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

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The Value Of Da Vinci Surgery

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

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