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The Value Of Da Vinci Surgery
 

The Value Of Da Vinci Surgery

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daVinci surgery has replaced open and laparoscopic surgery for many operations due to the many advantages of using the robotic interface

daVinci surgery has replaced open and laparoscopic surgery for many operations due to the many advantages of using the robotic interface

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    The Value Of Da Vinci Surgery The Value Of Da Vinci Surgery Presentation Transcript

    • The da Vinci Advantage:The Value of daVinci Surgery
      Randy Fagin, MD
      Senior Medical Advisor – Training | Intuitive Surgical
      Director of Robotic Surgery | The Hospital at Westlake Medical Center
    • The da Vinci Advantage:Why Listen to Me
      In 2000 I trained in LRP with Bertrand Guionneau and Guy Valancien in Paris, France
      I performed over 300 LRP
      Operative Time 2 - 2½ hours
      Blood transfusion rate less than 1%
      Return to erections 75%
      I assumed what I was doing was “best in class”
      I felt threatened by da Vinci surgery
      I believed “you don’t need a fancy multimillion dollar robot to do a good operation”
    • The da Vinci Advantage:Why Listen to Me:
      In 2000 I trained in LRP with Bertrand Guionneau and Guy Valancien in Paris, France
      I performed over 300 LRP
      Operative Time 2 - 2½ hours
      Blood transfusion rate less than 1%
      Return to erections 75%
      I assumed what I was doing was “best in class”
      I felt threatened by da Vinci surgery
      I believed “you don’t need a fancy multimillion dollar robot to do a good operation”
    • The da Vinci Advantage:Why Listen to Me:
      “you don’t need a fancy multimillion dollar robot to do a good operation”
      TRUE
      However, you do need one if you want to do a better operation
    • The da Vinci Advantage:Why Listen to Me
      “you don’t need a fancy multimillion dollar robot to do a good operation”
      TRUE
      However, you do need one if you want to do a better operation
    • The da Vinci Advantage:Why Listen to Me:
      On August 22nd, 2003 I sat down for the 1st time at a da Vinci console
      I spent the next 12 months on a mission to get my hospital to purchase a daVinci system
    • The da Vinci Advantage:Why Listen to Me
      Monday October 1, 2004 I performed my first dVP
      Monday April 25, 2005 I performed dVP #200
      Wednesday April 27, 2005 I performed 2dVP’s
      Thursday April 28, 2005 I performed 1 LRP
      some insurance would not cover da Vinci surgery back then
      Friday April 28, 2005 I decided never to perform another LRP again
      As of today I have performed ≈2,000 dVP’s my patients have come from
      over 30 of the United States
      and 12 countries
    • The da Vinci Advantage:Why Listen to Me
      Monday October 1, 2004 I performed my first dVP
      Monday April 25, 2005 I performed dVP #200
      Wednesday April 27, 2005 I performed 2dVP’s
      Thursday April 28, 2005 I performed 1 LRP
      some insurance would not cover da Vinci surgery back then
      Friday April 28, 2005 I decided never to perform another LRP again
      As of today I have performed ≈2,000 dVP’s my patients have come from
      over 30 of the United States
      and 12 countries
    • The da Vinci Advantage:Why Listen to Me
      Monday October 1, 2004 I performed my first dVP
      Monday April 25, 2005 I performed dVP #200
      Wednesday April 27, 2005 I performed 2dVP’s
      Thursday April 28, 2005 I performed 1 LRP
      some insurance would not cover da Vinci surgery back then
      Friday April 28, 2005 I decided never to perform another LRP again
      As of today I have performed ≈2,000 dVP’s my patients have come from
      over 30 of the United States
      and 12 countries
    • The da Vinci Advantage:Why Listen to Me
      Monday October 1, 2004 I performed my first dVP
      Monday April 25, 2005 I performed dVP #200
      Wednesday April 27, 2005 I performed 2dVP’s
      Thursday April 28, 2005 I performed 1 LRP
      some insurance would not cover da Vinci surgery back then
      Friday April 28, 2005 I decided never to perform another LRP again
      As of today I have performed ≈2,000 dVP’s my patients have come from
      over 30 of the United States
      and 12 countries
    • The da Vinci Advantage:Why Listen to Me
