The da Vinci Robot in the minimally invasive surgery field: applications and opportunities

The goal of the interventional surgery is to minimize the invasiveness of its operations whenever possible. An instrument with an excellent performance status that achieves this result is the da Vinci System, a high-tech platform that works with extreme precision allowing robotic assistance on a narrow operating field.

What is the Da Vinci surgical system

Developed by Intuitive Surgical Inc. in order to remotely operate on wounded soldiers, the da Vinci Robot was introduced in the civil healthcare field in 1998. With its historical experience and almost thirty years of case history, at this point the system is in its fourth generation and it’s considered one of the most efficient surgical systems on a global scale. It is also the most used by healthcare facilities all around the World.

How does it work

The main aspect of the da Vinci Robot, the one that makes it so efficient, is its ability to overcome the obstacles and the limitations of a traditional surgical approach, thanks to the use of highly miniaturized instruments that replicate with extreme precision the movements of the surgeon’s hand and fingers with up to 7 degrees of mobility, pivoted on mechanical arms.
The surgeon operates on the affected area using incisions that will allow him access to the operating field, minimizing the size of the incisions and limiting, if not completely avoiding, the visibility and persistence of wounds and scars left by them.

The surgeon has a perfect view of the operating area, in terms of clarity, contrast, lighting and viewing angle, thanks to the vision cart, which is one of the system’s parts.
The Da Vinci machine’s great precision comes from the lack of natural body tremblings (which a doctor would have, especially on the upper parts of the body) and from the demultiplication of its movements.
The enlarged view of the intervention area and its three-dimensionality, if available for the generation of the system that’s being used, allows the precise distinction of all the anatomical details, making the operation easier even on smaller structures.

The interaction with the transmitted images of the operating field by the entire staff is ensured by the possibility of creating freehand sketches on them, to make the operation (or any changes to it) even clearer.
The system’s reliability is granted by the big amount of automatic technical checks. They’re about a million, that the system makes in just one second, allowing a perfect functionality other than monitoring the patient’s vital parameters.

With such performance status, the benefits of undergoing a surgical operation such as a robotic prostatectomy by using such an approach become clear. Contact us if you need any info regarding the operations performed with the Da Vinci robotic surgery.

The components

The main units that make the Da Vinci robotic system are:

The patient cart, on which the movable arms are positioned and through which the surgeon carries the operation. These arms can handle surgical instruments with ease, thanks to its rotating mechanical wrists, purposely built to expand the movement possibilities of its human counterpart;
The surgical console, with which the surgeon, using a joystick and some pedals, can move the instrumentation, keeping its movements under control on the operating field through a monitor;
The vision cart, made of an elaboration system and an HD monitor that shows the images produced by the endoscope applied on the operating area. It retransmits such frames that can be enlarged up to 6 to 10 times with a camera shooting angle of 60 degrees.

Configuration

Both the operating room and the Da Vinci system’s configurations are quite easy, with the presence of a step-by-step guide aimed at the operator and the possibility of memorizing the arms’ positions depending on the target operating field, its characteristics and the preferences for adjusting the most convenient settings for the surgical team.

Furthermore, the modularity of the Da Vinci robot allows it to be used for many different types of medical interventions, and its complementarity allows its integration into a wide range of operating procedures.
The communication between members of the surgical staff inside the operating room are ensured by the advanced real-time contact system already integrated into the console.

A proper online training for the surgeon is ensured as well – although sometimes the on-site training procedure is preferable. It focuses on the chosen version, touching on topics such as the observation of the case and its resolution through operational simulations which can also include the room team, technological training and participation in events.

Different versions of the Da Vinci robotic system and its costs

The Da Vinci robotic system gets produced and shipped in four different versions: Standard, dating back to the 2000-07 time period, S from 2006, Si HD from 2011 with access to modern technologies such as the single access door, and Xi HD (2014), which uses Firefly Imaging that allows to view the different tissues after the inoculation of indocyanine ICG. This one is the most advanced and its functions are based on an aerial beam that allows the rotation of the articulated arms, allowing a better flexibility in the direction of patient approach; furthermore, compared to its predecessor, the Da Vinci Xi robot has thinner arms, longer instruments and allows camera switching on every door.

