Introduction of da Vinci surgical system & Robotic radical prostatectomy at the Vattikuti Urology Institute

Presenter: Dr. Md. Monowarul Islam rtn24@yahoo.com 8801818169894 Dhaka,Bangladesh

Minimally Invasive Surgery

Approximately 20 years ago, surgeons began practicing a new approach to performing surgery, an approach that is MIS.

Traditional MIS has significant technical drawbacks:

1.The surgeons operate using a 2D monitor. 2.The resulting image flattened the natural depth of field, and 3.the fixed-wrist instruments limits his/her dexterity. 4.the surgeon is to move the instrument in the opposite direction as the instrument tip.

As a result, this type of MIS is suitable for a narrow range of surgical procedures.
Dexterity:
the ability to perform a difficult action quickly and skillfully

Robotic-Assisted MIS
Intuitive Surgical introduced the da Vinci Surgical System in the late 1990s. These innovations meet the preconditions for minimally invasive solutions.

3 components

da Vinci improvisations

1.da Vinci 2. da Vinci S 3. da Vinci Si

Features and Benefits of the da Vinci Surgical System

1.Superior Visualization
2.Enhanced Dexterity, Precision and Control 3.Superior Ergonomics

Superior Visualization

The da Vinci System provides visualization of the target anatomy with natural depth-of-field, enhanced contrast and magnification.
That enables surgeon to perform delicate tissue handling and dissection with added precision.

Enhanced Dexterity, Precision and Control

The da Vinci System's tremor reduction, motion control and proprietary EndoWrist instrumentation enhance ambidexterity for precision and control beyond the capabilities of the human hand.

Enhanced Dexterity, Precision and Control

The surgeon can now move instruments with such accuracy that the current definition of surgical precision is exceeded & reduced learning curve. MIS procedures feel more like open surgery as twohanded intracorporeal suturing is now standard practice.

Superior Ergonomics
Surgeon operates in sitting posture. which is not only more comfortable, but also clinically advantageous due to reduced surgeon fatigue.
natural hand-eye alignment at the surgeon's console, which provides better ergonomics than traditional laparoscopic technology.
Ergonomics: the scientific study of the peoples working conditions

EndoWrist Instruments

EndoWrist Instruments
EndoWrist Instruments can offer an even greater range of motion than the human hand. They truly allow to take surgical precision and technique beyond the limits of the human hand.

Features of EndoWrist Instruments

7 degrees of freedom 90 degrees of articulation Intuitive motion and provide enhanced dexterity, precision and control finger tip control Motion scaling and tremor reduction

Wide Selection

The EndoWrist product line includes a variety of forceps, needle drivers, scissors; monopolar and bipolar electrocautery instruments; scalpels and other specialized instruments.
available in 5 mm and 8 mm diameters.

4 Arms

4 Arms

The first two arms, representing the surgeon's left and right hands. A third arm positions the endoscope, allowing the surgeon to easily change, move, zoom and rotate his or her field of vision from the console.

4th Arm
The optional 4th Arm perform additional tasks like applying countertraction. This optional feature potentially eliminates the need for a patient-side surgeon.

FAQs

Q. Why is the company called Intuitive Surgical?

Because its technologies are designed to allow surgeons to operate with the same skills learned in open surgery.

Q. Why is the product called the da Vinci Surgical System?

because Leonardo da Vinci invented the first robot. He also used unparalleled anatomical accuracy and three-dimensional details to bring his masterpieces to life.

Drawings by Leonardo da Vinci(1452-1519). The skull bisected and sectioned (1489) in an attempt to locate the sites of the mental faculties.: Orthogonal views of the skeleton (c 1510-11). (Collection of Her Majesty the Queen).

The Last Supper 14951498(Leonardo)

Q. Is a surgeon using the da Vinci Surgical System

operating in "virtual reality"? Although seated at a console a few feet away from the patient, the surgeon views an actual image of the surgical field while operating in real-time.

Q. Is this telesurgery? Can you operate over long distances?

The da Vinci Surgical System can theoretically be used to operate over long distances. This capability, however, is not the primary focus and thus is not available with the current da Vinci Surgical System.

Q: Where is the da Vinci Surgical System being used now?

United States, Austria, Belgium, Canada, Denmark, France, Germany, Italy, India, Japan, the Netherlands, Romania, Saudi Arabia, Singapore, Sweden, Switzerland, United Kingdom, Australia and Turkey.( 19 countries)

Q. Will the da Vinci Surgical System make the surgeon unnecessary?

It cannot be programmed, or can make decisions on its own to perform any type of surgical maneuver without the surgeon's input.

Q. What are the benefits of using the da Vinci Surgical System over
more traditional methods of surgery?

greater surgical precision, increased range of motion, improved dexterity, enhanced visualization and improved access.

Q. Is this "robotic surgery?"

The system replicates the surgeon's movements in real time. Sometimes, however, the general term "robotic surgery" is used to refer to this technology.

Q. While using the da Vinci Surgical System, can the surgeon

feel anything inside the patient's chest or abdomen?

The system relays some force feedback sensations from the operative field back to the surgeon throughout the procedure. This force feedback provides a substitute for tactile sensation.

Q: What procedures have been performed using the da Vinci Surgical

System?

general, urologic, gynecologic, thoracoscopic, and thoracoscopically-assisted cardiotomy procedures have been performed using the da Vinci Surgical System.

Q: How many da Vinci Systems have been sold?

June 30, 2009, there have been 1,242 unit shipments worldwide - 916 in the USA, 221 in Europe, and 105 in the rest of the world.

da Vinci

Demonstrations in an operation

Nerve Sparing Robotic radical prostatectomy at the Vattikuti Urology Institute

Author: Dr.Mani Menon, M.D

Authors Biography
Dr. Menon earned his medical degree from the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry The first robotic prostate surgery in the United States was started by Mani Menon, M.D., at the Vattikuti Urology Institute in 2001 Dr. Menon has published more than 300 papers

Awards
Gold Cystoscope Award American Urological Association Shustruta Award of Distinction in Urology Indian American Urological Association

Jawaharlal Institute of Postgraduate Medical Education and Research

Video

Thank you