da Vinci Robot Surgery System
The Robot OR invasion continues -- this week we learn that the Da Vinci System is headed for... the prostate. This UPenn press release shows how Dr. Lee and his team have cut down on prostatectomy side effects with the help of robots:
Robotic technology offers a number of advantages during surgery. For instance, the robotic "arms" filter even minute tremors of the human hand so to provide steadiness. The robot's camera also provides a three-dimensional, stereoscopic image of the body's interior, as opposed to a two-dimensional image on a flat screen. This improved perspective enables depth perception that sharpens the visualization of the prostate and the network of nerves and tissue surrounding it. Additionally, by scaling down the motion of the robotic instruments, the surgeon can perform extremely precise, intricate movements during the procedure. For example, if the surgeon's hand moves five centimeters, he/she can scale the robotic hand to move only one centimeter.
Robotic technology also offers a number of advantages after surgery. Because laparoscopic surgery is minimally invasive and no large incisions are involved, robotic-assisted surgery provides numerous benefits for prostate cancer patients, including: less pain and scarring, diminished blood loss, a shorter hospital stay and reduced recovery period for a quicker return to daily activities.
The actual robot consists of a tower that manipulates instruments controlled from a console that is situated a few feet from the patient. At the console, the surgeon operates four robotic "arms" and "wrists" using hand and foot controls. One of the robotic arms holds a tiny video camera, one works as a retractor and the other two replicate the surgeon's exact hand movements. The camera and instruments are inserted through small keyhole incisions in the patientâ€™s abdomen. The surgeon then directs the robotic instruments to dissect the prostate gland and surrounding tissue.
The OR continues to be crowded by giant robots. Hot on the heels of the Penelope Surgical Instrument Server comes the new da Vinci Surgical System, from Intuitive Surgical:
"The robot takes us a big step beyond traditional laparoscopy. It allows us to operate more naturally, the way we do in open surgeries, but still preserve a minimally invasive approach with small incisions."
...After sleeve placement, the robot, much like a post with three arms, is wheeled over and its center arm docked to a port that holds the camera and the other arms docked to the instrument ports.
However, surgery with the da Vinci does not mean close proximity to the patient. Unlike with laparoscopy, the surgeon is seated across the room from the patient, with arms inserted into the nearby console, fingers on stirrup-like holders and eyes fixed on lenses for sharp magnified images of the surgical site. Focus is adjusted via foot pedals.
While laparoscopy allows manipulation of instruments up, down and side-to-side, surgery with the da Vinci allows more natural wrist movement.
The robot's arms have wrists with eight degrees of freedom that allow the surgeon "to bend around corners and work in ways that are much more natural," said Boggess. This allows full range of motion and the ability to rotate instruments 360 degrees through tiny incisions. Direct and natural hand-eye instrument alignment is similar to open surgery, with "all-around" vision and the ability to zoom in and out.
Another advantage with da Vinci is the elimination of tremor...
Professor Boggess says patients who've been operated on with the robotic system have shorter hospital stays, require fewer pain meds, and return to normal activities more quickly. We suspect robotic patients would fare even better
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