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Surgical System (surgical + system)

Distribution by Scientific Domains

Medical Sciences	100%

Kinds of Surgical System

da vinci surgical system

vinci surgical system

Selected Abstracts

Endo-robotic resection of the submandibular gland in a cadaver model,

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 11 2005
David J. Terris MD
Abstract Background. By means of a prospective, nonrandomized investigation, we evaluated the feasibility of performing endo-robotic resection of the submandibular gland in a cadaver model and compared the results of robotically enhanced endoscopic surgery with those from a conventional endoscopic technique. Methods. Procedural times were recorded in a consecutive series of 11 endoscopic submandibular gland resections using the daVinci Surgical System (Intuitive Surgical, Sunnyvale, CA) and a modified endoscopic surgical approach previously developed in a porcine model. The presence of neurovascular injury was assessed postoperatively, and the specimens were examined histologically. Results. Eleven endo-robotic submandibular gland resections were successfully performed in six cadavers (no conversions to open resection were necessary). The median duration of the procedures was 48 minutes (range, 33,82 minutes). Creation of the operative pocket took an average (±SD) of 12.2 ± 5.3 minutes, assembly of the robot required 9.3 ± 4.1 minutes, and the mean time for submandibular gland resection was 29.4 ± 8.9 minutes. The time required for robotic assembly was offset by the reduced operative time necessary compared with conventional endoscopic resection. Histologic examination confirmed the presence of normal glandular architecture, without evidence of excessive mechanical or thermal injury. There were no cases of apparent neurovascular injury. Conclusions. Robotically enhanced endoscopic surgery in the neck is feasible and offers a number of compelling advantages over conventional endoscopic neck surgery. Clinical trials will be necessary to determine whether these advantages can be achieved in clinical practice. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source]

Robot-Assisted Isolation of the Pulmonary Veins with Microwave Energy

JOURNAL OF CARDIAC SURGERY, Issue 1 2006
F.A.C.S., J. Michael Smith M.D.
This study evaluated the feasibility of performing a minimally invasive left atrial isolation on a beating heart using the da Vinci Robotic Surgical System and a flexible microwave probe (Flex 10 by AFx, Inc., Fremont, CA, USA), and the reliability of exit block pacing to confirm transmurality of the lesions created. Methods: On six canines, the Flex 10 probe was passed around the left atrium posterior to the superior vena cava, through the transverse sinus, and back through the oblique sinus via a right-chest-only approach using the da Vinci Robotic Surgical System. Prior to ablation, pacing outside the atrial cuff was confirmed. Ablation was then carried out on the beating heart and repeated (as needed) until electrical isolation was demonstrated by exit block pacing. Probe position was confirmed at the completion of the procedure via sternotomy. Analysis included acute histologic and gross examination of the targeted area. Results: There was no significant difference (p = 0.110) in procedure time, although it decreased 39.6% from the first three cases to the last three cases. Electrical evidence of electrical left atrial isolation was achieved in all subjects. Acute histologic examination confirmed transmurality inconsistently. Additionally, in two animals, the Flex 10 probe was found to be anterior to the left atrial appendage. All animals survived the procedure. Conclusion: A minimally invasive left atrial isolation procedure using monopolar microwave energy with the da Vinci Robotic Surgical System is simple and feasible. However, despite creating an electrical block, transmurality was not demonstrated consistently and further confirmation of catheter positioning is necessary during a right-chest-only approach. [source]

Advanced da Vinci surgical system simulator for surgeon training and operation planning

THE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 3 2007
L. W. Sun
Abstract Background Although patients benefit considerably from minimally invasive surgery, the use of new instruments such as robotic systems is challenging for surgeons, and extensive training is required. Method We developed a computer-based simulator of the da Vinci Surgical System, modelling the robot and designing a new interface. Results The simulator offers users a two-handed interface to control a realistic model of the da Vinci robot. The simulator can be applied (i) to provide an environment in which to practice simple surgical skills and (ii) to serve as a visualization platform on which to validate port placement and robot pose for operation planning. Conclusions Virtual reality is a useful technique for medical training. The simulator is currently in its early stages, but this preliminary work is promising. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Assessment of Intraoperative Safety in Transoral Robotic Surgery,

