Robotic Surgery Student Watch

“Taking surgery beyond the limits of the human hand”™

Stuart Graham RN

Robotic Surgery Coordinator

Evolution of Surgery

– Open surgery: mid-19th Century

– Minimally invasive surgery:Began in late 1980’s

(Laparoscopic Surgery)

– Computer Assisted (Robotic) surgery with da Vinci: 1999

1987

Advantages of Minimally Invasive Surgery (MIS)

– Faster recovery– Shorter hospital stay– Quicker return to work– Less postoperative pain– Better cosmesis– Patient Expectation

Minimally Invasive Surgery Access

Open Surgical Incision da Vinci™ Prostatectomy Incision

Laparoscopic Surgery

• Minimally invasive surgery

• Ability to operate through small keyhole incisions

• Camera and instruments fit through the keyhole incisions

• Better visualization than open surgery

Conventional Laparoscopic Surgery Drawbacks

• 2–D flat image video• Rigid instruments - chopsticks• Instruments controlled at a distance - fulcrum effect• Decreases your surgeon’s precision, dexterity and control• Higher surgeon fatigue• Makes complex operations more difficult

How can we overcome these drawbacks?

Technical ConceptsRobotic Surgery Computer- enhanced Surgery

AESOP Lineage(Automated Endoscopic System for Optimal Positioning)

• AESOP 1000 (1993)First CMI product

• AESOP 2000 (1996) Incorporates voice recognition control

• AESOP 3000 (1998) Adds:– Double-jointed elbow– 3-D manual mode button

Early AESOP Robotic Scope Positioner with remote control – no voice

FREFLEX Force-Reflecting Exoskeletal Arm Master

(1994)

NuclearTelemanipulation

CentralResearchLabs

• Superior 3-D imaging

• ‘Open’ surgery orientation

InSiteTM 3-D Vision System

da VinciTM Surgical System

Intuitive Movement

Robotic Freedom Of Movement

Surgical Benefits

• Improved vision with a true 3 dimensional view magnified up to 10x.

• Scaled surgeon movement. Ratios vary from 1:1, 3:1 and 5:1. This allows for very fine work and offers great benefits in pediatric laparoscopic surgery.

• Improved surgical dexterity with wristed instruments allows for 6 degrees of surgical freedom rather than the 4 in traditional laparoscopic surgery.

• Improved surgeon comfort – Surgeon seated at console during the majority of the surgery.

Robotic Prostatectomy

So What’s Next?High Resolution Display – Multiple Inputs

da Vinci system placements

1999200020012002

2004

Alaska

2003

20052006-through Q1 close

da Vinci Surgical Network

OR Integration:OR Integration:ConceptsConcepts

Predicting the future…

“I think there is a world market for about five computers”

Thomas WatsonChairman IBM,

1943

Thank You

For more info go to www.davincisurgery.com