The past 20 years have brought about revolutionary changes in surgical technique and technology. A new surgical approach and approach was developed, which was called minimally invasive surgery (IIR).
Although MII strikingly reduces operational trauma and, accordingly, the length of hospitalization, it has significant technical disadvantages. The surgeon operates using a standard two-dimensional video monitor, instead of looking at his own hands. Video flattenes the natural depth of the surgical field, and fixed wrists and instruments limit motor capabilities. The lack of three-dimensional visualization of the surgical field, poor ergonomics and controllability are the main constraints on further progress. As a result, endoscopic surgery, as a form of IIR, limits its use to only a narrow circle of surgical interventions.
The revolutionary frontier in the development of surgical technology was achieved with the advent of the Da Vinci system. It is equipped with manipulators with artificial wrists having seven degrees of freedom (similar to a human hand) and three-dimensional intuitive visualization (3D monitor). These innovations created the prerequisites for minimally invasive complex operations in various fields of surgery.
The Da Vinci system improves surgical outcomes by fundamentally changing surgery in three ways:
Many of the surgical procedures performed today using standard equipment can be performed faster and easier with the system, because Da Vinci creates “visibility and sensation” similar to open surgery.
A number of operations that could not be performed using traditional minimally invasive technologies can now be done using a surgical complex. The large EndoWrist toolkit allows surgeons to do more operations through small accesses.
The surgical system consists of an ergonomic surgeon console, a stand with four interactive robotic arms at the operating table, a high-performance InSite viewing system and patented EndoWrist tools. Armed with state-of-the-art robotic technology, the surgeon’s hand movements are scaled, filtered and evenly converted to the exact movements of EndoWrist instruments. The result is an intuitive interface with superior surgical capabilities.
Surgical System Components
Using Da Vinci, the surgeon operates by sitting comfortably at the console and seeing a three-dimensional image of the surgical field.
The surgeon's fingers grab the handles under the display, and his hands and wrists are naturally positioned in relation to his eyes. The system evenly translates the movements of the fingers, brushes and wrists of the surgeon into the exact movements of surgical instruments inside the patient in real time.
The system rack holds up to four electromechanical hands manipulating tools. Tools and the camera are easily attached to the hands and easily moved from the console or assistant.
The first two hands of the robot, corresponding to the surgeon's right and left hands, hold EndoWrist tools. The third hand holds the endoscope, allowing the surgeon to easily change, move, zoom in and turn the field of view from the console. This mobility eliminates the need for an assistant.
The fourth hand allows you to add a third EndoWrist tool and perform additional tasks, such as supporting continuous seam. This eliminates the need for another assistant.
The surgeon can simultaneously control any two hands using the pedals under the console.
Patterned after the human wrist, EndoWrist instruments have even greater range of motion than the human hand. They truly allow the system to advance surgical accuracy and technique beyond the capabilities of the human hand. Similar to human tendons, the EndoWrist internal tool cables provide maximum response, enabling fast and accurate suturing, dissection and tissue manipulation. A manipulator with a tool at its end has 7 degrees of mobility, like a human hand.
The InSite viewing system with a high-resolution 3D endoscope and image processing system provides a natural image of the surgical field. An endoscope controlled by a robotic arm, coupled with two 3-chip cameras, transfers the surgeon “inside” the patient.
The Intuitive Surgical video system is equipped with two independent image transmission channels paired with two high-resolution color monitors. The system also has image processing equipment consisting of two video cameras, edge enhancement algorithms and noise reduction.
The resulting high-resolution three-dimensional image is bright, clear and sharp, without tiring flickering and attenuation. Camera control through handles and pedals ensures smooth movement in the operating space. Moving the surgeon’s head on the console does not affect image quality.
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