Slashdot Mirror

Well, thanks guys. I am happy to provide the perspective of an MD in a sub-specialty. I actually paged a few of my friends that do CT surgery to ask them if they used the da Vinci system because I was curious. All of them had heard of it, and a few had been in cases with it, and again, unfortunately, all of them said it was a sideshow currently. At another major teaching hospital, the most experienced surgeon had about 100 cases with the device: far, far fewer than standard (they do 2-3 operations *per day*.) When used, they had the patient sign special forms beforehand.

On the summary it notes that the da Vinci system has been around since the 90's.

We all agreed it was important stuff though, and should continue with research / development / implementation in some areas.

Somebody said that surgeons hate to admit they are wrong -- yeah, that is generally a stereotype, along with "Americans are all fat," "girls can't do math," and "slashdotters are all virgins in their mother's basement." Sometimes true, but a bit offensive in its generalization. Yes, there are colleagues of mine that are simply arrogant and don't want to talk to patients or can't admit they are wrong, and there are balanced individuals whom I would send any family member to be a patient without hesitation.

Slashdot is fun, and we have EE's, MD's, and prominent programmers (John Carmack, Torvalds, etc.) on here, but also a wealth of teenagers, or their mental/emotional equivalent, that say the dumbest things because their Mom isn't around to tell them to shut up, and think that doing two internet searches is going to provide them with more perspective than a professional and make them seem smart. Not that I can't be wrong, of course, and I love to learn about new technology, but I hope I know what goes on every day at work. :)

I wasn't trying to trap you, but by your response maybe I did?

Since we're trading silly insults, I've heard some surgeons don't really like any hint they might be wrong, about anything, even if its just a silly mistake or outside their field of expertise.

For your information (or rather for someone else reading this who is actually interested), Da Vinci appears to be fully FDA certified, NOT as a research device, for some procedures since 2000 or 2001. I believe they have been certified for some endoscopic cardiac procedures as well. Yes, here's an FDA press release about approval of the device for coronary artery bypass surgery: http://www.fda.gov/bbs/topics/answers/2004/ANS01298.html. (from 2004)

501(k) applications and decisions are here.

From the company's site, listing procedures for which the robot is certified: http://www.intuitivesurgical.com/products/fdaclearance/index.aspx.

The U.S. Food and Drug Administration (FDA) has cleared the da Vinci® Surgical System for adult and pediatric use in urologic surgical procedures, general laparoscopic surgical procedures, gynecologic laparoscopic surgical procedures, general non-cardiovascular thoracoscopic surgical procedures and thoracoscopically assisted cardiotomy procedures. The da Vinci System may also be employed with adjunctive mediastinotomy to perform coronary anastomosis during cardiac revascularization.

Representative Uses: The da Vinci System has been successfully used in the following procedures, among others:

• Radical prostatectomy, pyeloplasty, cystectomy, nephrectomy, ureteral reimplantation
• Hysterectomy, myomectomy and sacrocolpopexy
• Cholecystectomy, Nissen fundoplication, Heller myotomy, gastric bypass, donor nephrectomy, adrenalectomy, splenectomy and bowel resection
• Internal mammary artery mobilization and cardiac tissue ablation
• Mitral valve repair, endoscopic atrial septal defect closure
• Mammary to left anterior descending coronary artery anastomosis for cardiac revascularization with adjunctive mediastinotomy

As a matter of fact, there are already robots that perform (assist, really) surguries. Davinci is the one I've seen. The surgeon sits at a console with a 3D (stereo) view inside the patient with a haptic interface to remote control the robots arms and instruments. Some robots even have a third arm.

The robotic surguries are most important when the surgeon is going to be navigating around lots important nerves. I don't think the robot makes the procedures go any faster, it just improves the success rate. And quite frankly, if you were the patient, you would care far more that the procedure was a success than that it was shorter.

The reason that there will always have to be a human controlling the robot is that even though many cases are routine, the robot won't know what to do when there's a complication. A simple minimally-invasive appendix removal can quickly turn into a full-blown emergency.

dom

I underwent robot-assisted surgery in 2003. A thoracic surgeon used Intuitive Surgical's daVinci robot to remove my thymus. The surgery was very successful. It was a minimally invasive procedure and the recovery was easy (compared to traditional open surgery).

http://www.intuitivesurgical.com/

Computer Integrated Surgical Systems and Technology
http://cisstweb.cs.jhu.edu/

Forbes article: Robo-docs
http://www.forbes.com/free_forbes/2006/0904/100.ht ml

http://www.intuitivesurgical.com/

I have seen a great demonstration of a similar technology used for robotic surgery by
Intuitive Surgical . It is said that by using a robot, our most experienced doctors can extend their careers by 5-10 years since hand tremors do not force them into retirement.

The manufacturer is Intuitive Surgical