How To Use A Da Vinci System

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1 Robotics in General Surgery

2

3 Keith Chae Kim Editor Robotics in General Surger y

4 Editor Keith Chae Kim, M.D., F.A.C.S. Metabolic Medicine and Surgery Institute Florida Hospital Celebration Health Celebration, FL, USA ISBN ISBN (ebook) DOI / Springer New York Heidelberg Dordrecht London Library of Congress Control Number: Springer Science+Business Media New York 2014 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (

5 There are many people who have been instrumental in the publication of this book and others who have been essential in creating the circumstances that led me to embrace robotic surgery. Thank you. I dedicate this book to Ella, Alex, Jennifer, John, Cathy, Sofi a, and Young, and especially to my parents, Sun Tok Kim, my mother, and Kwi Hyon Kim, my father, who have taught me through their actions that hard work and perseverance have no equal.

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7 Preface Robotic surgery will prove to be the most significant advance in surgery for this generation of surgeons and the next few generations to come. The current platform, the da Vinci system, is the product of an evolution from the US Department of Defense s efforts to produce telerobotic capabilities in order to provide injured frontline soldiers with advanced surgical care from remote locations to commercial efforts to provide enhanced dexterity to facilitate complex surgeries while maintaining minimally invasive techniques. The enhanced dexterity, based on an anthropomorphic model whereby the robotic system is designed to mimic the human hand in its range and freedom of movements, is fairly advanced and has allowed both average surgeons to adopt minimally invasive techniques and skilled surgeons to push the envelope in the complexity of minimally invasive procedures. The robotic approach has permeated essentially every specialty in general surgery. More importantly, however, the robotic platform has introduced two new dynamics between the patient and the surgeon that will have a far greater impact. First, the system is based on a master slave relationship in which the surgeon is remote from the patient and performs the operation by controlling a patient cart slave that is docked to the patient. Second, the console represents a digital interface between the surgeon and the patient. In these aspects, we are just starting to scratch the surface of the possibilities. The master slave configuration allows for telepresence as was dramatically demonstrated by Professor Marescaux and colleagues in Operation Lindbergh, a transatlantic cholecystectomy. This capability will not only have a profound impact on providing sophisticated and complex care to remote locations from a command center but will also dramatically facilitate professional education and collaborative surgery. Experts will be able to have a global presence without having to leave their operating rooms and will be able to demonstrate surgery as well as assist or take over surgeries being performed in remote locations by linking their console to the remote patient cart. Additionally, the master slave platform will eventually allow for the manipulation of wireless slave components that will form the foundation of the future of endoscopy, interventional radiology, and natural orifice interventions. The digital interface, which allows for the collection and manipulation of data that can be used for diagnostic or interventional purposes, represents an even greater potential. Even in the relatively early stages, imaging technology vii

8 viii Preface is being used to identify structures and provide a road map to the surgical anatomy in real time. The future will see the digital interface between patient and surgeon evolve to facilitate image-guided surgery, computer-aided surgery, as well as pre-performed surgery in simulation models that is reproduced by a computer-driven system on the actual patient. This textbook, the first comprehensive overview of the role of robotic surgery in general surgery, is intended as a how-to reference of robotically performed procedures in general surgery. Additionally, in recognition of the importance of understanding the evolution of robotic surgery thus far, and the impact that it will have on the future of surgery, this book provides a historical perspective of robotic surgery as well as an overview of the emerging technology and future robotic platforms. Celebration, Florida, USA Keith Chae Kim, M.D., F.A.C.S.

9 Contents Part I Overview of the Robotic System 1 History of Robotic Surgery... 3 Haidar Abdul-Muhsin and Vipul Patel 2 Introduction to the Robotic System... 9 Monika E. Hagen, Hubert Stein, and Myriam J. Curet 3 Overview of General Advantages, Limitations, and Strategies Erik B. Wilson, Hossein Bagshahi, and Vicky D. Woodruff Part II Surgical Techniques: Esophagus 4 Robotic Assisted Minimally Invasive Esophagectomy Abbas E. Abbas and Mark R. Dylewski 5 Robotic Assisted Operations for Gastroesophageal Reflux Daniel H. Dunn, Eric M. Johnson, Kourtney Kemp, Robert Ganz, Sam Leon, and Nilanjana Banerji 6 Achalasia Julia Samamé, Mark R. Dylewski, Angela Echeverria, and Carlos A. Galvani Part III Surgical Techniques: Thoracic 7 Complete Port-Access Robotic-Assisted Lobectomy Utilizing Three-Arm Technique Without a Transthoracic Utility Incision Mark R. Dylewski, Richard Lazzaro, and Abbas E. Abbas 8 Robotic Pulmonary Resection Using a Completely Portal Four-Arm Technique Robert James Cerfolio and Ayesha S. Bryant ix

