Robotic Surgery Status Quo + Development Martin Kaloš Czech Society for Robotic Surgery 3rd of December 2012 Almaty

Czech Society of Robotic Surgery

da Vinci ® Si HD

S Model Updates Si Model Updates 3D HD Vision (720p) Multi-quadrant access Interactive video displays Enhanced HD Vision (1080i) Dual Console option Upgradable architecture 3D Vision EndoWrist Instrumentation Intuitive ® Motion Core Technology Rev A 4/

Current Development da Vinci ® Si™ Firefly™ Fluorescence Imaging Skills ® Simulator™ Advanced Instrumentation* Single-Site™ *EndoWrist Stapler is pending 510(k) clearance Rev A 4/12

Single Site Surgery: Open Surgery Single Incision Laparoscopy Laparoscopic Surgery PN Rev A 11/11 Single-Site™ Instrumentation has CE Mark and is FDA-cleared for cholecystectomy.

da Vinci TM Single Site SCOPE

da Vinci TM Single Site

New Instruments

Fluorescence Excitation laser light from illuminator Return signal from fluorescing ICG

Identify vessels during IMA / IMV dissection Assess perfusion of large bowel prior to transection Assess perfusion of rectal stump prior to transection Fluorescence

ROBOTIC SURGERY IN THE WORLD

Installations worldwide: – 389 v Europe – USA – 245 Rest of the World

Installments – World Data

Procedures – World Data

Abdominal Surgery Thoracic Surgery General surgery Vascular Surgery Gynecology Lung Surgery UROLOGY Cardiosurgery ENT ThyreidoctomyTongue Base CA

Indications – World Data

Indications – Czech data

Adoption curve: Q2 2009

Adoption curve: : Q2 2010

Adoption curve: : Q2 2011

Urology Most Frequent 1.daVinci Radical Prostatectomy 2.daVinci Partial Nephrectomy

daVinci Prostatectomy Results

Oncological effects of Robotic Surgery Positive margins Robotic x Laparo x Open

1.dVH : da Vinci Hysterectomy 2.dVSC : da Vinci Sacrocolpopexis 3.dVM : da Vinci Myomektomie Gynecology Most Frequent

daVinci Hysterectomy Results

General Surgery Most Frequent 1.dV LAR : da Vinci Low Anterior Resection 2.dVTh : da Vinci Thyreoidectomy

robotic Versus Laparoscopic Low Anterior Resection of Rectal Cancer: Short-Term Outcome of a Prospective Comparative Study* from Dr. Baik. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea Annals of Surgical Oncology *Baik, et al. robotic Versus Laparoscopic Low Anterior Resection of Rectal Cancer: Short-Term Outcome of a Prospective Comparative Stud. Ann Surg Oncol DOI /s Da Vinci Low Anterior Resection (Baik)

Other 1.ENT – Transoral 2.Cardiac 3.Lung

Thank you !