The Da Vinci SP is also worth mentioning, it’s a version developed exclusively for single incisions or natural access surgery, which uses a single arm that serves as a server for three multi-articulating instruments and a three-dimensional, high definition endoscope. It also has a perfect wrist for checking restricted surgical areas and has 3 single doors.
The introduction to the surgical da Vinci robot is the model X which, starting from the structure of the da Vinci Xi’s arm, allows a simplified configuration combined with the same surgical console as the most recent version, with the same instruments as well.

The da Vinci robot’s price varies depending on the version, which can include devices with advanced technologies that support the da Vinci procedure; some of these can be suture tools – like clips – 3DHD endoscopes – with their own management software – tools that increase the cutting speed and its subsequent vessels and tissues sealing process.
And last, there are articulated drivers for needles, irrigators and aspirators. From this it’s clear that the cost of a da Vinci machine can be clear only after having established its areas of use beforehand.

Application fields

There are many procedures that can use the da Vinci surgical system. It is used especially for interventions that involve the heart, the digestive system, fibroids, cancer and benign tumors.
It is also frequently used in the general surgery and gynecology fields, and it is particularly useful for robotic assisted laparoscopic prostatectomy.

The benefits and risks of the da Vinci surgical system

Taking the advantages of the da Vinci system into consideration, beyond being able to perform minimally invasive operations that involve really small and more precise cuts, it also limits hemorrhages and trauma.
In the next phase, there’ll be less pain and scars – including a limited amount of possible complications and a significantly shorter hospital stay – a faster recovery with a noticeably faster return to daily activities and fewer infections.

Just like any other intervention, in this case there can be risks as well: complications with general anesthesia and significant bleeding, although they’re rare; the best way to prevent them is to carefully follow the surgeon’s post-operative advice, attending all scheduled appointments; for the period of time established by the doctor, it’s advisable to pay particular attention to some symptoms, in order to immediately report them if they appear. These symptoms include redness, swelling, drainage or feelings of pain focused in the surgical area.

Other symptoms to report to the doctor are a fever above 38 degrees Celsius and pain that increases despite taking painkillers.

The disadvantages can be limited to the time and cost of the operation with the da Vinci surgical system: the latter can’t be quantified immediately since it can vary depending on factors such as the complexity of the operation, the healthcare facility – which can allow its funding – from any accommodation, even with a da Vinci surgery it is possible in various cases to return home on the same day, and from the doctor’s fee.

Differences between da Vinci and open-air interventions and the related preparation

As previously mentioned, the access range to the operating field and the related cuts – which on average do not exceed 10 mm – represent the greatest gap between these two techniques; the use of a laparoscopic approach, the small size of the instruments and a significant lower number of stitches make the da Vinci robotic surgery system a preferable method compared to traditional surgery.
Generally, the preparation phase is the same for both methods; however, it should be kept in mind that the detailed directives in this regard are provided by the surgical team based on the target of the operation and the age and medical history of the patient.

Conclusions

We’ve talked about how the da Vinci surgical system ensures considerable advantages for both the surgical staff and the patient, although in different fields; the awareness of the reduced hospital stay, combined with the precision and minimal invasiveness of the operation carried out with this method, does not leave many doubts regarding its convenience.

The opportunity to undergo the da Vinci procedure to solve a health problem once and for all, while reducing the resulting inconveniences as much as possible is our goal; contact us, then, to book a personalized consultation and a medical examination: the staff will guide you to make the right decision, putting your needs at the center and suggesting, if requested, solutions to be able to comfortably pay for the operation.

Today is the right day to say “enough” to the pathologies affecting you and to start living your life to the fullest again.

Do you need help? Contact us and speak with a private consultant.