10 x Contents Part IV Surgical Techniques: Stomach 9 Gastric Cancer: Partial, Subtotal, and Total Gastrectomies/Lymph Node Dissection for Gastric Malignancies Woo Jin Hyung and Yanghee Woo Part V Surgical Techniques: Bariatric 10 Robotic Roux-en-Y Gastric Bypass Erik B. Wilson, Hossein Bagshahi, and Vicky D. Woodruff 11 Robotic Sleeve Gastrectomy Jorge Rabaza and Anthony M. Gonzalez 12 Robotic Biliopancreatic Diversion: Robot-Assisted (Hybrid) Biliopancreatic Diversion with Duodenal Switch Ranjan Sudan and Sean Lee Part VI Surgical Techniques: Hepatobiliary/Pancreas 13 Robotic Pancreaticoduodenectomy (Whipple Procedure) Martin J. Dib, Tara Kent, and A. James Moser 14 Robotic Distal Pancreatectomy Anusak Yiengpruksawan 15 Robotic Hepatic Resections: Segmentectomy, Lobectomy, Parenchymal Sparing M. Shirin Sabbaghian, David L. Bartlett, and Allan Tsung Part VII Surgical Techniques: Colon and Rectum 16 Robotic Right Colectomy: Four- Arm Technique Gyu Seog Choi 17 Robotic Right Colectomy: Three- Arm Technique Henry J. Lujan and Gustavo Plasencia 18 Robotic Left Colectomy Eduardo Parra-Davila and Carlos M. Ortiz-Ortiz 19 Totally Robotic Low Anterior Resection Jung Myun Kwak and Seon Hahn Kim 20 Robotic Hybrid Low Anterior Resection Eric M. Haas and Rodrigo Pedraza 21 Robotic-Assisted Extralevator Abdominoperineal Resection Kang Hong Lee, Mehraneh D. Jafari, and Alessio Pigazzi

11 Contents xi 22 Robotic Single-Port Colorectal Surgery Byung Soh Min, Sami Alasari, and Avanish Saklani 23 Robotic Transanal Surgery Sam Atallah and Matthew Albert Part VIII Surgical Techniques: Endocrine 24 Robotic Thyroidectomy and Radical Neck Dissection Using a Gasless Transaxillary Approach Jandee Lee and WoongYoun Chung 25 Robotic Adrenalectomy Halit Eren Taskin and Eren Berber Part IX Surgical Techniques: Solid Organ 26 Robot-Assisted Splenectomy Luciano Casciola, Alberto Patriti, and Graziano Ceccarelli 27 Robotic Donor Nephrectomy and Robotic Kidney Transplant Ivo G. Tzvetanov, Lorena Bejarano-Pineda, and José Oberholzer Part X Surgical Techniques: Hernias 28 Robot-Assisted Ventral and Incisional Hernia Repair Brad Snyder Part XI Surgical Techniques: Pediatric 29 Pediatric Robotic Surgery John J. Meehan Part XII Surgical Techniques: Microsurgery 30 Robotic-Assisted Microsurgery for Male Infertility and Chronic Orchialgia Jamin V. Brahmbhatt, Ahmet Gudeloglu, and Sijo J. Parekattil Part XIII Education and Training 31 Developing a Curriculum for Residents and Fellows Brian Dunkin and Victor Wilcox 32 Challenges and Critical Elements of Setting Up a Robotics Program Randy Fagin

12 xii Contents 33 Professional Education: Telementoring and Teleproctoring Monika E. Hagen and Myriam J. Curet Part XIV Evolving Platforms 34 Single-Incision Platform Giuseppe Spinoglio 35 TilePro Woo Jin Hyung and Yanghee Woo 36 ICG Fluorescence Giuseppe Spinoglio Part XV Future 37 Robotics and Remote Surgery: Next Step Jacques Marescaux and Michele Diana 38 The Future of Robotic Platforms Mehran Anvari Index

