da Vinci X and XI I&A Flashcards
Traditional Instruments - Design, Use, Advantages, Challenges
Design: larger & handheld at patient-side
Use: primarily open surgery, but also used in MI procedures
Adv: intuitive instrument control, high level of accessibility, lower costs, well established work-flow
Challenge: invasive - larger incisions sites, ergonomically challenging.
Laparoscopic instruments - Design, use, advantage, challenge
Design: long-shafted, and handheld at patient side
use: laparoscopic procedures, also robotic
Adv: MI incisions, shorter length of stay, recovery time, risk of infection
Challenge: counterintuitive and limited instrument control. 2D vision, awkward positions.
Robotic instruments: Design, uses, Advantages, Challenges
Design: long-shafted, mounted on patient cart at patient side
Use: robotic procedures
Adv: MI, Ergo friendly, intuitive control, greater range of motion than the hand. built in safety features
Challenge: initial learning curve
Features of da Vinci Xi instruments – Flexibility
8mm w/ multiple tip designs
range of motion greater than the hand
7 degrees of freedom
90 degrees of articulation
540 degrees of rotation
Features of da Vinci Xi instruments – Control
Remote center technology
Intuitive motion: alignment of the instrument tip to hand movement
Motion scaling
tremor filtration
Architecture - Housing
EndoWrist component that interfaces with the robotic patient cart.
What does the housing contain - side
Release button - used to remove the instrument
Maximum use indicator - turns red when the instrument has reaching its max us
What does the housing contain - top
Grip release socket - used to open or move grips manually during system fault
Cautery cord interface - used to connect monopolar and bipolar energy instruments to an ESU
What does the housing contain - back
The flush ports - used for cleaning the insides of the instruments
What does the housing contain - front
Discs - translate the movements at the surgeons hand controls to the movements of the shaft, wrist, and jaws
Components of the jaws
wrist, tines, tips
Closing force - definition, use
force generated at the tip of an instruments jaws
pre-programed, can be higher or lower depending on instrument type.
jaw length - definition
distance between distal joint of wrist and distal tip of jaws
jaw open angle - definition
angle between tines when jaws are completely open
Jaw inner surface geometry - definition and 2 notable features
shape of the interior surface of the jaws
- Serration
- Fenestration
Serration - definition
the presence of “teeth” along the inner surface of the jaw.
Fenestration - its benefit
The presence of a window within the times of a jaw
allows for some tissue to protrude through the window in the tines, allowing for a more secure grip
What happens if a higher closing force is applied
can create more pressure on the tissue, which can lead to relatively higher tissue trauma
What is the benefit of a higher surface area
allows for lower pressure applied to the tissue
Serration - benefit / disadvantage
Benefit: a more firm grip
disadvantage: higher tissue trauma
Lives/ fires - definition
the number of uses for which instruments are indicated
When is an instrument life/fire used?
when the instrument has been installed and is brought under surgeon control
What happens when the instrument is out of lives/fires?
it will not engage, and a message on the system will state that the instrument has expired.
How many lives/fires for each:
8mm?
training instruments?
Clip appliers?
8mm - 10-18
training - 30
clip appliers - 100
