A robotically assisted surgical system used for prostatectomies, cardiac valve repair and gynecologic surgical procedures
|Other names||Robotically-assisted surgery|
Robotic surgery are types of surgical procedures that are done using robotic systems. Robotically-assisted surgery was developed to try to overcome the limitations of pre-existing minimally-invasive surgical procedures and to enhance the capabilities of surgeons performing open surgery.
Surgery is a medical specialty that uses operative manual and instrumental techniques on a patient to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function or appearance or to repair unwanted ruptured areas.
In the case of robotically-assisted minimally-invasive surgery, instead of directly moving the instruments, the surgeon uses one of two methods to control the instruments; either a direct telemanipulator or through computer control. A telemanipulator is a remote manipulator that allows the surgeon to perform the normal movements associated with the surgery whilst the robotic arms carry out those movements using end-effectors and manipulators to perform the actual surgery on the patient. In computer-controlled systems, the surgeon uses a computer to control the robotic arms and its end-effectors, though these systems can also still use telemanipulators for their input. One advantage of using the computerized method is that the surgeon does not have to be present, but can be anywhere in the world, leading to the possibility for remote surgery.
A remote manipulator, also known as a telefactor, telemanipulator, or waldo, is a device which, through electronic, hydraulic, or mechanical linkages, allows a hand-like mechanism to be controlled by a human operator. The purpose of such a device is usually to move or manipulate hazardous materials for reasons of safety, similar to the operation and play of a claw crane game.
A robotic arm is a type of mechanical arm, usually programmable, with similar functions to a human arm; the arm may be the sum total of the mechanism or may be part of a more complex robot. The links of such a manipulator are connected by joints allowing either rotational motion or translational (linear) displacement. The links of the manipulator can be considered to form a kinematic chain. The terminus of the kinematic chain of the manipulator is called the end effector and it is analogous to the human hand.
In robotics, an end effector is the device at the end of a robotic arm, designed to interact with the environment. The exact nature of this device depends on the application of the robot.
Laparoscopic procedures are considered a form of minimally-invasive surgery. Several small incisions, called keyhole incisions, are made. These types of surgeries are associated with shorter hospital stays than open surgery, as well as less postoperative pain and scarring and lower risks of infection and need for blood transfusion.
Blood transfusion is the process of transferring blood or blood products into one's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood, such as red blood cells, white blood cells, plasma, clotting factors, and platelets.
In the case of enhanced open surgery, autonomous instruments (in familiar configurations) replace traditional steel tools, performing certain actions (such as rib spreading) with much smoother, feedback-controlled motions that could be achieved by a human hand. The main object of such smart instruments is to reduce or eliminate the tissue trauma traditionally associated with open surgery without requiring more than a few minutes' training on the part of surgeons. This approach seeks to improve open surgeries, particularly cardio-thoracic, that have so far not benefited from minimally-invasive techniques.
Robotic surgery has been criticized for its expense, with the average costs in 2007 ranging from $5,607 to $45,914 per patient.This technique has not been approved for cancer surgery as of 2019 with concerns that it may worsen rather than improve outcomes.
Major advances aided by surgical robots have been remote surgery, minimally invasive surgery and unmanned surgery. Due to robotic use, the surgery is done with precision, miniaturization, smaller incisions; decreased blood loss, less pain, and quicker healing time. Articulation beyond normal manipulation and three-dimensional magnification help to result in improved ergonomics. Due to these techniques, there is a reduced duration of hospital stays, blood loss, transfusions, and use of pain medication.The existing open surgery technique has many flaws like limited access to the surgical area, long recovery time, long hours of operation, blood loss, surgical scars, and marks.
Remote surgery is the ability for a doctor to perform surgery on a patient even though they are not physically in the same location. It is a form of telepresence. A robot surgical system generally consists of one or more arms, a master controller (console), and a sensory system giving feedback to the user. Remote surgery combines elements of robotics, cutting edge communication technology such as high-speed data connections and elements of management information systems. While the field of robotic surgery is fairly well established, most of these robots are controlled by surgeons at the location of the surgery. Remote surgery is essentially advanced telecommuting for surgeons, where the physical distance between the surgeon and the patient is less relevant. It promises to allow the expertise of specialized surgeons to be available to patients worldwide, without the need for patients to travel beyond their local hospital.
