Page 27 - World Association of Laparoscopic Surgeons - Journal

B Srinivas

The da Vinci surgical system comprises three AIM OF STUDY
components:
The aim of this review article is to appraise and to evaluate
• A surgeon’s console,
the present and future role of robotics in Whipple’s surgery.
• A patient-side robotic cart with four arms manipulated
The following parameters were evaluated:
by the surgeon (one to control the camera and three to
1. Patient and disease factors
manipulate instruments), and
2. Technical considerations
• A high-definition 3D vision system. Articulating surgical
3. Operating time
instruments are mounted on the robotic arms which are
4. Intra- and postoperative complications
introduced into the body through cannulas.
5. Postoperative morbidity
Three generations of da Vinci surgical systems have 6. Hospital stay
developed so far: 8
7. Cost-effectiveness
1. da Vinci surgical system (1999): It consists of three
8. Quality of life analysis.
components: The viewing and control console, surgical
arm unit (three or four arms depending on the model) MATERIALS AND METHODS
and optical three-dimensional vision tower (Figs 1A to C).
A literature search was performed using search engine
2. da Vinci S HD surgical system (2006): This second
google, Springer, HighWire, Sages, IJA, PubMed, etc. and
generation surgical robot is equipped with wide range
the literature analyzed.
of motion of robotic arms and extended length
instruments, interactive video displays and touch screen
KEYWORDS
monitor.
3. da Vinci Si HD surgical system (2009): It has • da Vinci robotic system
dual console capability to support training and • Robotic Whipple
collaboration, advanced 3D HD visualization with up • Robotic pancreaticoduodenectomy
to 10× magnification, ‘EndoWrist’ ® instrumentation • Robotic surgery
with dexterity and range of motion more than the human • Minimally invasive surgery
®
hand and ‘Intuitive motion technology’(Figs 2A and B), • Pancreatectomy
which replicates the experience of open surgery by • Pancreatic resection
8
preserving natural eye-hand-instrument alignment. The • Pancreaticoduodenectomy
new da Vinci HD SI released in April, 2009 currently • Whipple’s surgery.
sells for $1.75 million.
CARCINOMA OF THE PANCREAS AND
SYNONYMS PERIAMPULLARY AREA
• Robotic surgery Essentials of diagnosis:
• Computer-assisted surgery • Obstructive jaundice (may be painless)
• Robotically-assisted surgery. • Enlarged gallbladder (Courvoisier’s sign)

A B C
Figs 1A to C: (A) The da Vinci system surgeon console (B) The cart with three mounted surgical arms (C) joysticks with
viewing ports in the console (courtesy: Intuitive Surgical Inc, Sunnyvale, CA)

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