Surgery with da Vinci

                              da Vinci                             

Many of us have seen robotic arms in car production assembly line , and the precision with which all these robots work together is very impressive , but what if we can also use this technology in medical surgeries. Isn’t would it be wonderful?  da vinci is all about this very precised and impressive technology.

With the da Vinci Surgical System, surgeons operate through just a few small incisions. The da Vinci System features a magnified 3D high-definition vision system and tiny wristed instruments that bend and rotate far greater than the human hand. As a result, da Vinci enables your surgeon to operate with enhanced vision, precision and control. Additionally, the enlarged image allows for expanded visibility beyond that of the human eye alone. Therefore, the da Vinci® Robot System provides surgeons an opportunity to perform more intricate and complicated surgical procedures than other traditional minimally invasive methods.

Many surgeons today are consistently looking for new, technologically advanced ways to perform procedures in a manner that provides faster recovery and fewer complications than traditional surgical methods. Currently, the da Vinci® Robot System is that answer.

The da Vinci System represents the latest in surgical and robotics technologies. da Vinci technology translates your surgeon’s hand movements into smaller, precise movements of tiny instruments inside your body.

The da Vinci Surgical System  is a robotic surgical system made by the American company Intuitive Surgical. Approved by the Food and Drug Administration (FDA) in 2000, it is designed to facilitate complex surgery using a minimally invasive approach, and is controlled by a surgeon from a console. The system is commonly used for prostatectomies, and increasingly for cardiac valve repair and gynecologic surgical procedures. According to the manufacturer, the da Vinci System is called "da Vinci" in part because Leonardo da Vinci's "study of human anatomy eventually led to the design of the first known robot in history.

Doctors need to have special training before they can carry out this type of surgery. It involves two machines

• The patient unit
• The control unit

• The patient unit

You lie on the operating table and the patient unit is beside you. The unit has 4 arms. One arm holds the camera and the others hold the surgical instruments. Three of the arms are for tools that hold objects, and can also act as scalpels, scissors, bovies, or unipolar or hi. The surgeon makes 5 small cuts in your abdomen. The camera and instruments are put in through the cuts to do the surgery. The patient unit is controlled by the control unit.

• The control unit

The control unit is where the surgeon sits. It is in the operating theatre with you but is separate from the patient unit. The surgeon can see the operating area on a screen. This gives the surgeon a 3D view that they can magnify up to 10 to 12 times. 

Below the screen are the controls. The surgeon uses these master controls to move the instruments on the patient unit. This turns any movements the surgeon makes into much smaller movements of the machine. It also reduces any shaking, allowing the surgeon to make very tiny, accurate movements. Cutting and putting in stitches is easier with the robotic assistance.

The surgeon must also rely on a patient-side assistant to position the camera correctly. In contrast, the da Vinci System's design allows the surgeon to operate from a seated position at the console, with eyes and hands positioned in line with the instruments and using controls at the console to move the instruments and camera.

The da Vinci System has been designed to improve upon conventional laparoscopy, in which the surgeon operates while standing, using hand-held, long-shafted instruments, which have no wrists.

MEDICAL USES

The da Vinci System has been successfully used in the following procedures:

1.Radical prostatectomy, pyeloplasty, cystectomy, nephrectomy and ureteral reimplantation;

2.Hysterectomy, myomectomy and sacrocolpopexy;

3.Hiatal hernia repair;

4.Spleen-sparing distal pancreatectomy, cholecystectomy, Nissen fundoplication, Heller myotomy, gastric bypass, donor nephrectomy, adrenalectomy, splenectomy and bowel resection;

5.Internal mammary artery mobilization and cardiac tissue ablation;

6.Mitral valve repair and endoscopic atrial septal defect closure;

7.Mammary to left anterior descending coronary artery anastomosis for cardiac revascularization with adjunctive mediastinotomy;

8.Transoral resection of tumors of the upper aerodigestive tract (tonsil, tongue base, larynx) and transaxillary thyroidectomy

9.Resection of spindle cell tumors originating in the lung

da Vinci Surgical Systems operate in hospitals worldwide, with an estimated 200,000 surgeries conducted in 2012, most commonly for hysterectomies and prostate removals.As of June 30, 2014, there was an installed base of 3,102 units worldwide, up from 2,000 units at the same time the previous year. The location of these units are as follows: 2,153 in the United States, 499 in Europe, 183 in Japan, and 267 in the rest of the world. The "Si" version of the system costs on average slightly under US$2 million, in addition to several hundred thousand dollars of annual maintenance fees. The da Vinci system has been criticised for its cost and for a number of issues with its surgical performance.

ADVANTAGES

1. Less bleeding
2. Less scarring
3. A shorter stay in hospital
4. A quicker recovery and faster return to normal daily activities.
5.  Less pain
6.  Less need for blood transfusions
7. Higher patient satisfaction

CRITICISM

Robotic surgery involves risk, some of which may be similar to those of conventional open surgery, such as a small risk of infection and other complications.

From a social analysis, a disadvantage is the potential for this technology to dissolve the creative freedoms of the surgeon, once hailed by scholar Timothy Lenoir as one of the most professional individual autonomous occupations to exist. Lenoir claims that in the "heroic age of medicine," the surgeon was hailed as a hero for his intuitive knowledge of human anatomy and his well-crafted techniques in repairing vital body systems. Lenoir argues that the da Vinci's 3D console and robotic arms create a mediating form of action called medialization, in which internal knowledge of images and routes within the body become external knowledge mapped into simplistic computer coding.

FUTURE

The possibility of long-distance operations depends on the patient having access to a da Vinci System, but technically the system could allow a doctor to perform telesurgery on a patient in another country. In 2001, Dr. Marescaux and a team from IRCAD used a combination of high-speed fiber-optic connection with an average delay of 155 ms with advanced asynchronous transfer mode (ATM) and a Zeus telemanipulator to successfully perform the first transatlantic surgical procedure, covering the distance between New York and Strasbourg. The event was considered a milestone of global telesurgery, and was dubbed "Operation Lindbergh".