The robot's costs range from $1 million to $2.5 million for each unit, and while its disposable supply cost is normally $1,500 per procedure, the cost of the procedure is higher. Additional surgical training is needed to operate the system. Numerous feasibility studies have been done to determine whether the purchase of such systems are worthwhile. As it stands, opinions differ dramatically. Surgeons report that, although the manufacturers of such systems provide training on this new technology, the learning phase is intensive and surgeons must perform 150 to 250 procedures to become adept in their use. During the training phase, minimally invasive operations can take up to twice as long as traditional surgery, leading to operating room tie-ups and surgical staffs keeping patients under anesthesia for longer periods. Patient surveys indicate they chose the procedure based on expectations of decreased morbidity, improved outcomes, reduced blood loss and less pain. Higher expectations may explain higher rates of dissatisfaction and regret.
Compared with other minimally invasive surgery approaches, robot-assisted surgery gives the surgeon better control over the surgical instruments and a better view of the surgical site. In addition, surgeons no longer have to stand throughout the surgery and do not tire as quickly. Naturally occurring hand tremors are filtered out by the robot's computer software. Finally, the surgical robot can continuously be used by rotating surgery teams.Laparoscopic camera positioning is also significantly steadier with less inadvertent movements under robotic controls than compared to human assistance.
There are some issues in regards to current robotic surgery usage in clinical applications. There is a lack of haptics, which means there is no force feedback, or touch feedback. Surgeons are thus not able to feel the interaction of the instrument with the patient. The robots can also be very large, have instrumentation limitations, and there may be issues with multi-quadrant surgery as current devices are solely used for single-quadrant application.
Critics of the system, including the American Congress of Obstetricians and Gynecologists,say there is a steep learning curve for surgeons who adopt the use of the system and that there's a lack of studies that indicate long-term results are superior to results following traditional laparoscopic surgery. Articles in the newly created Journal of Robotic Surgery tend to report on one surgeon's experience.
A Medicare study found that some procedures that have traditionally been performed with large incisions can be converted to "minimally invasive" endoscopic procedures with the use of the Da Vinci Surgical System, shortening length-of-stay in the hospital and reducing recovery times. But because of the hefty cost of the robotic system, it is not clear that it is cost-effective for hospitals and physicians despite any benefits to patients since there is no additional reimbursement paid by the government or insurance companies when the system is used.
Complications related to robotic surgeries range from converting the surgery to open, re-operation, permanent injury, damage to viscera and nerve damage. From 2000 to 2011, out of 75 hysterectomies done with robotic surgery, 34 had permanent injury, and 49 had damage to the viscera. Prostatectomies were more prone to permanent injury, nerve damage and visceral damage as well. Very minimal surgeries in a variety of specialties had to actually be converted to open or be re-operated on, but most did suffer some kind of damage and/or injury. For example, out of seven coronary artery bypass grafting, one patient had to go under re-operation. It is important that complications are captured, reported and evaluated to ensure the medical community is better educated on the safety of this new technology.
There are also current methods of robotic surgery being marketed and advertised online. Removal of a cancerous prostate has been a popular treatment through internet marketing. Internet marketing of medical devices are more loosely regulated than pharmaceutical promotions. Many sites that claim the benefits of this type of procedure had failed to mention risks and also provided unsupported evidence. There is an issue with government and medical societies promotion a production of balanced educational material.In the US alone, many websites promotion robotic surgery fail to mention any risks associated with these types of procedures, and hospitals providing materials largely ignore risks, overestimate benefits and are strongly influenced by the manufacturer.
As of 2004, three types of heart surgery are being performed on a routine basis using robotic surgery systems.These three surgery types were:
There is also a system for robotic heart surgery that learns to tie knots using recurrent neural networks. The EndoPAR system is an experimental robotic surgical platform developed at the University of Munich. Four robotic arms have force-feedback instruments where the fourth one holds a 3-D endoscopic stereo camera. This robot is controlled by a PHANToM Premium 1.5 device that allows for the surgeon to finely control knot tying with stabilization filters and displaying forces in all translational directions.
Thoracic surgery has become more widespread in thoracic surgery for mediastinal pathologies, pulmonary pathologies and more recently complex esophageal surgery.
