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Computer-integrated surgery focuses on computer-based techniques, systems, and applications exploiting quantitative information from medical images and sensors to assist clinicians in all phases of treatment, from diagnosis to preoperative planning, execution, and follow-up. It emphasizes the relationship between problem definition, computer-based technology, and clinical application.

Overview
Russel Taylor has argued that “The impact of Computer-Integrated Surgery (CIS) on medicine in the next 20 years will be as great as that of Computer-Integrated Manufacturing on industrial production over the past 20 years.” One advantage of Computer-Integrated Surgery over normal surgery, is that it is minimally-invasive. These computers combine doctor-created models which are specific to each patient, with an optimal surgical plan. The result is a surgery that is tailored to the specific needs of each patient, as well as safe and minimally invasive. The doctors and computer systems they use combine images and other information about a patient with “atlas” (overall or general) information about human anatomy to help doctors plan how to treat the patient. As the surgery is being performed, the patient-specific plan and model are updated in real-time. The system makes use of a variety of technologies, including robots and “augmented reality” displays to assist the surgeon in carrying out the procedure safely and accurately. Doctors then use the same technology to assist in the patient follow-up. This allows the doctors to use statistics gathered from data from the surgery as a quality control to help improve the overall efficacy and safety of the surgery.

Uses
Computer-Integrated Surgery is used most commonly for orthopedic surgery, such as knee or hip replacements, which call for a surgery tailored to the unique needs of the individual patient. For these reasons, it is also used for soft-tissue surgery such as the removal of tumors.

Plan of Action
Patient-specific information is gathered. This information can come from a variety of sources including computed tomography (CT scan), magnetic resonance imagining (MRI) or positron emission tomography (PET) just to name a few. This information about the patient is then taken and combined with current statistical information about human anatomy, its physiology and disease. This information is used to create a computer model of the patient, which is then used to create an optimal surgical plan. While in the operating room, this patient model and surgical plan must be "registered" to the patient. Doctors do this by finding anatomical structures or markers on the patient and their corresponding model to create a map of sorts. This is extremely helpful as if the patient's anatomy changes, all that need be done is update their respective model and surgical plan. The procedure is then carried out with the assistance of robots. As the procedure is performed, additional imaging monitors the patient's vitals and the procedure's progress in order to verify that the procedure has been executed correctly. After the surgery, further imaging and modeling is done for the patient follow-up and to see if additional surgery is necessary.

Factors Affecting Wide-Spread Use
There are a number of factors that researchers developing new robotics and techniques, as well as the doctors who implement them need to consider before this technology can become more commonplace. For one, the advantages of this form of surgery are often difficult to measure as the results can take a while to assess and be interpreted.

Advantages
Quality: Computer-Integrated Surgery can improve the quality of surgical technique used by doctors, thus reducing the need for revision surgery to repair mistakes made in the initial surgery. Reduces Time and Cost: Computer-Integrated Surgery can improve the speed and reduce the cost of some types of surgery. Since the surgery is tailored for each individual patient, it allows doctors to more quickly and efficiently perform the surgery, as well as reducing costs that arise from healing and revision surgery. Less Invasive: Computer-Integrated Surgery is less invasive as the procedure is so well planned beforehand, is tailored to the needs of the individual patient, and takes advantage of feedback from previous surgeries. Since the procedure is less invasive, it also reduces infection risk, recovery time and cost. Safety: Computer-Integrated Surgery reduces the possibility of surgical complications and errors which, again, lowers costs and reduces recovery times.

Disadvantages
There are some disadvantages to using this new technology. Poor Judgment: As opposed to doctors, robots inherently have poor judgment, being unable to adapt to situations as they arise. Limited Dexterity: Whereas a human's hands are very dexterous and able to take many different shapes and perform a variety of tasks, robots lack this dexterity and as such make performing very fine movements much more difficult.

Research
Computer-Integrated Surgery is generally led by the group ERC CISST: Computer Integrated Surgical Systems and Technology. The ERC CISST state their mission as "that of developing surgical systems that integrate novel computer and human/machine interface technologies that will revolutionize surgical procedures, extending the surgeon's abilities to achieve better outcomes at lower costs." CISST is currently affiliated with the following companies: Acoustic MedSystems, Inc. American Shared Hospital Services Foster-Miller GE Healthcare Hologic, Inc. Intuitive Surgical, Inc. Medtronic Northern Digital, Inc. Philips Siemens. Johns Hopkins University, led by Doctor Russel Taylor has been the lead institution for all Computer-Integrated Surgery research and work.

Some universities are doing research in this area including Johns Hopkins University, MIT and Carnegie Mellon University.