and it even the doctor's hand was achieved. Touch is very important for the doctor's hands, the doctor's hand exactly knew this was the tumor and normal tissue, the mould will know whether the following have arteries, don't damage it. Knot and stitching we do pay attention to the points won't be pulled apart or cause drag mark. I know that a new generation of Da Vinci also have tactile feedback.

Thick and bulky. We open surgery, 10 cm incision wound is large, the laparoscopic 3-5 mm hole can go in, the robot into 8 mm now, it should be more and more fine should not be more and more thick, we are in pursuit of more and more delicate.

Less, leonardo Da Vinci now have three machine arm. 3 a robot arm is enough? May 4. In fact we do surgery an aide to a butcher has four hands, 3 hand is not enough, can convert instruments is limited, especially ultrasonic knife, with a lot, but not endoscopy network.

And patients, surgery is separate, surgery and assistant is separated. I'm here to surgery, my assistant team patient in another place, is separated. The separation, is a selling point of leonardo Da Vinci, remote control operation. War is very good, when space is very good, but we normally do surgery, why so far to the patient. Actually far is a risk. If I tell you the patient for surgery, what do you do in shenzhen, the doctor in Beijing. The patient certainly don't feel safe. So civil should still safe beside the bed, and not the pursuit of a remote control, half one thousand to do what to do with network was broken. We sometimes surgery suddenly found in the process of large blood vessel injury bleeding, it's a race against time. This is existing civil phase, attaches great importance to the bedside.

A new generation of robots should be? Can we imagine, after is a small machine worm cast into the veins or belly finish operation, that's too far away. But we hope that the next generation of robots, we as doctors expect, the robot should have thought, to see through, the costumers, smaller volume, hands and feet, like a pillar.

Have thinking, robot like "alpha dog" can learn, have the function of learning, he gave the patient surgery after a few times to know how to do the surgery, the other in some dangerous place to doctors to remind. In addition we want to put the patient's data input into the computer, the input to the machine inside the brain and the original data are compared, whether surgery or steps do give us some hints that are useful.

See it through, we by ultrasound, CT and MR imaging become a three-dimensional image. Our image, tumor here, how to cut the tumor, the two together, will know that the tumor should be cut deeper here, can avoid some damage. Where can also help us to identify the blood vessels, don't damage, how to protect, where the tumor, to cut it clean.

Now there are some very good technology, as one eye tracking mode, the doctor's eyes to the vision is to the left, near to the right vision, vision left back, these techniques should soon can use on the robot.

The costumers, mainly through the force feedback, get the hand feeling, now do not have a feeling, there should be a feeling in the future. Now a lot of equipment, when we encounter groups, hardness, elasticity, can feel, and we can think through existing, like ultrasound has an elastic imaging function, can by ultrasound elasticity imaging function to identify the nature of the organization, ultrasound has been doing now.

Volume is small, I found a small online robot arm, mainly to solve the problem in the endoscopy network. Now robots in endoscopic surgery main key technologies is network, with the hand, the doctor is very convenient operation, many complex surgery can be completed, especially the stitching technology can be done through a very simple small instrument, not necessarily make into a big MAC.

We have porous said laparoscopic surgery, and also has a single span. Single-hole surgery robot now has, through a hole instrument, can complete the operation, the majority is navel after surgery, no scar, can also through the anus, a woman can be done through vaginal surgery, conventional laparoscopic doing now, but do it very difficult. I believe that a robot after the operation problem will be solved. Single-hole surgery may be more and more applied in the clinical.

The last one, hands and feet, like a spider. Like a spider on the patio, with four or five boom stretched down, sitting next to the doctor, we can put a VR glasses, left a butcher right a helper, can be more secure and practical.

To summarise, robotic surgery is the development direction of modern surgery, laparoscopic robot existing leonardo Da Vinci is now the most advanced, and it is more accurate and stable, the operation but haven't reach the perfect state. How do the surgeon to look forward to the next generation of robots, I think it should be flexible, sensitive, minimally invasive, and smart.