Multiple types of procedures have been performed with either the 'Zeus' or da Vinci robot systems, including bariatric surgery and gastrectomyfor cancer. Surgeons at various universities initially published case series demonstrating different techniques and the feasibility of GI surgery using the robotic devices. Specific procedures have been more fully evaluated, specifically esophageal fundoplication for the treatment of gastroesophageal reflux and Heller myotomy for the treatment of achalasia.
Robot-assisted pancreatectomies have been found to be associated with "longer operating time, lower estimated blood loss, a higher spleen-preservation rate, and shorter hospital stay[s]" than laparoscopic pancreatectomies; there was "no significant difference in transfusion, conversion to open surgery, overall complications, severe complications, pancreatic fistula, severe pancreatic fistula, ICU stay, total cost, and 30-day mortality between the two groups."
Robotic surgery in gynecology is of uncertain benefit with it being unclear if it affects rates of complications. Gynecologic procedures may take longer with robot-assisted surgery but may be associated with a shorter hospital stay following hysterectomy.In the United States, robotic-assisted hysterectomy for benign conditions has been shown to be more expensive than conventional laparoscopic hysterectomy, with no difference in overall rates of complications.
This includes the use of the da Vinci surgical system in benign gynecology and gynecologic oncology. Robotic surgery can be used to treat fibroids, abnormal periods, endometriosis, ovarian tumors, uterine prolapse, and female cancers. Using the robotic system, gynecologists can perform hysterectomies, myomectomies, and lymph node biopsies.
A 2017 review of surgical removal of the uterus and cervix for early cervical cancer robotic and laparoscopic surgery resulted in similar outcomes with respect to the cancer.
Robots are used in orthopedic surgery.
Robotic devices started to be used in minimally invasive spine surgery starting in the mid-2000s.As of 2014, there were too few randomized clinical trials to allow judgement as to whether robotic spine surgery is more or less safe than other approaches.
Transplant surgery (organ transplantation) has been considered as highly technically demanding and virtually unobtainable by means of conventional laparoscopy. For many years, transplant patients were unable to benefit from the advantages of minimally invasive surgery. The development of robotic technology and its associated high-resolution capabilities, three-dimensional visual system, wrist type motion, and fine instruments, gave an opportunity for highly complex procedures to be completed in a minimally invasive fashion. Subsequently, the first fully robotic kidney transplantations were performed in the late 2000s. After the procedure was proven to be feasible and safe, the main emerging challenge was to determine which patients would benefit most from this robotic technique. As a result, recognition of the increasing prevalence of obesity amongst patients with kidney failure on hemodialysis posed a significant problem. Due to the abundantly higher risk of complications after traditional open kidney transplantation, obese patients were frequently denied access to transplantation, which is the premium treatment for end-stage kidney disease.
General surgeons focus on any abdominal contents. With regards to robotic surgery, this type of procedure is currently best suited for single-quadrant procedures, in which the operations can be performed on any one of the four quadrants of the abdomen.
Cost disadvantages are applied with procedures such as a cholecystectomy and fundoplication, but are suitable opportunities for surgeons to advance their robotic surgery skills.
Robotic surgery in the field of urology has become very popular, especially in the United States.It has been most extensively applied for excision of prostate cancer because of difficult anatomical access. It is also utilized for kidney cancer surgeries and to lesser-extent surgeries of the bladder.
As of 2014, there is little evidence of increased benefits compared to standard surgery to justify the increased costs.Some have found tentative evidence of more complete removal of cancer and fewer side effects from surgery for prostatectomy.
In 2000, the first robot-assisted laparoscopic radical prostatectomy was performed.
The first robot to assist in surgery was the Arthrobot, which was developed and used for the first time in Vancouver in 1985.This robot assisted in being able to manipulate and position the patient’s leg on voice command. Intimately involved were biomedical engineer Dr. James McEwen, Geof Auchinleck, a UBC engineering physics grad, and Dr. Brian Day as well as a team of engineering students. The robot was used in an orthopaedic surgical procedure on 12 March 1984, at the UBC Hospital in Vancouver. Over 60 arthroscopic surgical procedures were performed in the first 12 months, and a 1985 National Geographic video on industrial robots, The Robotics Revolution, featured the device. Other related robotic devices developed at the same time included a surgical scrub nurse robot, which handed operative instruments on voice command, and a medical laboratory robotic arm. A YouTube video entitled Arthrobot- the world's first surgical robot illustrates some of these in operation.
