a victim of uncontrolled trauma a
surgical patient is exposed to trauma
but the trauma is controlled abdominal
operations have traditionally required
large incisions larger the incision the
bigger the trauma surgery with smaller
incisions has significant benefits less
pain quicker recovery more cosmetically
appealing and they probably have less of
an insult to the immune system
laparoscopic surgery is a way to do a
number of abdominal operations with tiny
incisions this is accomplished by
inserting cannulas or trocars through
the abdominal wall a camera and
instruments are inserted through the
trocar the images are projected onto a
monitor the surgeon stands at the
bedside stares at the monitor and
manipulates the target Anatomy with
instruments that basically opened or
similarly places trocars and instruments
into the abdominal cavity but these
instruments are connected to robotic
arms this has a major difference because
the vision is much much better
the camera with a robotic platform
preserves depth perception there’s a
lens for the left eye and a lens for the
right eye so you see the target Anatomy
in three dimensions as it truly is as
opposed to looking at a monitor it’s
only two dimensions the first video this
is an incarcerated left inguinal hernia
I’m operating with three active arms a
camera and two instruments the robotic
instruments are not rigid but wristed so
the tip is flexible and fully controlled
from the console not at the patient’s
bedside this allows for a more precise
anatomic dissection this is the hernia
here which may appear to be winning this
tug-of-war what will ultimately succumb
the hernias nose is no match for a
surgeon in a robot there’s some
dissection just producing this
incarcerate appropriate nail fad and
peritoneum but soon you’ll see a hole
which is very obvious and the remaining
part of that operation is to place
basically a large patch at over that
hole the in more complex operations you
can introduce there we go
and more complex operations you can
introduce a third arm so you have a
camera and three arms and that can be
useful in a number of different ways the
second video is a cholecystectomy which
is to remove a patient’s gallbladder if
you were a guest in the operating room
the OU our staff would tell you that
robotic cases are quite different than
any other procedures we do in the
operating room the surgeon is not at the
patient’s bedside except for placing the
instruments through the abdominal wall
but is actually sitting at the console
and appears to be playing a video game
but is in fact doing the operation
because I mentioned earlier with with
more complicated cases you can introduce
instruments that have even more of a
versatility than these see two of these
instruments are not wristed but but
rigid
so the laparoscopic instruments are as I
showed before are just straight that
open and close and the robotic
instruments the tip moves that’s what we
call wristed not rigid and it actually
has more degrees of freedom than a human
wrist and as I mentioned a moment ago
you get to have a third wrist I’ve been
in the practice of general surgery for
26 years have done thousands of
operations most peering into a surgical
wound or staring at a monitor more
recently I’ve had the privilege to do
those same operations robotically the
difference is truly amazing and it’s
predicated on the vision imagine walking
by a house in your neighborhood a
thousand times
every time you look in the house you
can’t see anything because the curtains
are drawn but then one day you walk by
the same house and you notice it looks a
little bit different the curtains not
there anymore
you take a look inside things look very
familiar they’re familiar because you’ve
read about them in anatomy textbooks
seeing illustrations but today you’re
the operating surgeon and you’re seeing
subtle anatomic features for the first
time and you’ve been in this
neighborhood thousands of times it’s an
amazing and lightning and inspiring
experience that never gets old
this is why I believe that surgery is
more precise on a robotic platform and
that the DaVinci robot changes the
paradigm and general surgery these are
the two critical structures during the
procedure one is a cystic duct the other
Cystic artery in a moment you’re gonna
see a change in color it’s a pretty
remarkable flash fairness so that was
the highlight so that is not an angry
patient turning into the Incredible Hulk
it’s actually technology called Firefly
and it’s a way during an operation in
real time to highlight different parts
of the anatomy and it’s a quite useful
tool thanks for your attention [Applause]