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 image at the surgical console Robotic interface: Manipulates surgeon’s movements exactly as performed, excluding errors the surgeon would make such as tremors EndoWrist Instruments: 7 degrees of freedom 180° articulation 540° rotation 8mm and 5mm platforms Over 40 instrument types

Procedures Performed by the da Vinci Cardiac revascularization Mitral valve repair* Gastric bypass Nissen fundoplication Thymectomy Lobectomy Mediastinal tumor resection Esophagectomy Pyeloplasty Prostatectomy * Cystectomy Nephrectomy Uretral reimplantation Hysterectomy* Myomectomy Cholecystectomy Aortic ring ligation Patent ductus arteriosus ligation Atrial septal defect closure *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 8-10inch incision Large blood loss Lengthy and uncomfortable recovery Risk of impotence and incontinence da Vinci Surgery 5 1-2cm incisions reduced blood loss Reduced pain and possible infection Reduced incidence of impotence and incontinence due to potential nerve sparing

Results of Urinary Continence with the da Vinci compared to open procedures 3 months: 54% 6 months: 80% 1 year: 93% da Vinci procedure 3 months: 92.9% 6 months: 94.9% 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 Overall potency: 71% Estimated blood loss: 910ml Avg Hospital Stay: 3.5 days da Vinci Surgery Overall potency: 86% Estimated blood loss: 150ml Avg Hospital Stay: 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 Pelvic Lymph Node dissection: 23.4 Transfusions: 4 pts Hospital stay: 3.17 day Estimated blood loss: 413ml da Vinci Surgery Pelvic Lymph Node dissection: 37 Transfusions: 0 pts Hospital stay: 1 day Estimated blood loss: 135ml Results from

Prostatectomy Video