In 1985 a robot, the Unimation Puma 200, was used to orient a needle for a brain biopsy while under CT guidance during a neurological procedure.In the late 1980s, Imperial College in London developed PROBOT, which was then used to perform prostatic surgery. The advantages to this robot was its small size, accuracy and lack of fatigue for the surgeon. In 1992, the ROBODOC was introduced and revolutionized orthopedic surgery by being able to assist with hip replacement surgeries. The latter was the first surgical robot that was approved by the FDA in 2008. The ROBODOC from Integrated Surgical Systems (working closely with IBM) could mill out precise fittings in the femur for hip replacement. The purpose of the ROBODOC was to replace the previous method of carving out a femur for an implant, the use of a mallet and broach/rasp.
Further development of robotic systems was carried out by SRI International and Intuitive Surgical with the introduction of the da Vinci Surgical System and Computer Motion with the AESOP and the ZEUS robotic surgical system.The first robotic surgery took place at The Ohio State University Medical Center in Columbus, Ohio under the direction of Robert E. Michler.
AESOP was a breakthrough in robotic surgery when introduced in 1994, as it was the first laparoscopic camera holder to be approved by the FDA. NASA initially funded the company, Computer Motion, that had produced AESOP, for its goal to create a robotic arm that can be used in space, but ended up becoming a camera used in laparascopic procedures. Voice control was then added in 1996 with the AESOP 2000 and seven degrees of freedom to mimic a human hand was added in 1998 with the AESOP 3000.
ZEUS was introduced commercially in 1998, and was started the idea of telerobotics or telepresence surgery where the surgeon is at a distance from the robot on a console and operates on the patient.Examples of using ZEUS include a fallopian tube reconnection in July 1998, a beating heart coronary artery bypass graft in October 1999, and the Lindbergh Operation, which was a cholecystectomy performed remotely in September 2001. In 2003, ZEUS made its most prominent mark in cardiac surgery after successfully harvesting the left internal mammary arteries in 19 patients, all of which had very successful clinical outcomes.
The original telesurgery robotic system that the da Vinci was based on was developed at Stanford Research Institude International in Menlo Park with grant support from DARPA and NASA. [ citation needed ] and the first all-robotic-assisted kidney transplant, performed in January 2009. The da Vinci Si was released in April 2009 and initially sold for $1.75 million.Ademonstration of an open bowel anastomosis was given to the Association of Military Surgeons of the US. Although the telesurgical robot was originally intended to facilitate remotely performed surgery in the battlefield and other remote environments, it turned out to be more useful for minimally invasive on-site surgery. The patents for the early prototype were sold to Intuitive Surgical in Mountain View, California. The da Vinci senses the surgeon's hand movements and translates them electronically into scaled-down micro-movements to manipulate the tiny proprietary instruments. It also detects and filters out any tremors in the surgeon's hand movements, so that they are not duplicated robotically. The camera used in the system provides a true stereoscopic picture transmitted to a surgeon's console. Compared to the ZEUS, the da Vinci robot is attached to trocars to the surgical table, and can imitate the human wrist. In 2000, the da Vinci obtained FDA approval for general laparscopic procedures and became the first operative surgical robot in the US. Examples of using the da Vinci system include the first robotically assisted heart bypass (performed in Germany) in May 1998, and the first performed in the United States in September 1999;
In 2005, a surgical technique was documented in canine and cadaveric models called the transoral robotic surgery (TORS) for the da Vinci robot surgical system as it was the only FDA-approved robot to perform head and neck surgery.In 2006, three patients underwent resection of the tongue using this technique. The results were more clear visualization of the cranial nerves, lingual nerves, and lingual artery, and the patients had a faster recovery to normal swallowing. In May 2006 the first artificial intelligence doctor-conducted unassisted robotic surgery was on a 34-year-old male to correct heart arrythmia. The results were rated as better than an above-average human surgeon. The machine had a database of 10,000 similar operations, and so, in the words of its designers, was "more than qualified to operate on any patient". In August 2007, Dr. Sijo Parekattil of the Robotics Institute and Center for Urology (Winter Haven Hospital and University of Florida) performed the first robotic-assisted microsurgery procedure denervation of the spermatic cord for chronic testicular pain. In February 2008, Dr. Mohan S. Gundeti of the University of Chicago Comer Children's Hospital performed the first robotic pediatric neurogenic bladder reconstruction.
