Da Vinci Surgical System

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da Vinci Surgical System
Laproscopic Surgery Robot.jpg
da Vinci Surgical System
Manufacturer Intuitive Surgical
CountryUnited States
Year of creation2000;24 years ago (2000)
(initial FDA clearance)
TypeMedical
PurposeMedical 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]

Contents

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]

Medical uses

The system has been used in the following procedures:

Device

da Vinci patient-side component (left) and surgeon console (right) Cmglee Cambridge Science Festival 2015 da Vinci.jpg
da Vinci patient-side component (left) and surgeon console (right)
A surgeon console at the treatment centre of Addenbrooke's Hospital Cmglee Cambridge Science Festival 2015 da Vinci console.jpg
A surgeon console at the treatment centre of Addenbrooke's Hospital

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.

FDA clearance

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.

Criticism

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]

See also

Related Research Articles

<span class="mw-page-title-main">Urology</span> Medical specialty

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.

<span class="mw-page-title-main">Laparoscopy</span> Minimally invasive operations within the abdominal or pelvic cavities

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.

<span class="mw-page-title-main">Hysterectomy</span> Surgical removal of the uterus

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.

<span class="mw-page-title-main">Prostatectomy</span> Surgical removal of all or part of the prostate gland

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.

<span class="mw-page-title-main">Robot-assisted surgery</span> Surgical procedure

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.

<span class="mw-page-title-main">Intuitive Surgical</span> American Biotechnology Company

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.

<span class="mw-page-title-main">Laparoscopic radical prostatectomy</span>

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.

<span class="mw-page-title-main">Mani Menon</span>

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.

<span class="mw-page-title-main">Ashutosh Tewari</span> American urologist, oncologist

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."

<span class="mw-page-title-main">McLaren Flint</span> Hospital in Michigan, United States

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<span class="mw-page-title-main">Michael Stifelman</span> American physician and urologist

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.

<span class="mw-page-title-main">Hudson Regional Hospital</span>

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<span class="mw-page-title-main">Dr. Georgi Stranski University Hospital</span> Hospital in Pleven Province, Bulgaria

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<span class="mw-page-title-main">Ben Challacombe</span> British urological surgeon

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.

References

  1. Fatima, Sakina (19 May 2022). "da Vinci Xi surgical robot perform kidney surgery in Dubai". The Siasat Daily . Retrieved 19 May 2022. 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,
  2. "Robots as surgical enablers". MarketWatch. 3 February 2005. Retrieved 17 March 2013.
  3. 1 2 "Prepping Robots to Perform Surgery". The New York Times . 4 May 2008. Retrieved 17 March 2013.
  4. 1 2 Babbage Science and technology (18 January 2012). "Surgical robots: The kindness of strangers". The Economist. Retrieved 21 February 2013.
  5. "Company – Past Present Future". Intuitive Surgical. Retrieved 14 January 2015.
  6. "Vall d'Hebron achieves the first fully robotic lung transplant with a new access route". Vall d'Hebron Barcelona Hospital Campus. Retrieved 17 April 2023.
  7. "How the da Vinci Si Works". NYU Langone Health.
  8. Gina Kolata (13 February 2010). "Results Unproven, Robotic Surgery Wins Converts". The New York Times. Retrieved 11 March 2010.
  9. "The Slow Rise of the Robot Surgeon". MIT Technology Review . 24 March 2010. Retrieved 23 March 2013.
  10. "Salesmen in the Surgical Suite". The New York Times. 25 March 2013. Retrieved 24 April 2013.
  11. "Patients Scarred After Robotic Surgery". CNBC. 19 April 2013. Retrieved 24 April 2013.
  12. "Questions About Robotic Hysterectomy". The New York Times. 25 February 2013. Retrieved 24 April 2013.
  13. Wright, Jason (20 February 2013). "Robotically Assisted vs Laparoscopic Hysterectomy Among Women With Benign Gynecologic Disease". The Journal of the American Medical Association. 309 (7): 689–98. doi:10.1001/jama.2013.186. PMID   23423414.
  14. "da Vinci Robot Allegedly Marketed to Less-Skilled Doctors". LawyersandSettlements.com. 23 April 2013. Retrieved 24 April 2013.