Biomedical Engineering Reference
In-Depth Information
a tissue model, and demonstrated that the surgical procedure in robotic heart surgery is
safer, quicker, and gentler for the patient and more comfortable for the surgeon when
using force feedback.
9.2 da Vinci
™
and Amadeus Composer
™
Robot Surgical System
ThedaVinci
Surgical System is a robotic surgical system manufactured by Intuitive
Surgical and designed to facilitate complex surgery using a minimally invasive approach.
The system is controlled by a surgeon from a console. It is commonly used for
prostatectomies (surgical removal of part of the prostate gland), and increasingly for
cardiac valve repair and gynecologic surgical procedures [23].
ThedaVinci
™
System consists of a surgeon's console, that is typically in the same room
as the patient, and a patient-side cart with four interactive robotic arms controlled from the
console. Two of the arms hold tools such as scissors and unipolar or bipolar electrocautery
instruments, the third acts as a scalpel. The fourth arm holds an endoscopic camera having
two lenses that gives the surgeon full stereoscopic vision from the console. The surgeon
sits at the console and looks through two eye holes at a 3-D image of the procedure,
meanwhile maneuvering the arms with two foot pedals and two hand controllers. The da
Vinci
™
System scales, filters, and translates the surgeon's hand movements (Figure 9.1a)
into more precise micro-movements of the instruments (Figure 9.1b,c,d,e), which operate
through small incisions in the body.
To perform a procedure, the surgeon uses the console's master controls to maneu-
ver the patient-side cart's three or four robotic arms (depending on the system model),
which secures the instruments and a high-resolution endoscopic camera. The instruments'
jointed-wrist design exceeds the natural range of motion of the human hand and motion
scaling and tremor reduction further interpret and refine the surgeon's hand movements.
The da Vinci™ System incorporates multiple, redundant safety features designed to mini-
mize opportunities for human error when compared with traditional approaches. At no time
is the surgical robot in control or autonomous; it operates on a 'master/slave' relationship,
the surgeon being the 'master' and the robot being the 'slave.'
The da Vinci™ System has been designed to improve upon conventional laparoscopy,
in which the surgeon operates while standing, using hand-held, long-shafted instruments,
which have no wrists. With conventional laparoscopy, the surgeon must look up and
away from the instruments, to a nearby 2D video monitor to see an image of the target
anatomy. The surgeon must also rely on his/her patient-side assistant to position the camera
correctly. In contrast, the da Vinci™ System's ergonomic design allows the surgeon to
operate from a seated position at the console, with eyes and hands positioned in line with
the instruments. To move the instruments or to reposition the camera, the surgeon simply
moves his/her hands.
By providing surgeons with superior visualization, enhanced dexterity, greater pre-
cision, and ergonomic comfort, the da Vinci™ Surgical System makes it possible for
more surgeons to perform minimally invasive procedures involving complex dissection
or reconstruction. For the patient, a da Vinci™ procedure can offer all the benefits of a
minimally invasive surgical procedure with less pain and blood loss, and hence a reduced
need for blood transfusions. Moreover, the da Vinci™ System enables a shorter hospital
internment, a speedier recovery, and quicker return to normal daily activities [24].
™