On 12 May 2008, the first image-guided MR-compatible robotic neurosurgical procedure was performed at University of Calgary by Dr. Garnette Sutherland using the NeuroArm.In June 2008, the German Aerospace Centre (DLR) presented a robotic system for minimally invasive surgery, the MiroSurge. In September 2010, the Eindhoven University of Technology announced the development of the Sofie surgical system, the first surgical robot to employ force feedback. In September 2010, the first robotic operation at the femoral vasculature was performed at the University Medical Centre Ljubljana by a team led by Borut Geršak.
General surgery is a surgical specialty that focuses on abdominal contents including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder, appendix and bile ducts, and often the thyroid gland. They also deal with diseases involving the skin, breast, soft tissue, trauma, peripheral vascular surgery and hernias and perform endoscopic procedures such as gastroscopy and colonoscopy.
Urology, also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the male and female urinary-tract system and the male reproductive organs. Organs under the domain of urology include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs.
Laparoscopy invented by George Kelling in 1901, in Germany, is an operation performed in the abdomen or pelvis using small incisions with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.
Hysterectomy is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries, fallopian tubes and other surrounding structures.
The Lindbergh operation was a complete tele-surgical operation carried out by a team of French surgeons located in New York on a patient in Strasbourg, France using telecommunications solutions based on high-speed services and sophisticated Zeus surgical robot. The operation was performed successfully on September 7, 2001 by Professor Jacques Marescaux and his team from the IRCAD. This was the first time in medical history that a technical solution proved capable of reducing the time delay inherent to long distance transmissions sufficiently to make this type of procedure possible. The name was derived from the American aviator Charles Lindbergh, because he was the first person to fly solo across the Atlantic Ocean.
Prostatectomy as a medical term refers to the surgical removal of all or part of the prostate gland. This operation is done for benign conditions that cause urinary retention, as well as for prostate cancer and for other cancers of the pelvis.
Intuitive Surgical Inc. is an American corporation that develops, manufactures and markets robotic products designed to improve clinical outcomes of patients through minimally invasive surgery, most notably with the da Vinci Surgical System. The company is part of the NASDAQ-100 and S&P 500. As of September 30, 2017, there was an installed base of 4,271 units worldwide – 2,770 in the United States, 719 in Europe, 561 in Asia, and 221 in the rest of the world.
Laparoscopic radical prostatectomy (LRP) is a form of radical prostatectomy, an operation for prostate cancer. Contrasted with the original open form of the surgery, it does not make a large incision but instead uses fiber optics and miniaturization.
Computer-assisted surgery (CAS) represents a surgical concept and set of methods, that use computer technology for surgical planning, and for guiding or performing surgical interventions. CAS is also known as computer-aided surgery, computer-assisted intervention, image-guided surgery and surgical navigation, but these are terms that are more or less synonymous with CAS. CAS has been a leading factor in the development of robotic surgery.
The Vattikuti Urology Institute (VUI) at the Henry Ford Hospital in Detroit, Michigan is a clinical and research center for urological care. The VUI is notable for being the first institute to establish robotic surgery as a treatment for patients with prostate cancer. To date, the VUI has performed more than 5,000 robotic procedures. The institute currently has 110 regular staff members, 19 full-time senior staff members, 14 clinical staff members and 5 full-time Ph.D scientists. Ranked consistently high by U.S. News and World Report, VUI is also one of the largest and most active urology departments in the United States, with nearly 50,000 patients annually from all 50 states and nearly 25 countries.
David B. Samadi is a celebrity doctor and is the former Chairman of Urology and Chief of Robotic Surgery at Lenox Hill Hospital. He is a board-certified urologist trained in the diagnosis and treatment of urologic diseases, prostate cancer, kidney cancer and bladder cancer, and specializes in advanced minimally invasive treatments for prostate cancer, including laparoscopic radical prostatectomy and laparoscopic robotic radical prostatectomy.
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."
