0 Preface
The Da Vinci surgical robot is an intelligent surgical platform widely used in the world. It is suitable for minimally invasive surgery in general surgery, urology, cardiovascular surgery, thoracic surgery, gynecology, ENT, and pediatric surgery. For decades, the development of minimally invasive surgical techniques has revolutionized the development of surgical procedures, and the endoscopic surgical robots based on Da Vinci surgical robots have further broadened the scope of minimally invasive surgery and led The high-tech and cutting-edge level of minimally invasive surgery. Da Vinci Surgical Robot is the only intelligent endoscope minimally invasive surgery system approved by the FDA (US Food and Drug Administration) for surgical clinical treatment. It has been put into clinical application since 2000. China was Beijing in 2008. The People's Liberation Army General Hospital took the lead in introducing.
1 International Da Vinci Surgical Robot Application Overview
1.1 Da Vinci Surgical Robot System Features and Latest Technology Progress
The Da Vinci surgical robot is manufactured by Intuitive Surgical. The Da Vinci surgical robot has high-definition 3D video imaging technology, and the image under the microscope can be magnified 10 times or more. The surgeon can control the joystick to remotely control the 8mm diameter mechanical arm into the body cavity for surgery. The surgical instrument movement has 7 freedoms. At the same time, the physiological vibration of the human hand is filtered out; the surgeon takes a sitting position and remotely controls the operation to avoid direct contact with the patient.
After nearly a decade of development and replacement, the second generation of DaVinciS (2005) surgical robots and the third generation Da Vinci (2008) surgical robots are currently in clinical use.
The first generation of DaVinci Standard (2000) surgical robots and Aesop (AESOP, 1994) and Zeus (ZEUS, 1999) surgical robots have been eliminated, and manufacturers no longer sell and provide technical support. Da Vinci surgical robot products and their associated equipment are still developing and innovating. New technologies for the third-generation Da Vinci surgical robot include: dual consoles for dual control, Da Vinci surgical simulators, intraoperative fluorescence imaging, and single-hole surgical equipment. At present, the latter two have not yet obtained the SFDA registration certification in China.
1.1.1 Dual console for two people
The third-generation Da Vinci surgical robot supports dual consoles for simultaneous manipulation by two doctors. The Da Vinci surgical robot has a lens arm and three instrument arms. A doctor can only control one lens arm at a time.
Or two instrument arms, when you need to control the third instrument arm, you need to use the foot pedal to switch operations. In the case of a double dual console, the two doctors can simultaneously control the movement of the three arms, and can optimize some surgical steps to improve efficiency and save operation time. The dual console can also be used by experienced robotic doctors to teach novice robotic doctors.
1.1.2 Da Vinci Surgery Simulator
The third-party software company MIMIC's DaVinci surgery simulation training program can now be combined with the third-generation Da Vinci surgical robot's console through an external chassis for doctors to perform simulation training. The current training content is a virtual reality tutorial, which makes the controller familiar with the manipulation of the robot's handles and pedals. Using the Da Vinci Surgery Simulator can shorten the doctor's learning process, correct some erroneous operations, or save the economic cost of animal surgery experiments.
1.1.3 Intraoperative Fluorescence Imaging Technology
A fluorescent dye called indigo green is injected into human blood, which will bind to plasma proteins and can be captured by a special near-infrared camera lens. The third-generation Da Vinci surgical robot can simultaneously display captured images and display bright green in the doctor's field of vision. According to the phase after the dye is injected into the blood vessel, the doctor can identify the arteries, veins, biliary tract, ureter and other tissues to facilitate the doctor to identify the complex anatomical region and determine the blood supply to the digestive tract. Depending on the specific tropism of the dye for specific tumors, metastatic lymph nodes, and adjacent organ tissues, doctors can also obtain judgments that are different from ordinary macroscopic observations to facilitate doctors to determine tumor boundaries in solid organs and to find lymph nodes in adipose tissue.
1.1.4 Single hole surgical equipment
The third-generation Da Vinci surgical robot will be able to perform single-hole robotic surgery. Through a special sleeve, a lens arm and two crossed bending arms enter the body cavity, the robot software will control the handle and
The device is re-paired so that the doctor's left hand continues to control the instrument on the left side of the field of view, and the right hand controls the instrument on the right side of the field of view, thus avoiding the discomfort of the right-handed laparoscopic right-handed reverse cross-control, reducing the difficulty of single-hole surgery.
1.2 Overview of the application of Da Vinci surgical robots in China
By the end of 2012, there were 14 hospitals equipped with Da Vinci surgical robots in China (excluding Hong Kong, Macao and Taiwan), and 15 Da Vinci surgical robots were deployed, including 4 local level A general hospitals: Huadong, Fudan University Hospital, Ruijin Hospital affiliated to Shanghai Jiaotong University, Zhongshan Hospital affiliated to Fudan University, Peking Union Medical College Hospital; 2 local level A special hospitals: Beijing Ditan Hospital, Shanghai Jiaotong University Affiliated Chest Hospital; Military Grade III A General Hospital 7 Home: Beijing People's Liberation Army General Hospital (2 units), Beijing People's Liberation Army Second Artillery General Hospital, Southwest Hospital of the Third Military Medical University, Nanjing General Hospital of Nanjing Military Region, Shenyang Military Region General Hospital, Changhai Hospital affiliated to the Second Military Medical University, Jinan Military Region General Hospital, Xijing Hospital affiliated to the Fourth Military Medical University. In July 2012, the first robotic surgery academic group in China, the Robotic Surgery Committee of the Surgical Branch of the Chinese Medical Association, was established.
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