Da Vinci (robot surgeon)

Main article: Robotic surgeons

Da Vinci (robot surgeon) is a surgical device manufactured by Intuitive Surgical. The equipment contains two units: one of them is intended for a surgeon-operator, and the second - a four-armed robot-manipulator - is an executive device. One of the robot's "hands" holds a video camera transmitting an image of the operated area, the other two reproduce the movements made by the surgeon in real time, and the fourth "hand" acts as an assistant surgeon.

2024: Robot Surgeon da Vinci 5 Announcement

In mid-March 2024, the American company Intuitive Surgical introduced a new generation robotic surgical system - the da Vinci 5 complex for minimally invasive operations. It is claimed to be Intuitive Surgical's most productive and intelligent platform.

Among the key advantages of da Vinci 5 the developer names tissue recognition technology, vibration and tremor control, improved three-dimensional visualization and high-precision navigation. Computing performance has increased approximately 10 thousand times compared to the previous generation da Vinci Xi complex.

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Other new features include improved console ergonomics designed to make it more comfortable for surgeons, as well as various improvements to simplify the workflow. In addition, the da Vinci 5 complex takes up less space in the operating room, thanks to which it is possible to further optimize the activities of medical teams. Feedback technology measures the pressure exerted on body tissue during surgery, which helps to improve the effectiveness of procedures and reduce the traumatic impact on the patient.

According to Intuitive Surgical, the da Vinci 5 platform helps to reduce the time for minimally invasive operations, thanks to which medical institutions can increase the throughput of patients. The new system is compatible with da Vinci Xi tools, making it easier to integrate into existing processes.

We believe da Vinci 5 is a breakthrough in robotic surgery. In preclinical trials, surgeons who used feedback tools had significantly less tissue impact, which can make procedures less traumatic compared to da Vinci Xi, says Myriam Curet, Chief Medical Officer of Intuitive.[1]

2023: Use for prostate removal begins

On April 28, 2023, the American company Intuitive announced the start of using the da Vinci SP robotic surgical system to perform a so-called simple prostatectomy.

This procedure is prescribed to patients with benign prostatic hyperplasia (BPH) - this is an overgrowth of prostate tissues without a tendency to damage neighboring structures or metastasis. The essence of the operation boils down to the fact that the surgeon removes the part of the enlarged prostate that blocks the flow of urine. At the same time, with radical prostatectomy, the surgeon removes the entire prostate gland - most often in patients diagnosed with cancer.

Robot surgeon da Vinci SP (Single Port)

The da Vinci SP (Single Port) platform provides doctors with a robotic system designed for deep access to body tissues. The ability to penetrate through a single small incision or through a natural opening can provide minimally invasive intervention in complex surgical procedures. This approach minimizes possible risks, reduces the level of postoperative discomfort for patients and speeds up rehabilitation.

The da Vinci SP system includes three multi-barrel instruments and a high-resolution 3D camera: they exit through a single cannula 2.5 cm in diameter. A special design avoids instrument collisions in narrow surgical workspaces. Doctors control the system through the same console as used in da Vinci X and Xi. It is possible to reach a penetration depth of up to 24 cm. In addition, you can triangulate instruments at the distal end. A key difference between the da Vinci SP system and its predecessors is that access to the patient's body is performed through a single incision.^[2]

2020: Systems recall due to defective software

In early June 2020, the Food and Drug Administration (FDA) announced the recall of the da Vinci SP robotic surgical system. The recall belongs to the second hazard category.

Initially, the company Intuitive Surgical initiated a recall of 17 versions of the device. According to the regulator's database, the company learned that the use of the da Vinci SP robotic system could be accompanied by mechanical vibration of the tool tips and endoscope due to a defect. software

Da Vinci robot surgeons recall over defective software

Vibration occurs only in rare, specific conditions, including when the user activates the "Adjust Mode," when the tool handle approaches its limit of vertical position, and when the user applies a stable force to the manual control device using the tactile feedback method.

On April 1, 2019, Intuitive Surgical sent a notice to buyers confirming that it would update the software on the ground as soon as possible by prior arrangement.

Customers are strongly advised to inform all personnel related to the damaged device that if in "Adjustment Mode" they feel the vibration of the instrument and/or endoscope tips and the instrument bracket approaches its vertical limit, they must stop applying a constant force to the manual control device by tactile feedback, exit the "Adjust Mode" or press the "Emergency Stop" button.

If mechanical vibration persists after these actions, customers were advised to stop using the system and contact technical support.^[3]

2019: Hospitals stage shenanigans with da Vinci robotic surgeons

In mid-April 2019, Taiwan's national health insurance authority accused several hospitals of fraud - they overestimated in reports the number of operations performed using da Vinci robotic surgical platforms manufactured by Intuitive Surgical.

Hospitals overstate operations by da Vinci robot surgeons to get reimbursement from state

The manufacturer's report revealed a discrepancy between data provided by hospital administrators and the number of operations performed on the da Vinci platform. These results were confirmed by an analysis conducted by Taiwan's health insurance authority.

A total of 13,903 operations were performed between early 2015 and February 2019, according to the report. Taiwan questioned 7,810 insurance claims totaling more than $11.3 million. In addition, it became known that in some hospitals patients had to pay for the operation (from $5,831 to $6,479), and the hospital management simultaneously applied for reimbursement of the costs covered by medical insurance, thereby receiving a double fee.

Of the 19 Taiwanese medical centers, 12 performed more than 200 operations a year using the da Vinci surgical platform, according to a report in the Taipei Times newspaper. Five of these centers sent falsified reports to the insurance organization, overstating the number of transactions carried out by more than 20%. The most suspicious data were found in the reports of Taipei Medical University Hospital (2,144 operations), China Medical University Hospital, Lin Chiang Gong Memorial Hospital, Shuang Ho Hospital of Taipei Medical University and Taiwan National University Hospital.

The Taiwan Health Insurance Authority has given hospitals one week to correct reports, adding that institutions will have to return illegally received money.^[4]

2016: Russia's first abdominal aorta surgery with a robot assistant

In November 2016, at the Novosibirsk Research Institute of Circulatory Pathology (NNIIPK) named after Academician E.N. Meshalkin, they performed the first operation on the abdominal aorta in Russia using a robot. This was reported on the website of the institution.

The da Vinci robotic surgical complex assisted in laparoscopic aorto-femoral bypass surgery - bypassing the affected aorta with a vascular prosthesis. Read more here.

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