Da Vinci Robot
TECHNOLOGICAL EVOLUTION
WHAT IS?
Although it is known as a robot, it actually is a “master-slave” instrument, that is, it is neither autonomous nor programmable and therefore, its actuation is surgeon-dependent. Videos related to this section reveal very much of its structure and functioning.
HISTORY
Once again, its application comes from innovations on fields distant to medical practice, in this case, it was the U.S. Defense Department. It was designed in the late 90’s with a subsequent fast international development.
PRACTICAL APPLICATION
The most frequent indication is the Radical prostatecnomy, that is, the complete removal of the prostate and seminal vesicles in the prostate cancer diagnosis.
The indication of Partial nephrectomy is becoming more frequent due to the high number of incidental kidney masses diagnoses. But it must be said that its use is spreading due to the advantages it provides: pyeloplasty for pyeloureteral junction stenosis, radical cystectomy for bladder cancer, urethral replantation for stenosis, colposacropexy for cystocele…
ADVANTAGES
· Laparoscopic Access: that is, no conventional abdominal incision, less pain, fewer complications of surgical wound, faster recovery, early hospital discharge.
· Technologic innovations: mobility of the robots grippers, 3-D vision, no tremors, surgeons ergonomics….provide definitive competitive advantages over conventional surgery and pure laparoscopy. All this is translated in better functional results on the patient (as for example erectile dysfunction and incontinence on radical prostatectomy), in the possibility of more complex surgical interventions (robotic partial nephrectomy), lower percentage of transfusions…
FUTURE
From its appearance, there have been constant improvements on each of its applications (vision, miniaturization, associated fluorescence…)