DA VINCI ROBOT / Robotic surgery

In traditional open surgery the surgeon's hands and instruments are often hampered by the cramp conditions of the "surgical field", bleeding, closed view angles. Conventional laparoscopy has then provided more space by insufflating the stomach using CO2 and the introduction of a camera has improved vision which does however remain two-dimensional (flat) and the instruments are still rigid and imprecise. Robotic surgery palliates these two major inconveniences. With robotic surgery equipment, the surgeon can manipulate instruments at a distance and with the utmost precision in a 3D environment.

The Da Vinci Robot is made of two connected equipments : the console  (1) and the arms (2).

The patient is surrounded with a system of three or four arms which the surgeon manipulates at the console.
This allows for the surgeon to visualise the operative field in three dimensions through a binocular camera. This camera offers a high magnification factor (up to 15 times bigger) which therefore makes the use of an optical microscope unnecessary.
The central arm carries the camera which allows the surgeon to view the area to be operated upon. It is linked to a high resolution 3D video system. The three side arms carry the instruments which can be changed according to the surgery procedures undertaken.

These very fine instruments are monitored by the surgeon who is seated at his console, generally a few feet away from the operating table. Next to the patient, the surgeon assistant and surgical technician carry out the switching of instruments, aspiration, threading …

At the disposal of the surgeon there is a series of hand and feet commands (3) which allow him or her to take control of the camera, set in action coagulation , adjust focus / sharpness, re-position the static instruments or find a more comfortable seated position at the console.
The surgeon’s movements are being exactly replicated.

The precision is even improved by miniaturisation and mobility ( 7 degrees of freedom) of the instruments extremities.
Technical devices make the parasite movements disappear, thereby adding to the fluidity of gestures and eliminating trembling.
This robot allows for potential improvement of operating results. It diminishes pains and bleeding and shortens the hospital stay .

Its applications are numerous, for all type of surgery.

This robot, the Da Vinci (Intuitive Company), is the only surgical robot commercially available on the international market. Robotic surgery of prostate cancer is at present the surgical reference in the United States where ,the benefits in terms of incontinence and impotence having been established , almost all surgery procedures are carried out using this robotic technique.

Our current skill is based on more than 2000 robotics procedures.

What are types of surgery concerned ?

Several surgeons working at the clinic have undergone a thorough training in the use of this new technology.
Urology surgery, gynaecology surgery, digestive surgery are the main specialities concerned.

One surgery procedure a day on average is carried out at the clinic.
The surgery procedures now available with the robot are :

  • In Urology : prostate, kidney, bladder and urethra surgery.
  • In Gynaecology : fertility surgery, hysterectomies, lombo-aortic and pelvic lymphanedectomy , prolapse surgery.
  • In Digestive surgery : gastric and rectal surgery, surgery in the treatment of obesit. 


What benefits ?

High precision equipment means that the surgeon can have a three-dimensional view and a safe access to the operative/surgical field making it less open to infectious contaminations.

Studies show less bleeding, less post-operative pains, a better respect of the neighbouring organs and nerve structures.
It reduces the number of complications linked to surgery procedures and the length of hospital stay.

Robotic surgery with the Da Vinci system has already been recognized as a major evolution in modern surgery just like laparoscopy was twenty years ago.
It is not a robot that is operating you, your surgeon’s hands are operating you using the latest technology. 


What is the robot ?

It is a highly precise equipment which has been conceived exclusively for minimally invasive surgery. The Da Vinci robot is a remote manipulation surgical system made of two interconnecting modules : a monitoring console and articulated arms.  


How does it work ? 

The surgeon, seated behind the console, now works with ultra-precise articulated handles remotely operating the robot’s arms which reproduce his movements with no trembling interference .

Surgical gestures are precisely translated and geared down thanks to fine 8 mm instruments which are at the entire disposal of the surgeon’s hands movements
( 540° of freedom, more than the human hand !).

The monitoring console allows the surgeon to visualise the operating field in three dimensions ( thanks to a binocular camera whose control is in his hands). There is a choice of an enlargement / magnyfying factor (up to 20 times).

The patient is surrounded by three to four robotic arms which the surgeon operates from the console. The surgical technician / operating theatre nurse / surgeon assistant is always in attendance next to the patient.

The three lateral arms carry the instruments which may be changed depending on the surgery procedures by the surgical technician.
The central arm carries the optical to view the area to be operated and is linked to a 3D vision system.