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da Vinci Surgical System

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The da Vinci Surgical System is a robotic surgical system that uses a minimally invasive surgical approach. The system is manufactured by the company Intuitive Surgical. The system is used for prostatectomies, increasingly for cardiac valve repair and for renal[1] and gynecologic surgical procedures.[2][3]

da Vinci Surgical System
da Vinci Surgical System
ManufacturerIntuitive Surgical
CountryUnited States
Year of creation2000; 24 years ago (2000)
(initial FDA clearance)
TypeMedical
PurposeMedical technology
Websitehttps://www.intuitive.com

It was used in an estimated 200,000 surgeries in 2012, most commonly for hysterectomies and prostate removals.[4] The system is called "da Vinci" in part because Leonardo da Vinci's study of human anatomy eventually led to the design of the first known robot in history.[5]

Medical uses

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The system has been used in the following procedures:

Device

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da Vinci patient-side component (left) and surgeon console (right)
 
A surgeon console at the treatment centre of Addenbrooke's Hospital

The da Vinci System consists of a surgeon's console that is typically in the same room as the patient, and a patient-side cart with three to four interactive robotic arms (depending on the model) controlled from the console. The arms hold objects, and can act as scalpels, scissors, bovies, or graspers. The final arm controls the 3D cameras.[7] The surgeon uses the controls of the console to manoeuvre the patient-side cart's robotic arms. The system always requires a human operator.

FDA clearance

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The Food and Drug Administration (FDA) cleared the da Vinci Surgical System in 2000 for adult and pediatric use in urologic surgical procedures, general laparoscopic surgical procedures, gynecologic laparoscopic surgical procedures, general non-cardiovascular thoracoscopic surgical procedures, and thoracoscopically assisted cardiotomy procedures.

Criticism

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Main article: Robotic surgery § Comparison to traditional methods

While the use of robotic surgery has become an item in the advertisement of medical services, there is a lack of studies that indicate long-term results are superior to results following laparoscopic surgery.[8] Critics of robotic surgery assert that it is difficult for users to learn.[3] The da Vinci system uses proprietary software, which cannot be modified by physicians, thereby limiting the freedom to modify the operating system.[4] The system has a cost of $2 million which places it beyond the reach of many institutions.[9]

The manufacturer of the system, Intuitive Surgical, has been criticized[10] for short-cutting FDA approval by a process known as 510(k) premarket notification instead of entering the market through a more stringent premarket approval process. The company has also been accused of providing inadequate training and encouraging healthcare providers to reduce the number of supervised procedures required before a doctor is allowed to use the system without supervision.[11]

There have also been claims of patient injuries caused by stray electrical currents released from inappropriate parts of the surgical tips used by the system. Intuitive Surgical counter this argument by saying the same type of stray currents can occur in non-robotic laparoscopic procedures.[12] A study published in the Journal of the American Medical Association found that side effects and blood loss in robotically-performed hysterectomies are no better than those performed by traditional surgery, despite the significantly greater cost of the system.[13][14] As of 2013, the FDA was investigating problems with the da Vinci robot, including deaths during surgeries that used the device; a number of related lawsuits were also underway.[15]

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Doctors in Japan were considering promoting the procedure for cardiac surgery. A way to show this, both its good and bad sides is through visual media. 2018 Japanese drama Black Pean takes on this challenge, showing both sides' point of view. Two University Hospitals are competing to be the best in the Cardiac Surgery Department. One, Tojo, has the best traditional surgeons, while the other, Teika, is all about researching and implementing the most recent technology. With this, Teika sends its technical specialist to Tojo to try to convince them to update their techniques, including the use of the Da Vinci robot (named in the drama as Darwin). Newhart Watanabe International Hospital, a pioneer in Da Vinci surgery for the heart in Japan, was used as background for the drama, with Dr. Gou Watanabe providing technical support.[16][17]

In Grey's Anatomy season 5 episode 23, Chief of Surgery Dr. Richard Webber (played by James Pickens Jr.) reveals to Chief Resident Dr. Miranda Bailey (played by Chandra Wilson) that he has purchased a Da Vinci surgical robot to entice her to choose general surgery over the paediatrics fellowship she is considering under the supervision of Dr. Arizona Robbins (played by Jessica Capshaw).

See also

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References

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  1. ^ Fatima, Sakina (19 May 2022). "da Vinci Xi surgical robot perform kidney surgery in Dubai". The Siasat Daily. Retrieved 19 May 2022. A group of surgeons and Da Vinci Xi surgical robot in Dubai have performed a surgery on an Emirati patient who was suffering from a blockage in the upper part of the ureter,
  2. ^ "Robots as surgical enablers". MarketWatch. 3 February 2005. Retrieved 17 March 2013.
  3. ^ a b "Prepping Robots to Perform Surgery". The New York Times. 4 May 2008. Retrieved 17 March 2013.
  4. ^ a b Babbage Science and technology (18 January 2012). "Surgical robots: The kindness of strangers". The Economist. Retrieved 21 February 2013.
  5. ^ "Company – Past Present Future". Intuitive Surgical. Retrieved 14 January 2015.
  6. ^ "Vall d'Hebron achieves the first fully robotic lung transplant with a new access route". Vall d'Hebron Barcelona Hospital Campus. Retrieved 17 April 2023.
  7. ^ "How the da Vinci Si Works". NYU Langone Health.
  8. ^ Gina Kolata (13 February 2010). "Results Unproven, Robotic Surgery Wins Converts". The New York Times. Retrieved 11 March 2010.
  9. ^ "The Slow Rise of the Robot Surgeon". MIT Technology Review. 24 March 2010. Retrieved 23 March 2013.
  10. ^ "Identification of predicate creep under the 510 (k) process: A case study of a robotic surgical device". PLoS One. 28 March 2023. Retrieved 8 October 2024.
  11. ^ "Salesmen in the Surgical Suite". The New York Times. 25 March 2013. Retrieved 24 April 2013.
  12. ^ "Patients Scarred After Robotic Surgery". CNBC. 19 April 2013. Retrieved 24 April 2013.
  13. ^ "Questions About Robotic Hysterectomy". The New York Times. 25 February 2013. Retrieved 24 April 2013.
  14. ^ Wright, Jason (20 February 2013). "Robotically Assisted vs Laparoscopic Hysterectomy Among Women With Benign Gynecologic Disease". The Journal of the American Medical Association. 309 (7): 689–98. doi:10.1001/jama.2013.186. PMID 23423414.
  15. ^ "da Vinci Robot Allegedly Marketed to Less-Skilled Doctors". LawyersandSettlements.com. 23 April 2013. Retrieved 24 April 2013.
  16. ^ "『ブラックペアン』ドラマ史上初、手術支援ロボ・ダビンチが登場". Oricon (in Japanese). 11 May 2018. Archived from the original on 13 June 2024. Retrieved 13 June 2024.
  17. ^ "第５話から登場する手術支援ロボット・ダーウィン(※)。最先端の"ロボット手術"について、監修先生のお話を基に紐解いていきます。". TBS Black Pean official site (in Japanese). Archived from the original on 13 June 2024. Retrieved 13 June 2024.
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