da vinci Flashcards
what are some critics towards robotic surgery?
- complicated
- learning curve
- expensive
- not superior
- not needed
- just marketing
what are the challenges in minimally invasive surgery?
- reduced degrees of freedom
- limited operating field
- leverage effects
- axial instruments
- space and depth assessment
- video eye-hand coordination
what are the components of the DaVinci robot? main function?
- console (2): where the surgeon is
- vision cart
- patient cart: 4 arms for instruments/camera
4 characteristics of the intruments
- natural movements
- like human hand
- smaller
- more flexible
what is one optional device that we can attach to the console?
simulator -> exercises with scores, cloud based
what are the 5 steps in the fundamentals setup of the robot?
1) port placement
2) deploy for docking
3) drive laser lines to endoscope port
4) perform targeting
5) perform manual arm adjustements
give 6 technical advantages of the robot
- best endoscopic camera
- fluorescence integrated
- more flexible than laparascopy
- comfortable for surgeon
- teaching console
- no tremor
give 6 limitations of the robot
- no haptic feedback
- just a manipulator (doesn’t do everything by itself)
- cost
- limited to one company
- another learning curve
- more prep before surgery
give examples of complex surgeries that could be performed with the DaVinci
- esophagus
- complex hernias
- colon and rectum
- pancreas
- liver
what is the difference between the learning curve of robotics vs laparascopy?
the robotics curve starts higher than the other, but the intersecting point is at 41 cases -> OR time becomes lower for robotics
what is the problem regarding research in robotic surgery? some reasons for the lack of evidence?
- only a few randomized trials
- not good quality evidence
- many unanswered questions
- often conflict of interest
- good results without the robot
- development is in small steps
- often the wrong questions asked in the trials/ groups too small
what is one way we could overcome the problem of the limited randomized trials?
enrol as many parameters as possible in data bases -> perform large data base analysis (possible problem of personal data protection)
where does the DaVinci save money?
less material to be bought, shorter hospital stays, lower cost per case because high case volume
what are the advantages of having competitors for the robot market?
- costs will decrease
- more and faster innovation
- more choices
how could AI assist robotic surgery in the future?
- recognize anatomy and situations
- warn / clues
- assist with camera
- help with navigation
- semiautonome surgeries
- complete autonome surgeries
