Manufacturer | Intuitive Surgical |
---|---|
Country | United States |
Year of creation | 2000 (initial FDA clearance) |
Type | Medical |
Purpose | Medical technology |
Website | https://www.intuitive.com |
The da Vinci Surgical System is a robotic surgical system that uses a minimally invasive surgical approach. The system is manufactured by the company Intuitive Surgical. The system is used for prostatectomies, increasingly for cardiac valve repair and for renal [1] and gynecologic surgical procedures. [2] [3]
It was used in an estimated 200,000 surgeries in 2012, most commonly for hysterectomies and prostate removals. [4] The 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. [5]
The system has been used in the following procedures:
The da Vinci System consists of a surgeon's console that is typically in the same room as the patient, and a patient-side cart with three to four interactive robotic arms (depending on the model) controlled from the console. The arms hold objects, and can act as scalpels, scissors, bovies, or graspers. The final arm controls the 3D cameras. [7] The surgeon uses the controls of the console to manoeuvre the patient-side cart's robotic arms. The system always requires a human operator.
The Food and Drug Administration (FDA) cleared the da Vinci Surgical System in 2000 for adult and pediatric use in urologic surgical procedures, general laparoscopic surgical procedures, gynecologic laparoscopic surgical procedures, general non-cardiovascular thoracoscopic surgical procedures, and thoracoscopically assisted cardiotomy procedures.
While the use of robotic surgery has become an item in the advertisement of medical services, there is a lack of studies that indicate long-term results are superior to results following laparoscopic surgery. [8] Critics of robotic surgery assert that it is difficult for users to learn. [3] The da Vinci system uses proprietary software, which cannot be modified by physicians, thereby limiting the freedom to modify the operating system. [4] The system has a cost of $2 million which places it beyond the reach of many institutions. [9]
The manufacturer of the system, Intuitive Surgical, has been criticized for short-cutting FDA approval by a process known as premarket notification instead of entering the market through the 510(k) process. The company has also been accused of providing inadequate training and encouraging healthcare providers to reduce the number of supervised procedures required before a doctor is allowed to use the system without supervision. [10]
There have also been claims of patient injuries caused by stray electrical currents released from inappropriate parts of the surgical tips used by the system. Intuitive Surgical counter this argument by saying the same type of stray currents can occur in non-robotic laparoscopic procedures. [11] A study published in the Journal of the American Medical Association found that side effects and blood loss in robotically-performed hysterectomies are no better than those performed by traditional surgery, despite the significantly greater cost of the system. [12] [13] As of 2013, the FDA was investigating problems with the da Vinci robot, including deaths during surgeries that used the device; a number of related lawsuits were also underway. [14]
Urology, also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary-tract system and the reproductive organs. Organs under the domain of urology include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs.
Laparoscopy 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 and cervix. Supracervical hysterectomy refers to removal of the uterus while the cervix is spared. These procedures may also involve removal of the ovaries (oophorectomy), fallopian tubes (salpingectomy), and other surrounding structures. The term “partial” or “total” hysterectomy are lay-terms that incorrectly describe the addition or omission of oophorectomy at the time of hysterectomy. These procedures are usually performed by a gynecologist. Removal of the uterus renders the patient unable to bear children and has surgical risks as well as long-term effects, so the surgery is normally recommended only when other treatment options are not available or have failed. It is the second most commonly performed gynecological surgical procedure, after cesarean section, in the United States. Nearly 68 percent were performed for conditions such as endometriosis, irregular bleeding, and uterine fibroids. It is expected that the frequency of hysterectomies for non-malignant indications will continue to fall given the development of alternative treatment options.
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, telecommunications 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 remote work 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.
Prostatectomy is 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.
Robot-assisted surgery or robotic surgery are any types of surgical procedures that are performed 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.
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 31 December 2021, Intuitive Surgical had an installed base of 6,730 da Vinci Surgical Systems, including 4,139 in the U.S., 1,199 in Europe, 1,050 in Asia, and 342 in the rest of the world.
Tubal reversal, also called tubal sterilization reversal, tubal ligation reversal, or microsurgical tubal reanastomosis, is a surgical procedure that can restore fertility to women after a tubal ligation. By rejoining the separated segments of the fallopian tube, tubal reversal can give women the chance to become pregnant again. In some cases, however, the separated segments cannot actually be reattached to each other. In some cases the remaining segment of tube needs to be re-implanted into the uterus. In other cases, when the end of the tube has been removed, a procedure called a neofimbrioplasty must be performed to recreate a functional end of the tube which can then act like the missing fimbria and retrieve the egg that has been released during ovulation.
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.
Single-port laparoscopy (SPL) is a recently developed technique in laparoscopic surgery. It is a minimally invasive surgical procedure in which the surgeon operates almost exclusively through a single entry point, typically the patient's navel. Unlike a traditional multi-port laparoscopic approach, SPL leaves only a single small scar.
Mani Menon, born 9 July 1948 in Trichur, India, is an American surgeon whose 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.
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 the current President of the Society for Urologic Robotic Surgeons (SURS) and the Committee Chair of the Prostate Program. Dr. Tewari is a world leading urological surgeon, and has performed over 10,000 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."
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.
Dong-A University Hospital (Korean: 동아대학교의료원) is a major general hospital affiliated with Dong-A University in Busan, South Korea.
Roger Sinclair Kirby FRCS(Urol), FEBU is a British retired prostate surgeon and professor of urology, researcher, writer on men's health and prostate disease, founding editor of the journal Prostate Cancer and Prostatic Diseases and Trends in Urology and Men's Health and a fundraiser for prostate disease charities, best known for his use of the da Vinci surgical robot for laparoscopic prostatectomy in the treatment of prostate cancer. He is a co-founder and president of the charity The Urology Foundation (TUF), vice-president of the charity Prostate Cancer UK, trustee of the King Edward VII's Hospital and as of 2020 is president of the Royal Society of Medicine (RSM), London.
Michael D. Stifelman Michael D. Stifelman, M.D., is Chair of Urology at Hackensack University Medical Center, Director of Robotic Surgery at Hackensack Meridian Health, and Professor and Inaugural Chair of Urology at Hackensack Meridian School of Medicine.
Hudson Regional Hospital (HRH) is an acute care hospital, located on the Hackensack River, in Secaucus, New Jersey, on Meadowlands Parkway near Route 3. 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.
Dr. Georgi Stranski University Hospital is a major hospital located in Pleven, Bulgaria. It is one of the oldest in the country, as well as the largest in northern Bulgaria.
Benjamin James Challacombe is a British consultant urological surgeon at Guy's & St Thomas' Hospitals, and at King’s College London, who specialises in the treatment of kidney and prostatic disease using robotic surgery. In 2005, he was part of the team that published the results of a randomised controlled trial of human versus telerobotics in the field of urology and renal transplant, one of the first of its kind.
A group of surgeons and Da Vinci Xi surgical robot in Dubai have performed a surgery on a Emirati patient who was suffering from a blockage in the upper part of the ureter,