THE LARYNGOSCOPE, Issue 2 2006
Neil G. Hockstein MD
Abstract Introduction: Robotic technology has been safely integrated into thoracic and abdominopelvic surgery, and the early experience has been very promising with very rare complications related to robotic device failure. Recently, several reports have documented the technical feasibility of transoral robotic surgery (TORS) with the daVinci Surgical System. Proposed pharyngeal and laryngeal applications include radical tonsillectomy, base-of-tongue resection, supraglottic laryngectomy, and phonomicrosurgery. The safety of transoral placement of the robotic endoscope and instruments has not been established. Potential risks specific to the transoral use of the surgical robot include facial skin laceration, tooth injury, mucosal laceration, mandible fracture, cervical spine fracture, and ocular injury. We hypothesize that these particular risks of transoral surgery are similar with robotic assistance compared with conventional transoral surgery. Methods: To test this hypothesis, we attempted to intentionally injure a human cadaver with the daVinci Surgical System by impaling the facial skin and pharyngeal and laryngeal mucosa with the robotic instruments and endoscope. We also attempted to extract or fracture teeth and fracture the cadaver's mandible and cervical spine by applying maximal pressure and torque with the robotic arms. Experiments were documented with still and video photography. Results: Impaling the cadaver's skin and mucosa resulted in only superficial lacerations. Tooth, mandible, and cervical spine fracture could not be achieved. Conclusions: Initial experiments performing TORS on a human cadaver with the daVinci Surgical System demonstrate a safety profile similar to conventional transoral surgery. Additionally, we discuss several strategies to increase patient safety in TORS. [source]

Robotic Transabdominal Kidney Transplantation in a Morbidly Obese Patient

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2010
P. Giulianotti
Kidney transplantation in morbidly obese patients can be technically demanding. Furthermore, morbidly obese patients experience a high rate of wound infections and related complications, which mostly result from the longer length and extent of the incision. These complications can be avoided through minimally invasive surgery; however, conventional laparoscopic instruments are unsuitable for the safe performance of a kidney transplant in morbidly obese patients. Herein, we report the first minimally invasive, total robotic kidney transplant in a morbidly obese patient. A left, deceased donor kidney was transplanted into a 29-year-old woman with a body mass index (BMI) of 41 kg/m2 who had been on hemodialysis for 5 years. The operation was performed intraabdominally using the DaVinci Robotic Surgical System with 4 trocars and a 7 cm midline incision. The operative time was 223 min, and the blood loss was less than 50 cc. The kidney had immediate graft function. No perioperative complications were observed, and the patient was discharged on postoperative day 5 with normal kidney function. Minimally invasive access and robotic technology facilitated the safe performance of a successful kidney transplant in a morbidly obese patient. [source]

Japan's First Robot-assisted Totally Endoscopic Mitral Valve Repair With a Novel Atrial Retractor

ARTIFICIAL ORGANS, Issue 10 2009
Norihiko Ishikawa
Abstract This case report presents the first robot-assisted totally endoscopic mitral valve plasty in Japan. A 54-year-old woman was found by echocardiography to have grade III mitral valve regurgitation because of prolapse of the posterior leaflet. Surgical repair was performed using the da Vinci Surgical System. For the totally endoscopic mitral valve repair, a right-sided approach was used through four ports. A transthoracic aortic cross-clamp and novel flexible port access retractor were inserted through a 5-mm skin incision. Quadrangular resection of the posterior leaflet was performed, and an annuloplasty band was placed into the atrium. Resection of the valve segment took 13 min, and band implementation, 45 min. The total pump time was 197 min and the aortic cross-clamp time, 117 min. Postoperative echocardiography confirmed the absence of mitral insufficiency. [source]

Current experiences with robotic surgery at Severance Hospital, Yonsei University in Korea

ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 1 2010
WJ Lee
Abstract We started performing laparoscopic cholecystectomies in 1991. Since that time, many surgeons have been trained in laparoscopic and minimally invasive surgery, and laparoscopic surgery has been used in numerous procedures, with patients benefitting as a result. We performed the first automated surgery in Korea using Automated Endoscopic System for Optimal Positioning in June 1996. Inspired by Inbae Yoon and assisted by his generous donation, our hospital started the IB Yoon Multi-Specialty Endoscopic Research & Training Center in 1998. Subsequently in March 2005, we started the Severance Robotic and Minimally Invasive Surgery Center. The establishment of these centers has enabled us to widen the use of laparoscopic surgery and to teach many surgeons the principles of and the techniques involved in laparoscopic and robotic surgery. We performed our first robotic surgery using the da Vinci Surgical System in July 2005. In the 4 years since introducing the da Vinci Surgical System, we have successfully performed more than 2600 robotic surgical procedures. As the collaboration between medicine and robotic engineering produces more technically advanced results, we hopefully can develop our own version of the robotic system in the near future. [source]

An integrated pneumatic tactile feedback actuator array for robotic surgery

THE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 1 2009
Miguel L. Franco
Abstract Background A pneumatically controlled balloon actuator array has been developed to provide tactile feedback to the fingers during robotic surgery. Methods The actuator and pneumatics were integrated onto a robotic surgical system. Potential interference of the inactive system was evaluated using a timed robotic peg transfer task. System performance was evaluated by measuring human perception of the thumb and index finger. Results No significant difference was found between performance with and without the inactive mounted actuator blocks. Subjects were able to determine inflation location with > 95% accuracy and five discrete inflation levels with both the index finger and thumb with accuracies of 94% and 92%. Temporal tests revealed that an 80 ms temporal separation was sufficient to detect balloon stimuli with high accuracy. Conclusions The mounted balloon actuators successfully transmitted tactile information to the index finger and thumb, while not hindering performance of robotic surgical movements. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Endoscopic Surgery of the Anterior Skull Base,

THE LARYNGOSCOPE, Issue 1 2005
John D. Casler MD
Abstract Objectives/Hypothesis: Traditional surgical approaches to the anterior skull base often involve craniotomy, facial incisions, disruption of skeletal framework, tracheotomy, and an extended hospital stay. As experience with endoscopic sinus surgery has grown, the techniques and equipment have been found to be adaptable to treatment of lesions of the anterior and central skull base. A minimally invasive endoscopic approach theoretically offers the advantages of avoiding facial incisions, osteotomies, and tracheotomy; surgery should be less painful, recovery quicker, and hospital stays should be shorter. The study attempted to assess endoscopic approaches to the anterior and central skull base for its ability to achieve those goals. Study Design: Retrospective review of 72 cases performed at a single institution from November 1996 to July 2003. A subgroup of 15 patients who underwent endoscopic approach to their pituitary tumors was compared with a similar group of 15 patients who underwent traditional open trans-sphenoidal surgery for their pituitary tumors. Methods: Patient records were analyzed and information tabulated for age, sex, disease, location of lesion, operative time, use of image-guided surgical systems, blood loss, length of intensive care unit stay, duration of operative pain, length of postoperative hospitalization, complications, and completeness of resection. Results: Of the cases, 86.1% were performed exclusively endoscopically, and 13.9% used a combination of endoscopic and open techniques. An image-guided surgical system was used in 83% of cases. Hospital length of stay was 2.3 days for the exclusively endoscopic group as opposed to 8 days for the combined group. With the patients with pituitary tumors, operative times were similar between the two groups (255.13 vs. 245.73 min), blood loss was less in the endoscopic group (125.33 vs. 243.33 mL), pain duration was shorter in the endoscopic group (10 of 15 patients pain free on postoperative day 1 vs. 2 of 15 patients pain free in the open group), and intensive care unit stay and hospital length of stay were both shorter in the endoscopic group. Complication rates and completeness of resection was similar in both groups, although the open group had a higher rate of complications related to the approach to the sella. Conclusion: The study demonstrated the safety and efficacy of judicious endoscopic approaches to anterior skull base lesions. An outcomes assessment in pituitary surgery demonstrates advantages of an endoscopic approach in appropriate cases. [source]