13 Contributors Abbas E. Abbas, M.D. Department of Surgery, Ochsner Clinic Foundation, New Orleans, LA, USA Haidar Abdul-Muhsin, M.D. Florida Hospital Celebration Health, Global Robotics Institute, Celebration, FL, USA Sami Alasari, M.D. Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea Matthew Albert, M.D., F.A.C.S., F.A.S.C.R.S. Center for Colon and Rectal Surgery, Florida Hospital, Altamonte, FL, USA Mehran Anvari, M.B.B.S., Ph.D., F.R.C.S., F.A.C.S. Department of Surgery, McMaster University, Hamilton, ON, Canada St. Joseph s Healthcare Hamilton, Hamilton, ON, Canada Sam Atallah, M.D., F.A.C.S., F.A.S.C.R.S. Center for Colon and Rectal Surgery, Florida Hospital, Winter Park, FL, USA Hossein Bagshahi, M.D. Department of Surgery, Harris Methodist Hospital, Fort Worth, TX, USA Reshape Bariatric and General Surgery of Fort Worth, Fort Worth, TX, USA Nilanjana Banerji, Ph.D. Neuroscience and Spine Clinical Service Line, Abbott Northwestern Hospital, Minneapolis, MN, USA David L. Bartlett, M.D. Department of Surgery and Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA Lorena Bejarano-Pineda, M.D. Division of Transplantation, Department of Surgery, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA Eren Berber, M.D., F.A.C.S. Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA Jamin V. Brahmbhatt, M.D. Department of Urology, Winter Haven Hospital and University of Florida, Winter Haven, FL, USA Ayesha S. Bryant, M.D., M.S.P.H. Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA xiii

14 xiv Contributors Luciano Casciola, M.D. Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, San Matteo degli Infermi Hospital, Spoleto, Italy Graziano Ceccarelli, M.D. Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, San Matteo degli Infermi Hospital, Spoleto, Italy Robert James Cerfolio, M.D., F.A.C.S., F.C.C.P. Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, AL, U S A Gyu Seog Choi, M.D., Ph.D. Colorectal Cancer Center, Kyungpook National University Medical Center, Daegu, South Korea WoongYoun Chung, M.D., Ph.D. Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea Myriam J. Curet, M.D. Intuitive Surgical International, Sunnyvale, CA, USA Department of Intuitive Surgery, Stanford University, Sunnyvale, CA, USA Michele Diana, M.D. Department of Digestive and Endocrine Surgery, IRCAD (Research Institute against Digestive Cancer), Strasbourg, France Martin J. Dib, M.D. Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA Brian Dunkin, M.D., F.A.C.S. Department of Surgery, The Methodist Hospital, Houston, TX, USA Daniel H. Dunn, M.D. Esophageal and Gastric Care Program, Virginia Piper Cancer Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA Mark R. Dylewski, M.D. Department of Cardiac Vascular and Thoracic Surgery, Baptist Health of South Florida, Miami, FL, USA Angela Echeverria, M.D. Department of Surgery, University of Arizona, Tucson, AZ, USA Randy Fagin, M.D. Texas Institute for Robotic Surgery, Hospital Corporation of America, Austin, TX, USA Intuitive Surgical International, Sunnyvale, CA, USA Carlos A. Galvani, M.D. Department of Surgery, University of Arizona, Tucson, AZ, USA Robert Ganz, M.D., F.A.S.G.E. Department of Gastroenterology, Abbott Northwestern Hospital, Bloomington, MN, USA Anthony M. Gonzalez, M.D. Bariatric Surgery, Baptist Health Medical Group, Miami, FL, USA Ahmet Gudeloglu, M.D. Department of Urology, Winter Haven Hospital and University of Florida, Winter Haven, FL, USA

15 Contributors xv Eric M. Haas, M.D. Division of Minimally Invasive Colon and Rectal Surgery, Department of Surgery, The University of Texas Medical School at Houston, Houston, TX, USA Colorectal Surgical Associates, Ltd, LLP, Houston, TX, USA Monika E. Hagen, M.D., M.B.A. Intuitive Surgical International, Sunnyvale, CA, USA Department of Digestive Surgery, University Hospital Geneva, Geneva, Switzerland Woo Jin Hyung, M.D., Ph.D. Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea Mehraneh D. Jafari, M.D. Department of Surgery, Irvine School of Medicine, University of California, Orange, CA, USA Eric M. Johnson, M.D. Department of Surgery, Abbott Northwestern Hospital, Minneapolis, MN, USA Kourtney Kemp, M.D. Specialists in General Surgery, Maple Grove Hospital, Maple Grove, MN, USA Tara Kent, M.D., F.A.C.S. Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA Keith Chae Kim, M.D., F.A.C.S. Metabolic Medicine and Surgery Institute, Florida Hospital Celebration Health, Celebration, FL, USA Seon Hahn Kim, M.D. Ph.D. Department of Surgery, Korea University Anam Hospital, Seoul, Republic of Korea Jung Myun Kwak, M.D., Ph.D. Department of Surgery, Korea University Anam Hospital, Seoul, Republic of Korea Richard Lazzaro, M.D. North Shore LIJ Health System, Lenox Hill Hospital, New York, NY, USA Jandee Lee, M.D., Ph.D. Department of Surgery, Eulji University College of Medicine, Seoul, South Korea Kang Hong Lee, M.D., Ph.D. Department of Surgery, Hanyang University College of Medicine, Seoul, South Korea Sean Lee, M.D. Division of Metabolic and Weight Loss Surgery, Duke University Medical Center, Durham, NC, USA Sam Leon, M.D. Minnesota Gastroenterology, Minneapolis, MN, USA Henry J. Lujan, M.D., F.A.C.S., F.A.S.C.R.S. Deparment of Surgery, Jackson South Community Hospital, Miami, FL, USA Jacques Marescaux, M.D., F.A.C.S., (Hon) F.R.C.S., (Hon) J.S.E.S. Department of Digestive and Endocrine Surgery, IRCAD (Research Institute against Digestive Cancer), Strasbourg, France John J. Meehan, M.D., F.A.C.S. University of Washington School of Medicine, Seattle Children s Hospital, Seattle, WA, USA

