Robotic Surgery

Robotic surgery is the use of robots in performing surgery. Three major advances aided by surgical robots have been remote surgery, minimally invasive surgery and unmanned surgery. Major advantages of robotic surgery are precision, miniaturization, smaller incisions, decreased blood loss, less pain, and quicker healing time. Further advantages are articulation beyond normal manipulation and three-dimensional magnification. In 1985 a robot was used to place a needle for a brain biopsy using CT guidance. In 1988, a robot developed at Imperial College London, was used to perform prostatic surgery. The current robot, da Vinci Surgical System, comprises three components: a surgeon’s console, a patient-side robotic cart with 4 arms manipulated by the surgeon (one to control the camera and three to manipulate instruments), and a high-definition 3D vision system.

Articulating surgical instruments are mounted on the robotic arms which are introduced into the body through cannulas. The surgeon’s hand movements are scaled and filtered to eliminate hand tremor then translated into micro-movements of the proprietary instruments. The camera used in the system provides a true stereoscopic picture transmitted to a surgeon’s console. The da Vinci System is FDA cleared for a variety of surgical procedures including surgery for prostate cancer, hysterectomy and mitral valve repair, and is used in more than 800 hospitals in the Americas and Europe. The da Vinci System was used in 48,000 procedures in 2006 and sells for about $1.2 million. The new da Vinci HD SI, which is used by Dr. Gonzalez, released in April 2009 currently sells for $1.75 million.