Robotic Skeletonized Internal Thoracic Artery Harvesting: The Sliding Fascia Technique

ARTIFICIAL ORGANS, Issue 6 2010
Norihiko Ishikawa
Abstract Robotic skeletonizing and harvesting of the internal thoracic artery, using the da Vinci surgical system, has a number of advantages over robotic pediculed ITA harvesting. The advantages include greater blood flow, a longer conduit, and less bleeding. The technique is facilitated by use of the EndoWrist spatula cautery and fine tissue forceps (Intuitive Surgical, Inc., Sunnyvale, CA, USA). How the technique is performed is described in this report. [source]

Robotic Replacement of the Descending Aorta in Human Cadaver

ARTIFICIAL ORGANS, Issue 9 2006
Norihiko Ishikawa
Abstract:, Robot-assisted replacement of the thoracic aorta was performed in a human cadaver. Temporary shunt bypass was established by inserting a left axillary artery catheter and directing it through the aortic arch toward the right femoral artery through the abdominal aorta. The technique utilized the da Vinci surgical system inserted through the 4-cm supramammary working port and two additional thoracoscopic ports. The working port allowed the introduction of an endoscope, endoscopic instruments, and artificial graft and suture materials. The aorta was dissected using the robotic instruments and was clamped with two transthoracic clamps. After transaction of the aorta, a 20-mm polytetrafluoroethylene graft was cut and an end-to-end anastomosis was then performed with running 3-0 Prolene sutures with robotic instruments. The robotic system provides superior optics and allows for enhanced dexterity. Minimally invasive robotic replacement of the descending aorta is an effective procedure and may add benefits for both surgeon and patients. [source]

Robot-assisted laparoscopic adrenalectomy: preliminary UK results

BJU INTERNATIONAL, Issue 3 2004
S. Undre
Authors from London describe the early results from the UK in the use of robot-assisted laparoscopic adrenalectomy. In a small group of patients they found that patients could be treated early, with early discharge from hospital. The use of retrograde balloon dilatation of PUJ obstruction is revisited by authors from Plymouth, who review their 10 years of experience with this technique. They found that the procedure gave good symptomatic relief in 76% of their patients, but found no relationship between symptom relief and renographic improvement. In a few patients with a long-term follow-up there was symptomatic improvement and good maintenance of split renal function. OBJECTIVE To describe the results of our first two cases of laparoscopic adrenalectomy using the da VinciTM surgical system (Intuitive Surgical, Inc., Mountain View, CA, USA). PATIENTS AND METHODS Amongst 75 robot-assisted procedures performed at our institution, two patients underwent robot-assisted laparoscopic adrenalectomy. The set-up time, procedure time, hospital stay, complications and outcomes were recorded. RESULTS Both operations were completed successfully using the robot; the mean (range) set-up time was 31 (25,37) min and mean procedure time 118.5 (107,130) min. One patient had a postoperative pulmonary embolus and was discharged 5 days after surgery; the second patient was discharged after 3 days. There were no intraoperative complications; both patients were well at the 1-year follow-up CONCLUSIONS Robot-assisted laparoscopic adrenalectomy is technically feasible and can be conducted efficiently and safely with the da Vinci surgical system. [source]

23G versus 20G for macular hole surgery.

ACTA OPHTHALMOLOGICA, Issue 2009
Efficacy, patient satisfaction, safety
Purpose To compare the 20gauge and 23gauge vitreoretinal surgical system and equipment in macular hole surgery. Methods We randomly assigned 38 patients in two different groups. Group 1. Used 20g surgical equipment and instrumentation. Group 2. Used 23g surgical equipment and instrumentation. All cases were operated by the same surgeon. The efficacy, the safety and the patient comfort were evaluated. Results No statistically significant difference found between the two groups regarding efficacy and complications. Group 2 was superior to group 1 regarding patient satisfaction (p<0.005). Conclusion 23g surgical equipment offers similar efficacy to the established 20g equipment for macular hole surgery. Though reduces the intraoperative time and patient overall satisfaction is greater. [source]