Robotic Surgery 12 years of robotic assisted surgery vs. conventional laparoscopic surgery

Transcription

1 Robotic Surgery 12 years of robotic assisted surgery vs. conventional laparoscopic surgery A new chapter in medicine.from the first remote surgery by Prof. Dr. Senner to the today`s da Vinci technology Conference at Heart Centre Kiev 29th January 2014

2 Robotic Surgery Fiction or Reality? The philosophy of a new revolution 150 years ago the famous Jules Verne showed in his literature a new world, which was full of dreams with a special touch of high tech! His work was the foundation of the new science fiction literature In the modern medicine today, the implementing of a complex robotic system for diagnostic and for assisted laparoscopic surgery is not a vision or fiction, but is a new reality with endless performance.

3 History 2000 Remote surgery from Strasbourg to New York cholecystectomy by Prof. Dr. Jaques Marescaux ( IRCAD Strasbourg ) 2003 Remote surgery from Munich to Klausenburg kidney prelevation for transplantation by Prof. Dr. Ralf Senner ( Robotic Surgery Clinic Munich ) The type of the medical robot system was called «Zeus» (telesurgery )

4 The priciple of robotic surgery The interposition of robots between surgeon and patient leads to : Increasing of surgeon skills by manipulation of EndoWrist instruments Increasing of surgery precision & efficiency by 3D visualisation The robot does not work independently. He can be moved by joystick, voice control and replaces the human assistence

5 Robotic surgery systems Zeus Telesugery EndroWrist instruments Voice contol visualisation Virtual surgery for robotic surgery training Geometry of trocar points Disection steps Simulation of anatomical situation Learning and teaching of new precdures Surgical education for young surgeons da Vinci Telesurgery EndroWrist instruments 3D visualisation Needle control & driving Socrates Teleteaching Telementoring telmedicine Aesop Voice control High precision manipulator according only to the surgeon voice Avioding voice interferences during the surgery

6 Zeus robot system World premiere remote surgery by Prof.Dr. Ralf Senner

7 Socrates robot system

8 Aesop robot system

9 Virtual robotic surgery

10 da Vinci robot system

11 Robotic assisted surgical steps by da Vinci can be done low risk in difficult anatomical places Endo Wrist 5 mm fine instruments manipulation allows the instruments moving during the fine dissection with natural dexterity the instrument can be manipulated & moved like a human hand with : flexibility and all properties in each directions allowed the surgery in very difficult anatomical places without major injury risk without open surgery, min invasive, mild robotic assisted surgical steps can be done low risk by revision surgery(second look)

12 Robotic assisted obesity surgery vs. conventional laparoscopy breaks any limits of conventional surgery! Why? obesity surgery is a high risk surgery because: generally morbid context of each patient anatomical particularities of obese and super obese patients like : big abdominal wall big fat amount inside of abdomen,/difficult anatomical demarcation /orientation big lever/splen Small anatomical place high organ injury risk (major complications->long stay in the hospital) High costs/long recovery time Death

13 Robotic assisted obesity surgery Go for it! Why? robotic improve the work ergonomics during the surgery one of the major advantage vs. conventional bariatric laparoscopy robotic surgery improves and augment the surgical/human skills key clinical advantage in surgery Robotic assisted surgery avoids : the organ injury major complication (long stay, long recovery)

14 Conclusion Robotic surgery by da Vinci HD, three-dimensional view (key clinical advantage in surgery) safe accurate low risk short stay in the hospital less pain min invasive very mild reduce the generally risk of bariatric surgery for patients with a high morbid character One part surgeon.one part machine. Both parts amazing