A Storied Tradition
Robotic-assisted surgery may be the future of medicine, but its fundamentals are rooted in practices that have been in place for generations.
If you've heard of laparoscopic surgery, a technique requiring only small incisions to perform abdominal surgery, you have some idea of the origins of robotic-assisted surgery.
However, laparoscopic procedures have their limitations, including instruments with only a limited range of motion. In addition, the surgeon must look away from the instruments to view procedures on a 2-D video monitor.
Robotic-assisted surgery, by comparison, provides surgeons with a greater range of motion and superior visualization.
Surgery is directed from a console, where the surgeon controls a camera, vacuum pump, saline cleansing solution and cutting tools, each located in its own small incision site. During surgery, the surgeon peers through a binocular viewer while operating hand- and foot-held controls to manipulate the instruments.
The instruments replicate the surgeon's motions, but with a range of 360 degrees – twice that of the human hand. Three-dimensional magnification provides the surgeon a true stereoscopic image, allowing for better views than if he were at the operating table.
The result is superior staging and precision during surgery, in addition to reduced pain and hemorrhaging, and shorter recovery times.
Robotics may sound like science fiction but, fact is, surgeons have been performing – and perfecting – robotic-assisted procedures for more than a generation.
- In 1985, a robot, the PUMA 560, was used to perform a brain biopsy.
- In 1988, the PROBOT, a product of the Imperial College of London, was used to perform prostate surgery.
- In 1992, the ROBODOC was used to assist in a hip-replacement procedure.
- In 1999, the nation's first robotic-assisted heart bypass was performed at Ohio State University
Today, surgeons at the University of Illinois Medical Center employ robotics to assist in 300 procedures per year. Dr. Pier Cristoforo Giulianotti, chief of the center's Division of General, Minimally Invasive and Robotic Surgery, has performed nearly 1,000 such procedures.
da Vinci Decoded
Its name is da Vinci, a nod to the legendary painter's dedication to details. The comparison is fitting, given that no other surgical system functions with such exacting precision – the reason UIC employs it to perform robotic-assisted surgery.
Da Vinci consists of three primary components:
- A surgeon's console.
- A patient-side robotic cart with four arms manipulated by the surgeon – one to control an endoscopic camera that provides full stereoscopic views from the console and three to manipulate a scalpel, scissors and other surgical instruments.
- A high-definition 3-D vision system capable of magnifying views nearly 30-fold.
During surgery, the surgeon views the procedure through a binocular viewer while maneuvering the arms with a pair of foot pedals and hand controllers. The da Vinci system scales, filters and translates the surgeon's hand movements into the more precise micro-movements of the surgical instruments. As a result, the instruments can perform tasks that a surgeon's hands can't.
By combining superior visualization, enhanced dexterity, greater precision and ergonomic comfort, the da Vinci Surgical System allows surgeons to perform minimally invasive procedures involving complex dissection or reconstruction.