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The Surgical System da Vinci™ is designed to regulate endoscopic instruments during surgical procedures of toracoscopy and laparoscopy and it consists of a surgical console with integrated Visor Stereo 3D, a surgical carriage, a camera with an arm and a two-armed instrument, and a vision carriage.
Sitting at the console, the surgeon works using two master positioners directly under a visualisor of the 3D enlarged operating field. The points of the instruments visualised on the display are aligned with the Master to guarantee natural and foreseeable movement to the instrument. The surgeon maintains the head/eye orientation and the natural sensibility of tradional surgery.
The System da Vinci™ puts the instrument's movements under direct control, in real time, by means of a cinematic structure (or articulated movement) that allows the surgeon to use the console as in traditional open surgical techniques. These techniques are immediately converted into minimally invasive surgery movements (MIS) at the surgical site. With the system da Vinci™ surgeons have the advantage of entering through small incisions without giving up the manual ability, precision and instinctive movements of open surgery.
The electronics of the system da Vinci™ allow the use of scale dimensioning of the surgeon's hands. The scale dimensioning reduces hand movements to corresponding movements smaller than the surgical instrument points. Different degrees of regulation allow the surgeons to optimise the scale dimensioning for different clinical applications. The natural tremble of the surgeon's hand is eliminated by an electronic filter which ensures a stable and predictable control of the instrument.
The instruments have a total of 6 grades of liberty plus the grip, two more at the point than the traditional endoscopic instrument. The point's articulations imitate the vertical and lateral flexibility of the human wrist. These articulations extend the possibility of the surgeon's MIS to new levels. The surgeon is therefore able to practise complex reconstruction surgery through incisions with a length shorter than1 cm.
The System da Vinci™ is produced by the Californian firm Intuitive Surgical Inc.and is distributed in Italy by AB MEDICA srl based in Mazzo di Rho.
Created to respond to the need of surgical intervention in epespecially difficult environments (as for example on battlefields ) in which even the use of satellites was planned, the robotic system da Vinci™ has opened up new horizons to surgery.
In particular it allows us to:
Simplify the actual procedure of mini-invasive cardio-surgery making it shorter and safer for the patient.
- Make mini-invasive operations routine.
- Perform currently also operations at a distance, extremely complex treatments that can be entrusted only to surgeons who are especially able and expert. For this reason we believe that this method will grow stronger with surgeons and institutions.
- Make possible new cardio-surgical applications so far impossible because of the difficulties connected with the impossibility of making wide and deep incisions.
The instrument, as has been said, can be used in any general surgery operation, vascular surgery, urology and gynacology etc. for working times that require precision: in fact the three-dimensional magnified image, the firm and precise movements, with the surgeon being in a comfortable ergonomic position, and the de-multiplier of movements allow the performance of microsurgery gestures.
The Aosta General Surgery Unit is in the lead position and is a point of reference in advanced laparoscopic surgery, not only in Italy but also in the international field. This instrument permits it to make another step forward entering into the very few surgical units in the world which possess this equipment.
The Aosta Surgery Unit is already a pole attraction for advanced laparoscopic surgery especially obesity and colon-rectum. At the moment codified operations can be carried out with greater precision and facility and the system can give the surgeon greater advantages, even if the difficulties of the operation are greater: the more difficult the operation in terms of site or access the more advantageous is the instrument!
But this is only the beginning: it is certain that the development of studies and research will allow in the future the performance of operations at a distance: The Aosta surgeon can intervene from Aosta on a patient who is hospitalised in another place or viceversa. A patient requiring a particular procedure will not have to move from the base, but could undergo the operation performed by the expert surgeon's robot at several kilometres distance.
This may seem like science fiction but already in 2001 the first transatlantic connection was made between NewYork and Strasburg and some parts of an operation were performed with the help of this Robot Instrument: the surgeon in Strasburg moved the instrument in the United States via satellite.
Actually, in fact, it is about operating with the assistance of a computer which receives and transmits the surgeon's movements to a machine (Robot) positioned on the operating table, which reproduces them in an "Intuitive" and perfect manner.
We cannot remain spectators, but we must be protagonists: and it must be clear and good protagonism always aimed at the sick persons' good health and well-being, and at the quality of their life.
Pictures: click on previews to see the enlarged pictures
