A new cutting-edge technological tool, the fourth-generation DA VINCI Xi robot accurately transcribes the complex movements of the surgeon’s hands using articulated and miniaturized forceps introduced by small incisions into the patient’s abdominal cavity. The surgical gesture is also optimized by high-definition 3D vision, and the possibility of a ten-zoomed vision for increased accuracy. An embedded fluorescence camera allows to operate in augmented reality for certain procedures, in particular in renal surgery: the intravenous injection of a tracer makes it possible to locate certain anatomical structures by their fluorescent coloration.
In 1999, the first Da Vinci system was introduced to the market for the placement of mitral valves in cardiac surgery. It allowed surgeons to overcome the limitations of traditional laparoscopy with a 3D view inside the patient’s body, with EndoWrist® instruments having an amplitude beyond the capacities of the human hand, the instruments move in The same direction as the surgeon’s hands. The approach is identical to open surgery and opposed to laparoscopy that surgeons often describe as counter-intuitive.
The fourth generation, the Da Vinci Xi was marketed in early 2014 in the United States. This new generation has a new arm architecture designed to facilitate anatomical access from virtually any surgical position, multi-quadrant surgery can be performed without having to reposition the system, an innovation long sought by Surgeons performing complex procedures, ability to fix optics on all arms, promoting multisite surgery.
The Xi is also compatible with “Firefly Fluorescence ImagingSystem” which combines infrared imaging with standard endoscopic light.
Urology is the surgical specialty where the rise and development of robotic surgery has been historically the most important with in particular the flagship intervention that constitutes the radical prostatectomy for the curative treatment of the prostate cancer.
An urologist trained in robotic surgery can now replicate with the assistance of the robot practically all the procedures that he used to practice in open surgery before and thus make patients benefit from the comfort of the suites of minimally invasive surgical techniques and especially:
➢ reduced length of hospital stay;
➢ decreased postoperative pain;
➢ less risk of infection;
➢ less probability of blood transfusion;
➢ a much shorter recovery time with a quicker return to home and normal activity.
But with the development of a multi-site system, the new DA VINCI Xi robot develops the expansion of robotic surgery in other surgical disciplines where its use has so far been scarce.
The robot allows minimally invasive surgery in digestive, urological, gynecological, thoracic and cardiac surgery, thus reducing complications during and after surgery.
The da Vinci surgical system is used in interventions dealing with a wide range of pathologies, for example, but not limited to:
➢ Bladder Cancer
➢ Gynecological cancer and in particular enlarged surgery for cervical cancers
➢ Congenital abnormalities of the kidney and reconstructive surgery of the urinary tract
➢ Kidney Cancer
➢ Prostate cancer
➢ Uterine fibroids
➢ Genital prolapse: uterine, bladder, rectal.
➢ Colorectal cancer
➢ Surgery of the tongue, larynx and pharynx trans-oral
➢ Coronary Artery Disease
➢ Gallbladder Disease
➢ Mitral valve disease
➢ Diseases of the heart valves
➢ Inter-auricular communication
➢ Thyroid tumors
➢ Breast cancer and breast reconstruction after surgery
Dr DAVODY speaks for himself and has no sponsorship from INTUITIVE SURGICAL.
Nephrectomy for live kidney donation by robot-assisted laparoscopy
Pavard, A. Decock, F. Bruyère
Progress in urology (2015) 25, 892-899