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Introduction of da Vinci surgical system

&

Robotic radical prostatectomy at theVattikuti Urology Institute

Presenter: Dr. Md. Monowarul Islam

rtn24@yahoo.com

8801818169894

Dhaka,Bangladesh

mailto:rtn24@yahoo.commailto:rtn24@yahoo.com

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Minimally Invasive Surgery

Approximately 20 years ago, surgeons began practicing a

new approach to performing surgery, an approach that isMIS.

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Traditional MIS has significant technical drawbacks:

1.The surgeons operate using a 2D monitor.

2.The resulting image flattened the natural depthof field, and

3.the fixed-wristinstruments limits his/her dexterity.

4.the surgeon is to move the instrument in the opposite direction asthe instrument tip.

As a result, this type of MIS is suitable for a narrow range of surgicalprocedures.

Dexterity: the ability to perform a difficult action quickly and skillfully

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Robotic-Assisted MIS

Intuitive Surgical introduced the da Vinci Surgical

System in the late 1990s.

These innovations meet the preconditions for minimally

invasive solutions.

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3 components

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da Vinci improvisations

1.da Vinci

2. da Vinci S3. da Vinci Si

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Features and Benefits of the da Vinci

Surgical System

1.Superior Visualization2.Enhanced Dexterity, Precision and Control

3.Superior Ergonomics

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Superior Visualization

The da Vinci System provides visualization of the targetanatomy with

natural depth-of-field,

enhanced contrastand magnification.

That enables surgeon to perform delicate tissue handlingand dissectionwith added precision.

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Enhanced Dexterity, Precision and Control

The da Vinci System's tremor reduction, motion control

and proprietary EndoWrist instrumentation enhance

ambidexterity for precision and control beyond the

capabilities of the human hand.

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Enhanced Dexterity, Precision and Control

The surgeon can now move instruments with suchaccuracy that the current definition of surgical precisionis exceeded & reduced learning curve.

MIS procedures feel more like open surgery as two-handed intracorporeal suturing is now standard practice.

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Superior Ergonomics

Surgeon operates in sitting posture.

which is not only more comfortable, but also

clinically advantageous due to reduced surgeonfatigue.

natural hand-eye alignment at the surgeon'sconsole, which provides better ergonomics thantraditional laparoscopic technology.

Ergonomics:the scientific study of the peoples working conditions

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EndoWrist Instruments

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EndoWrist Instruments

EndoWrist Instruments can offer an even greater range

of motion than the human hand.

They truly allow to take surgical precision and

technique beyond the limits of the human hand.

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Features of EndoWrist Instruments

7 degrees of freedom

90 degrees of articulation

Intuitive motion and

provide enhanced dexterity,

precision and control

finger tip control

Motion scaling and

tremor reduction

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Wide Selection

The EndoWrist product line includes a variety of forceps,

needle drivers, scissors; monopolar and bipolar

electrocautery instruments; scalpels and otherspecialized instruments.

available in 5 mm and 8 mm diameters.

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4 Arms

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4 Arms

The first two arms, representing the surgeon's left and

right hands. A third arm positions the endoscope, allowing the

surgeon to easily change, move, zoom and rotate his or

her field of vision from the console.

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4th Arm

The optional 4th Arm perform additional tasks like

applying countertraction. This optional feature potentially

eliminates the need for a patient-side surgeon.

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FAQs

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Q. Why is the company called Intuitive Surgical?

Because its technologies are designed to allow surgeons to operatewith the same skills learned in open surgery.

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Q. Why is the product called the da Vinci Surgical System?

because Leonardo da Vinciinvented the first robot. He alsoused unparalleled anatomicalaccuracy and three-dimensionaldetails to bring his masterpiecesto life.

Drawings by Leonardo da Vinci(1452-1519). The skull bisected and sectioned (1489)in anattempt to locate the sites of the mental faculties.: Orthogonal views of the skeleton (c 1510-11).

(Collection of Her Majesty the Queen).

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The Last Supper 14951498(Leonardo)

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Q. Is a surgeon using the da Vinci Surgical Systemoperating in "virtual reality"?

Although seated at a console a few feet away from the patient,

the surgeon views an actual image of the surgical field while

operating in real-time.

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Q. Is this telesurgery? Can you operate over long distances?

The da Vinci Surgical System can theoretically be used

to operate over long distances. This capability, however,

is not the primary focus and thus is not available with the

current da Vinci Surgical System.

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Q: Where is the da Vinci Surgical System being used now?

United States, Austria, Belgium, Canada, Denmark, France, Germany, Italy,

India,Japan, the Netherlands, Romania, Saudi Arabia, Singapore,Sweden,

Switzerland, United Kingdom, Australia and Turkey.( 19 countries)

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Q. Will the da Vinci Surgical System make the surgeon unnecessary?

It cannot be programmed, or can make decisions on

its own to perform any type of surgical maneuver

without the surgeon's input.

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Q. What are the benefits of using the da Vinci Surgical System overmore traditional methods of surgery?

greater surgical precision,

increased range of motion,

improved dexterity,

enhanced visualization and

improved access.

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Q. Is this "robotic surgery?"

The system replicates the surgeon's movements in real

time. Sometimes, however, the general term "robotic

surgery" is used to refer to this technology.

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Q. While using the da Vinci Surgical System, can the surgeonfeel anything inside the patient's chest or abdomen?

The system relays some force feedbacksensations from

the operative field back to the surgeon throughout the

procedure. This force feedback provides a substitute fortactile sensation.

Q

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Q: What procedures have been performed using the da Vinci SurgicalSystem?

general, urologic, gynecologic, thoracoscopic, and

thoracoscopically-assisted cardiotomy procedures have

been performed using the da Vinci Surgical System.

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Q: How many da Vinci Systems have been sold?

June 30, 2009, there have been 1,242 unit shipments

worldwide - 916 in the USA,

221 in Europe, and105 in the rest of the world.

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da Vinci

Demonstrations in an operation

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Nerve Sparing

Robotic radical prostatectomy at the

Vattikuti Urology Institute

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Author: Dr.Mani Menon, M.D

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Authors Biography

Dr. Menon earned his medical degree from the Jawaharlal Instituteof Postgraduate Medical Education and Research (JIPMER)Pondicherry

The first robotic prostate surgery in the United States was startedby Mani Menon, M.D., at the Vattikuti Urology Institute in 2001

Dr. Menon has published more than 300 papers

Awards Gold Cystoscope AwardAmerican Urological Association Shustruta Award of Distinction in UrologyIndian American

Urological Association

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Jawaharlal Institute of Postgraduate Medical Education and Research

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Video

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Thank you