1. Robot-Assisted Laparoscopic Surgery - da Vinci System *Some of the slides adopted from: Amanda Neves University of Rhode Island Department of Computer, Electrical, and Biomedical Engineering by Shachar Ilan

2. Robot-Assisted Surgery The Vision – Ridley Scott

3. What is Laparoscopic surgery? Minimally invasive operation performed in pelvis or abdomen through small incisions Done for diagnostic purpose or to perform a surgical procedure

4. Tools for Standard Laparoscopic Surgery Digital laparoscope - Small Camera + Light source Inserted through tiny tube (cannula) to see the operation Abdomen is then inflated with carbon dioxide (not harmful to body) to raise abdominal wall above organs Click for video: https://www.youtube.com/watch?v= 8vlKmnIVxZU

5. Laparoscopic Surgery – Pros and Cons Pros - Patients experience less pain, smaller chance of hemorrhaging, and shorter recovery time Cons - Awkward motion for surgeon Displaced hands and view Requires surgeons to stands Hard to learn – leads to complications with inexperienced doctors Open Surgery ScarLaparoscopy Scar

6. da Vinci System - Console Surgery is performed without any direct contact between surgeon and patient Doctor sits away from operating table at an ergonomic, customizable computer console viewing 3D visual of operative region Can theoretically be in another room (or another continent)

7. da Vinci System - Robot Multi-arm laparoscopic surgery robot replicates the surgeons’ motions with tiny tools inserted in the patients’ body through small incisions. Surgeon's hand movements are scaled, filtered and translated the into more precise micro- movements of the instruments. Click to play: https://www.youtube.com/watch? v=LzYmDbISnzY

8. da Vinci Operation Room

9. Components of da Vinci System Dual consoles allows doctors to collaborate in a very small space. 7 DOF with wrist at tip of tool, allow for a very wide range of motion, wider than a human hand. A variety of tools can be mounted on robotic arms and switched easily. Tool positions can be memorized and re- positioned by system Force applied can be limited electronically Con – Surgeon gets no force feedback

10. da Vinci System – Some Statistics FDA Approved since 2000 Approximately 300,000 da Vinci procedures performed yearly Cost ~1.8M$ + ~150K$ Yearly Maintenance 2000+ Systems installed worldwide ◦ 1500 in USA, 5 in Israel Most common procedures: ◦ hysterectomies and prostate removals

11. Pros and Cons of da Vinci System Pros Can perform more delicate procedures Does not leave a large surgical scar More high risk patients can undergo surgery because it’s less invasive Cons Cost - $1+ million Steep learning curve Expensive training Inability to feel the tissue Surgery with this system takes 40-50 minutes longer

12. Future of Robotic Surgery – Possibilities ◦ Tele-surgery ◦ Haptics ◦ Single incision port with miniature snake-like robotic arms ◦ In-surgery guidance by fusing information from prior CT, PET, MRI etc. ◦ Surgery performed first in simulator planning environment, then robot re-enacts successful surgery on patient ◦ Far future –Semi/Fully automated surgery

13. Thank you Sources: ◦ Amanda Neves, University of Rhode Iland: www.ele.uri.edu/courses/ele482/S10/AmandaN_1.ppt ◦ Anna Oleksiewicz, University of Illinois: https://wiki.engr.illinois.edu/display/BIOE414/Description+of+the+major+components+in+th e+da+Vinci+surgical+system https://wiki.engr.illinois.edu/display/BIOE414/Description+of+the+major+components+in+th e+da+Vinci+surgical+system ◦ Jennifer Poland, Business Insider: http://www.businessinsider.com/the-future-of-robotic-surgery-2012-7 ◦ Ryan Bradley, Fortune: http://tech.fortune.cnn.com/2013/01/15/robotic-surgeons ◦ Intuitive Surgical: http://www.intuitivesurgical.com/ ◦ Dr. Catherine Mohr, TED Talk: http://www.ted.com/talks/catherine_mohr_surgery_s_past_present_and_robotic_futre.html ◦ Wikipedia: http://en.wikipedia.org/wiki/Robotic_surgery