16 xvi Contributors Byung Soh Min, M.D., Ph.D. Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea A. James Moser, M.D., F.A.C.S. Institute for Hepatobiliary and Pancreatic Cancer, Beth Israel Deaconess Medical Center, Boston, MA, USA José Oberholzer, M.D. Division of Transplantation (MC 958), University of Illinois Hospital and Health Sciences System, Chicago, IL, USA Carlos M. Ortiz-Ortiz, M.D. Department of General Surgery, Florida Hospital Celebration, Celebration, FL, USA Sijo J. Parekattil, M.D. Department of Urology, Winter Haven Hospital and University of Florida, Winter Haven, FL, USA Eduardo Parra-Davila, M.D., F.A.C.S., F.A.S.C.R.S. Departments of General Surgery, Colorectal, Bariatric, Florida Hospital Celebration, Celebration, FL, USA Vipul Patel, M.D. Florida Hospital Celebration Health, Global Robotics Institute, Celebration, FL, USA Alberto Patriti, M.D., Ph.D. Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, San Matteo degli Infermi Hospital, Spoleto, Italy Rodrigo Pedraza, M.D. Division of Minimally Invasive Colon and Rectal Surgery, Department of Surgery, The University of Texas Medical School at Houston, Houston, TX, USA Colorectal Associates, Ltd, LLP, Houston, TX, USA Alessio Pigazzi, M.D., Ph.D. Division of Colorectal Surgery, Department of Surgery, Irvine Medical Center, University of California, Orange, CA, USA Gustavo Plasencia, M.D., F.A.C.S., F.A.S.C.R.S. Department of Surgery, Jackson South Community Hospital, Miami, FL, USA Jorge Rabaza, M.D. South Miami Hospital, Baptist Health Medical Group, Miami, FL, USA M. Shirin Sabbaghian, M.D. Division of Surgical Oncology, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA Avanish Saklani, M.S., F.R.C.S. Colorectal Division, Surgical Oncology, Tata Memorial Centre, Parel, Mumbai, India Julia Samamé, M.D. Department of Surgery, University of Arizona, Tucson, AZ, USA Brad Snyder, M.D. Department of Surgery, Memorial Hermann Texas Medical Center, Houston, TX, USA Giuseppe Spinoglio, M.D. Department of General and Oncological Surgery, City Hospital SS. Antonio e Biagio, Alessandria, Italy

17 Contributors xvii Hubert Stein, DIPL.-ING, BMT Clinical Development Engineering, Intuitive Surgical Inc., Sunnyvale, CA, USA Ranjan Sudan, M.D. Department of Surgery, Duke University Medical Center, Durham, NC, USA Halit Eren Taskin, M.D. Endocrine Surgery Division, Cleveland Clinic, Cleveland, OH, USA Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA Allan Tsung, M.D. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Pittsburgh Medical Center Liver Cancer Center, Montefiore Hospital, Pittsburgh, PA, USA Ivo G. Tzvetanov, M.D. Division of Transplantation, Department of Surgery, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA Victor Wilcox, M.D. Department of Surgery, Houston Methodist Hospital, Houston, TX, USA Erik B. Wilson, M.D. Department of Surgery, The University of Texas Health Science Center, Houston, TX, USA Yanghee Woo, M.D. Division of GI/Endocrine Surgery, Center for Excellence in Gastric Cancer Care, Columbia University Medical Center, New York, NY, USA Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY, USA Department of Surgery, New York Presbyterian Hospital, New York, NY, USA Vicky D. Woodruff, Ph.D. Department of Surgery, University of Texas Health Science Center, Houston, TX, USA Anusak Yiengpruksawan, M.D., F.A.C.S. Department of Surgery, The Valley Minimally Invasive and Robotic Surgery Center, The Valley Hospital, Ridgewood, NJ, USA

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