In 2002, University of Iowa Hospitals and Clinics became one of the first hospitals in the state to acquire new robotic technology for certain surgical treatments. The da Vinci system has been updated and UI Hospitals and Clinics has recently acquired a second, more sophisticated robotic surgical system, called the da Vinci S.
Howard Winfield, MD, FACS, director of Urologic Laparoscopic Surgery and Endourology as well as director of Robotic surgery at UI Hospitals and Clinics, talks about this updated robotic system:
How does the da Vinci robotic system work?
The da Vinci robot systems consist of three key components:
- The robot platform which has either three or four arms attached
- the surgeon console at which the surgeon sits and controls the robotic arms
- The tower that houses the powerful light sources
Instruments are attached to the robot arms and then passed down the very thin, hollow tubes (or what we call laproscopic ports) to the patient to perform the surgery.
"Robotic" sounds like surgeons and staffs are not involved in procedures, is that correct?
No, absolutely not. The surgeons and staff are very much involved in the surgery. One surgeon sits at the console and controls the robotic arms, but there needs to be at least one or two assistants at the tableside or at the patient side. In addition, we have the OR nursing staff, as well as anesthesia staff involved in the procedure.
What types of surgical procedures are ideal for the da Vinci system?
University if Iowa Hospitals and Clinics, we have four surgical services that use the robot:
- Urology - Robotically-assisted radical prostatectomy for patients with prostate cancer; robotically-assisted pyeloplasty for patients who have obstruction of the urethra-pelvic junction.
- Gynecology - Hysterectomies, lymph node dissections, myomectomies, and tubal reanastomoses.
- Cardiovascular surgery - Esophageal procedures and some aspects of cardiac bypass surgery and valve surgery.
- Pediatric general surgeons - Variety of procedures related to the stomach, the spleen, the intestine
Do patients need to qualify to be considered for a da Vinci procedure ?
Patients who would qualify for an open or laproscopic approach would be candidates for a robot procedure. However there may be certain surgical issues, such as if they are significantly obese or they've had a lot of previous surgery which might have lead to a lot of scar tissue within their abdominal or chest cavity.
How is the new da Vinci S different from the current robotic system?
The new da Vinci Vision S system has four arms instead of three arms which are on the initial da Vinci system. The da Vinci S Vision system is high definition and we have the ability to change the magnification as we proceed. It also allows us to teach better with tele-illustration. I think these are the major big differences.
Does the new da Vinci S system allow for different types of procedures the first da Vinci is not capable of doing ?
No, I think that the earlier machine was able to do all that the four-arm, new machine can do, the fourth arm makes it easier. It's like having another hand, so to speak, in the procedure.
With the new da Vinci S system on board, will the older robotic system be retired?
No. Our surgical volume for robotic surgery has increased, so having two units allows us to handle the larger clinical load. I think that if we get a third robot unit, this would allow the original machine to be transferred down to the laboratory for teaching and research purposes.
How long has the da Vinci S system been in use at UI Hospitals and Clinics?
We have been using the new da Vinci S system since September of 2007, so we're going on about seven or eight months.
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