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Basics of Robotic Surg
Dr. Raguram Ga
Consultant Endourologist & A
The Lifeline Superspeciali
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Thanks to My Me
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Drawbacks with ConventionalLaparoscopic Surgery
Surgeon operates from a 2D image
Straight, rigid instruments
(limited range of motion)
Instrument tips controlled at a distance
ounter intuiti!e motion
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Drawbacks with ConventionalLaparoscopic Surgery
Reduced de"terity, precision and control
#nsteady camera controlled by assistant
Dependent on assistant through accessory
Greater surgeon fatigue
$a%es comple" operations more di&cult
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'aparoscopy is li%e eating chop stic%s
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How to overcome these drawba
Improve visualization
Improve instrument control
Use superior ergonomics
Enhance dexterity for technically
challenging aspects of the procedure
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Da Vinci Surgical Robot
Da Vinci Standard
(1999)
Da Vinci S System
(2006)
Da Vinci Si Sy
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Da Vinci Xi (2!"#
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Surgeon onsole Immersi!e !ie $ %D &D' !
)agni*cation
$aster controls + ,atural han-+
eye positioning
Scaled don * +remor less The syste) sea)lessly translates
the surgeon.s han-' wrist an- *nger
)ove)ents into precise' real+ti)e
)ove)ents o/ surgical instru)ents
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-ther ad!antages tosurgeon
0nly syste) that allows surgeons to operate while
1etter ergono)ics than tra-itional open an- lapar
surgery
Re-uce- surgeon /atigue
,o risk o/ trans)ission o/ -iseases
ten-s the surgical li/e o/ the Surgeon3
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atientside art
Master $ SlaveConcept
4our ar)s
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atientside art
The robotic ar)s )ovearoun- *e- pivot points5
The syste) re6uires thatevery surgical )aneuver beun-er the
-irect control o/ thesurgeon5
Repeate- sa/ety checksprevent any in-epen-ent)ove)ent o/ the
instru)entsor robotic ar)s5
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/ndorist Instruments n-owrist8 instru)ents with 9
-egrees o/ /ree-o) Range o/ )otion /ar greater than
the hu)an han- 9 -egrees o//ree-o)
Mini)i:es surgeon han- tre)ors
ach instru)ent has a speci*csurgical )ission such as
cla)ping'suturing an- tissue )anipulation5
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0ision System
The vision syste) is e6uippe-with a high+-e*nition'
&Den-oscope
;)age processing e6uip)entthat provi-es true+to+li/e
i)ages o/ the patient
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0R set up
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Dual console /or gui-e-training
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da Vinci Xi SurgicalSystem
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da Vinci S Surgical Sys
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Speci1c role in comple"Gynecological surgeries
=-vance- n-o)etriosis
Co)ple layere- suturing like )yo)ecto)y
Co)ple reconstruction like vesicovaginal *stula rep
>recise -issection in sacrocolpopey
=ccuracy in tubo+tubal anasto)osis
tensive an- precise clearance in )alignancy
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Gynecological -ncology
Ra-ical %ysterecto)y
>elvic an- paraaortic ly)ph no-e -issection
Trachelecto)y
0ophorecto)y
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linical -utcomes
1etter or si)ilar in co)ple proce-ures Less bloo- loss
Lower operating ti)e
Less co)plications
4aster recovery
,o establishe- a-vantages /or si)ple proc
Disa-vantage is the higher cost
Rare proble)s with )achinery
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uestions3
