The field of surgical robotics is scarcely a quarter century old. The first surgical procedure carried out robotically was in 1988. Intuitive Surgical introduced the Ilinois da Vinci Surgical Robot five years later. This robot is made up of three components: there is a console behind which the surgeon sits and directs the operation. There is a robotic cart with four arms next to the patient: one arm controls a dual lens camera system and the other three arms manipulate instruments - such as scalpel, bovie, scissors, and electrocautery instruments - under the control of the surgeon. The movements of the surgeon's hands are filtered by the robot to eliminate hand tremors, and then are translated into micro-motions of the articulating surgical instruments on the robot's arms. The third component of the system is a high definition three-dimensional viewing system, which provides a stereoscopic picture of the procedure on the surgeon's console. The surgeon sits at the console and looks through eyepieces at a three-dimensional magnified view inside the patient's body, while he manipulates the robot's arms with two hand controllers and two foot pedals. There is actually no need for the surgeon to be anywhere near the patient: remote operations with the patient and surgeon in different countries or even continents are already practicable.
The first surgery on the heart took place in 1896; and surgery on the great vessels became common practice in the early twentieth century. Early cardiothoracic surgery required stopping the heart and draining it of blood, which was successfully achieved in the 1950's by shunting the patient's circulation through the heart and lungs of a family member during the operation; and later by using a pump oxygenator. In the early 1990's coronary artery bypass surgery was performed with the patient's heart still beating. The first use of the da Vinci surgical robot to assist in cardiothoracic surgery occurred in 1998 when a German surgeon performed the first heart bypass surgery in Leipzig Germany. A year later the first beating-heart coronary artery bypass was performed in Canada. The principal advantage of robot assisted heart surgery is that the incision size does not need to be large enough to accommodate the surgeon's hands. Rather, small incisions just large enough to put the small robot's hands through are all that is required, which means that there is less trauma, blood loss, and quicker healing time for the patient. Many patients can resume playing sports in a few weeks (instead of months) after surgery.
Another medical field which has been completely revolutionized by da Vinci robotics is prostate cancer treatments. Prostate cancer is an illness in which malignant cells grow in the prostate gland. The prostate gland is the part of the male reproductive system which produces semen, located in front of the rectum and below the bladder. Prostate cancer is commonly treated by removing the prostate surgically, known as a radical prostatectomy. Traditional prostatectomy involves large incisions which result in large blood loss and an uncomfortable and lengthy recovery period, with the risk of incontinence and impotence. The minimally-invasive da Vinci prostatectomy leaves small incisions which heal quickly, resulting in early return of continence and sexual function as well as a higher and longer rate of survival than traditional treatments.
The Ilinois da Vinci surgical robot is not only the treatment of choice for cardiothoracic surgery. Small incisions means minimal loss of blood and quick healing time, which has made the da Vinci system the gold standard for prostate cancer treatments as well.
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