Advances in Robotic

Surgery:
The da Vinci System
 da vinci System
Robotic surgical console located within the
operating suite that the surgeon
manipulates to perform various techniques
and procedures by replacing the surgeon’s
hands with robotic arms
Provides robotic surgical services to the
patient that gives better surgical
enhancements and outcomes as compared
to pure laparoscopic and/or open
procedures
 Why it’s cool…
High resolution 3-D EndoWrist
image at the Instruments:
surgical console – 7 degrees of
Robotic interface: freedom
– Manipulates – 180° articulation
surgeon’s – 540° rotation
movements exactly – 8mm and 5mm
as performed, platforms
excluding errors the – Over 40 instrument
surgeon would types
make such as
tremors
 Procedures Performed
by the da Vinci
Cardiac Cystectomy
revascularization Nephrectomy
Mitral valve repair* Uretral reimplantation
Gastric bypass Hysterectomy*
Nissen fundoplication Myomectomy
Thymectomy Cholecystectomy
Lobectomy Aortic ring ligation
Mediastinal tumor Patent ductus
resection arteriosus ligation
Esophagectomy Atrial septal defect
Pyeloplasty closure
Prostatectomy *
*Focus of research for this project
“Minimally invasive surgery focuses more
on the quality of life for the patient.”
- Mehmet Oz, MD
The da Vinci provides less trauma to the
body during surgery
It reduces blood loss
There is less post-operative pain and
discomfort
Less risk of infection
Shorter hospital stay
Faster recovery and return to normal daily
activities
 da Vinci Prostatectomy
Normal Surgery da Vinci Surgery
– 8-10inch incision – 5 1-2cm incisions
– Large blood loss – reduced blood loss
– Lengthy and – Reduced pain and
uncomfortable possible infection
recovery – Reduced incidence
– Risk of impotence of impotence and
and incontinence incontinence due to
potential nerve
sparing
Results of Urinary Continence with
the da Vinci compared to open
procedures
Open Procedure da Vinci procedure
– 3 months: 54% – 3 months: 92.9%
– 6 months: 80% – 6 months: 94.9%
– 1 year: 93% – 1 year: 97.4%

Studies from Locke, et al and Walsh PC, 2003

Results of other statistics with the
da Vinci compared to open
procedures
Open Procedure da Vinci Surgery
– Overall potency: – Overall potency:
71% 86%
– Estimated blood – Estimated blood
loss: 910ml loss: 150ml
– Avg Hospital Stay: – Avg Hospital Stay:
3.5 days 1.2 days

Results from Walsh, PC 2003, Menon, et al, 2003, Tewari, et

al, 2006
 Results of Mitral Valve Repair
(versus replacement) with the da
Vinci compared to open procedures
5 major differences:
– Intubation time: 12.8h vs 11.4h
– ICU time: 48.5h vs 35.7h
– Total Blood Loss: 566.2ml vs 477.2ml
– Patient’s receiving transfusions: 4 vs 2
– Length of hospital stay: 9days vs 7days
Results from Folliguet, et al, 2006
Results of Hysterectomy with the
da Vinci compared to open
procedures
Open Procedure da Vinci Surgery
– Pelvic Lymph Node – Pelvic Lymph Node
dissection: 23.4 dissection: 37
– Transfusions: 4 pts – Transfusions: 0 pts
– Hospital stay: 3.17 – Hospital stay: 1
day day
– Estimated blood – Estimated blood
loss: 413ml loss: 135ml
Results from
Prostatectomy Video