      Monday October 1, 2004 I performed my first dVP
      Monday April 25, 2005 I performed dVP #200
      Wednesday April 27, 2005 I performed 2dVP’s
      Thursday April 28, 2005 I performed 1 LRP
      some insurance would not cover da Vinci surgery back then
      Friday April 29, 2005 I decided never to perform another LRP again
      As of today I have performed ≈2,000 dVP’s my patients have come from
      over 30 of the United States
      and 12 countries
    • The da Vinci Advantage:Why Listen to Me
      IF you believe that your current surgery is
      “as good as it gets”
      THEN you are performing
      yesterday’s standard of care
      maybe today’s standard of care
      but DEFINITELY NOT tomorrow’sstandard of care
    • The da Vinci Advantage:Why Listen to Me
      IF you believe that your current surgery is
      “as good as it gets”
      THEN you are already behind
    • The da Vinci Advantage:
      The Vision-Precision Advantage
      The Consistency Advantage
    • The da Vinci Advantage:The Vision – Precision Advantage
      Vision
      Stereoscopic view (better depth AND detail)
      10x magnification
      High definition
      You place the camera EXACTLY where you want it
      If I can see it better I can do a better operation
      Precision
      Scaled motion
      Allows for more precise movements than my own hands are capable of
      With improved ergonomics comes improved precision
      If I have a more precise tool
      I can create less collateral damage
    • The da Vinci Advantage:The Vision – Precision Advantage
      Better Vision and Improved Precision:
      IS NOT a replacement for skill
      IS an advantage for ALL SURGEONS no matter what their skill level
    • The da Vinci Advantage:The Consistency Advantage
      What do YOUR LAP surgeons believe
    • The da Vinci Advantage:The Consistency Advantage
      What do YOUR LAP surgeons believe
      “my outcomes are as good as they get”
      “I’m at the TOP of my game”
    • The da Vinci Advantage:The Consistency Advantage
      What do YOUR LAP surgeons believe
      “my outcomes are as good as they get”
      “I’m at the TOP of my game”
      and if they never convert to dVP they are right
    • The da Vinci Advantage:The Consistency Advantage
      What do YOUR LAP surgeons believe
      OUTCOMES
      best
      LAP
      worst
    • The da Vinci Advantage:The Consistency Advantage
      What do YOUR LAP surgeons need to know
      OUTCOMES
      best
      dV
      best
      worst
      LAP
      worst
    • The da Vinci Advantage:The Consistency Advantage
      What do YOUR LAP surgeons need to know
      OUTCOMES
      easy
      dV
      easy
      hard
      LAP
      hard
    • The da Vinci Advantage:The Consistency Advantage
      YOUR LAP surgeons need to know
      They are STUCK at their current level if they continue with LAP
      There is a level above LAP, but to get there they need to transition to daVinci
    • The da Vinci Advantage:The Consistency Advantage
      daVinci surgery
      Improves the best outcomes A LITTLE
      Improves the worst outcomes A LOT
      Reduces the distance between
      BEST-WORST
      EASIEST-HARDEST
    • The da Vinci Advantage:The Consistency Advantage
      daVinci surgery
      Reduces Variability in the Difficulty of an Operation
      Reduces Variability in Outcomes
    • The da Vinci Advantage:The Consistency Advantage
      daVinci surgery
      Reducing Variability in Outcomes
      Better Vision
      Improved Precision
      4th Arm
      Improved control over your operation
      Reduced Fatigue
    • The da Vinci Advantage:The Consistency Advantage
      Reduced Fatigue
      Ergonomic Advantage of daVinci surgery
      87% of surgeons who regularly perform standard laparoscopic surgery experience discomfort/pain neck, hand, and lower extremities
      J Am CollSurg 2010
      Standard Laparoscopic Surgery increases surgeon fatigue and reduces performance
      Surgery 2010;147:318-30
    • The da Vinci Advantage:The Consistency Advantage
      Reduced Fatigue
      Ergonomic Advantage of daVinci surgery
      Improve ergonomics of performing an operation
      Improve Performance of the Surgeon
      Improve Consistency of Patient Outcomes
    • The da Vinci Advantage:
      Surgery today is NOT as good as it gets
      Better Vision and a More Precise tool is an advantage for ALL surgeons
      Reducing Variability in Difficulty Reduces Variability in Outcomes