Mani Menon, born 9 July 1948 in Trichur, India, is an American surgeon whose pioneering work has helped to lay the foundation for modern robotic cancer surgery. He is the founding director and the Raj and Padma Vattikuti Distinguished Chair of the Vattikuti Urology Institute at the Henry Ford Hospital in Detroit, MI, where he established the first cancer-oriented robotics program in the world. Menon is widely regarded for his role in the development of robotic surgery techniques for the treatment of patients with prostate, kidney, and bladder cancers, as well as for the development of robotic kidney transplantation.
Menon is the recipient of the Gold Cystoscope award, Hugh Hampton Young award, the Keyes Medal, the prestigious B.C. Roy award. He has been inducted into the Johns Hopkins Society of Scholars, the highest honor awarded by the University. The Society of Urologic Robotic Surgery instituted a Gold Medal in Menon's name in 2017, of which he was the first recipient. An exhibit titled Many Voices, One Nation at the Smithsonian National Museum of American History incorporates some of Menon's person effects.
Ashutosh K. Tewari is the Chairman of Urology at the Icahn School of Medicine at Mount Sinai Hospital in New York City. He is a board certified American urologist, oncologist, and principal investigator. Before moving to the Icahn School of Medicine in 2013, he was the founding director of both the Center for Prostate Cancer at Weill Cornell Medical College and the LeFrak Center for Robotic Surgery at NewYork–Presbyterian Hospital. Dr. Tewari was the Ronald P. Lynch endowed Chair of Urologic Oncology and the hospital's Director of Robotic Prostatectomy, treating patients with prostate, urinary bladder and other urological cancers. He is a world leading urological surgeon, and has performed over 9,000 robotically assisted procedures using the da Vinci Surgical System. Academically, he is recognized as a world-renowned expert on urologic oncology with over 250 peer reviewed published papers to his credit; he is on such lists as America's Top Doctors, New York Magazine's Best Doctors, and Who's Who in the World. In 2012, he was given the American Urological Association Gold Cystoscope Award for "outstanding contributions to the field of urologic oncology, most notably the treatment of prostate cancer and the development of novel techniques to improve the outcomes of robotic prostatectomy."
Sharp Memorial Hospital is a hospital in San Diego, California, in the United States. Opened in 1955, Sharp Memorial is Sharp HealthCare's largest hospital and the system's only designated Level II trauma center. Located in Serra Mesa, the hospital has 334 private patient rooms, including 48 for intensive-care services.
McLaren Flint is a nonprofit, 378 bed tertiary teaching hospital located in Flint, Michigan. McLaren is affiliated with the Michigan State University College of Human Medicine's medical residency programs, including family medicine, internal medicine, general surgery, orthopedic surgery and radiology. McLaren also maintains a hematology/oncology fellowship program in partnership with Michigan State University and is sponsoring a surgical oncology fellowship program. McLaren Flint is a subsidiary of McLaren Health Care Corporation.
The ZEUS Robotic Surgical System (ZRSS) was a medical robot designed to assist in surgery, originally produced by the American robotics company Computer Motion. Its predecessor, AESOP, was cleared by the Food and Drug Administration in 1994 to assist surgeons in minimally invasive surgery. The ZRSS itself was cleared by the FDA seven years later, in 2001. ZEUS had three robotic arms, which were remotely controlled by the surgeon. The first arm, AESOP, was a voice-activated endoscope, allowing the surgeon to see inside the patient’s body. The other two robotic arms mimicked the surgeon’s movements to make precise incisions and extractions. ZEUS was discontinued in 2003, following the merger of Computer Motion with its rival Intuitive Surgical; the merged company instead developed the Da Vinci Surgical System.
Hudson Regional Hospital (HRH) is an acute care hospital, located on the Hackensack River, in Secaucus, New Jersey, in the middle of the New Jersey Turnpike and busy Route 3 traffic flow. HRH has a helipad for transporting injured persons from the scene of an accident to the hospital and/or for transferring patients in critical need of specialized services from HRH to another hospital having that capability.
Sanjay Razdan is a board certified American urologist, oncologist, and principal investigator, specialized in the treatment of prostate cancer and urological diseases. He is an urological robotic surgeon and has performed over 6,500 robotically assisted procedures using the Da Vinci Surgical System.
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