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Athens Medical Center Robotic Surgery Clinic
 

Athens Medical Center Robotic Surgery Clinic

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Progress reported in Athens, Greece Medical Center Robotic Surgery Clinic

Progress reported in Athens, Greece Medical Center Robotic Surgery Clinic

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  • Συμφωνία Συνεργασίας Ιατρικού Αθηνών και Ερρίκος Ντυνάν 21/01/2009 Το Διοικητικό Συμβούλιο του Κοινωφελούς Ιδρύματος ΕΡΡΙΚΟΣ ΝΤΥΝΑΝ αποφάσισε ομοφώνως τη μακροχρόνια συνεργασία του με τον Όμιλο "ΙΑΤΡΙΚΟ ΑΘΗΝΩΝ" για τη λειτουργία μαιευτικής-γυναικολογικής κλινικής εντός του Νοσοκομείου του Ιδρύματος. Συγκεκριμένα τη λειτουργία και εκμετάλλευση εκ μέρους του Ιδρύματος, αναλαμβάνει η κατά 100% θυγατρική εταιρεία του Ιατρικού Αθηνών με την επωνυμία "Μαιευτική-Γυναικολογική Κλινική - ΓΑΙΑ". Η μαιευτική γυναικολογική κλινική θα είναι δυναμικότητας 147 κλινών με Μονάδα Εντατικής Θεραπείας Ενηλίκων (ΜΕΘ) 6 κλινών, Μονάδα Εντατικής Νοσηλείας Νεογνών (ΜΕΝΝ) 12 κλινών και νοσηλεία μιας ημέρας 25 κλινών. Θα διαθέτει 7 χειρουργικές αίθουσες και 17 αίθουσες ωδινών και θα ξεκινήσει τη λειτουργία της εντός τριμήνου από σήμερα. Θα παρέχει υπηρεσίες υψηλού επιπέδου που εγγυάται το Ιατρικό Αθηνών και το Ερρίκος Ντυνάν, ενώ θα συνεργάζεται με κορυφαίους καταξιωμένους και επώνυμους επιστήμονες του χώρου. Η ως άνω κλινική θα περιλαμβάνει πέραν της σύγχρονης χειρουργικής και των μαιεύσεων, άκρως εξειδικευμένες υπηρεσίες όπως μονάδα μαστού, μονάδα εξωσωματικής γονιμοποίησης, τμήματα γυναικολογικής ογκολογίας, γενετικής μοριακής βιολογίας, χημειοθεραπείας, αισθητικής δέρματος, κ.α. Με τη συμφωνία αυτή το Ερρίκος Ντυνάν επεκτείνει το κοινωφελές του έργο σε νέους τομείς καθόσον αριθμός κλινών θα διατεθεί για νοσηλεία ή τοκετούς απόρων γυναικών που θα υποδεικνύονται από τον Ελληνικό Ερυθρό Σταυρό, ενώ το Ιατρικό Αθηνών εισέρχεται στο χώρο των μαιευτηρίων και στην Αττική
  • Slide 1 - The daVinci Surgical System is The Enabling Tool as part of a comprehensive, minimally invasive cardiothoracic program. the da Vinci System has been cleared by the FDA for a variety of procedures that reside in three distinct areas; revascularization, valves and specialty procedures. Within revascularization, da Vinci enables a very precise minimally invasive IMA/BIMA takedown, the rate-limiting step for a successful MVST procedure. Within valves, da Vinci facilitates a highly reproducible, minimally invasive mitral valve repair, as well as tricuspid valve repair. Additionally, da Vinci is instrumental in facilitating a variety of specialty cardiothoracic procedures such as Bi-V lead placement, ASD repair and complex thoracic procedures like lobectomy, thymectomy and esophagectomy.
  • From the console the surgeon controls the wristed instruments as well as the camera. The console surgeon directs the procedure. The surgeon sees images in 3 dimension while the monitors in the room show the traditional 2 dimensional view.
  • The da Vinci ® Surgical System consists of an ergonomically designed surgeon ’ s console, a patient-side cart with four interactive robotic arms, a high-performance vision system and proprietary EndoWrist ® Instruments. Powered by state-of-the-art robotic technology, the surgeon ’ s hand movements are scaled, filtered and seamlessly translated into precise movements of the EndoWrist Instruments. The net result; an intuitive interface with breakthrough surgical capabilities.
  • The da Vinci System has FDA clearance for a wide variety of surgical procedures in the areas of cardiac, prostate, general and pediatric surgery. We work very closely with our installed base of surgeons to develop new applications for the da Vinci Systems that further improve patient outcomes.
  • Whipples > 8 /year Pancreas 15-20
  • The da Vinci System has FDA clearance for a wide variety of surgical procedures in the areas of cardiac, prostate, general and pediatric surgery. We work very closely with our installed base of surgeons to develop new applications for the da Vinci Systems that further improve patient outcomes.
  • The da Vinci System has FDA clearance for a wide variety of surgical procedures in the areas of cardiac, prostate, general and pediatric surgery. We work very closely with our installed base of surgeons to develop new applications for the da Vinci Systems that further improve patient outcomes.
  • The da Vinci System has FDA clearance for a wide variety of surgical procedures in the areas of cardiac, prostate, general and pediatric surgery. We work very closely with our installed base of surgeons to develop new applications for the da Vinci Systems that further improve patient outcomes.
  • The da Vinci System has FDA clearance for a wide variety of surgical procedures in the areas of cardiac, prostate, general and pediatric surgery. We work very closely with our installed base of surgeons to develop new applications for the da Vinci Systems that further improve patient outcomes.
  • The da Vinci System has FDA clearance for a wide variety of surgical procedures in the areas of cardiac, prostate, general and pediatric surgery. We work very closely with our installed base of surgeons to develop new applications for the da Vinci Systems that further improve patient outcomes.
  • The da Vinci System has FDA clearance for a wide variety of surgical procedures in the areas of cardiac, prostate, general and pediatric surgery. We work very closely with our installed base of surgeons to develop new applications for the da Vinci Systems that further improve patient outcomes.
  • The da Vinci System has FDA clearance for a wide variety of surgical procedures in the areas of cardiac, prostate, general and pediatric surgery. We work very closely with our installed base of surgeons to develop new applications for the da Vinci Systems that further improve patient outcomes.

Athens Medical Center Robotic Surgery Clinic Athens Medical Center Robotic Surgery Clinic Presentation Transcript

  • ATHENS MEDICAL CENTER About the Group and Robotic Surgical Clinic S.C.Hiridis MD General Surgeon Bern 2009
      • The largest Medical Group in Greece
      • 1500 beds
    Athens Medical Centre S.A. The Company's principal activities are the establishment and operation of medical centres in Greece and other Balkan countries. Company operates a medical centre in Athens as well as a clinic in Paleo Faliro and Thessaloniki. Also acts as consultant to the Albanian Ministry of Health services. The Group has diagnostic centres in Russia, Romania, Bulgaria and the Czech Republic.
  • President of Athens Medical Group, Dr. G.Apostolopoulos 1983 : foundation of Athens Medical Center Today, leading role in the field of health care in southeastern Europe . Listed in Superbrands catalogue Forbes Magazine ranks us among the 200 most important companies in the world European Business Magazine : 100 most important Companies
  • ATHENS MEDICAL NETWORK
    • 8 modern hospital Units for high-quality health care services
    • 7 of them in Attica –Athens area
    • 8 th : Thessaloniki –Transbalkanic Center
      • “ perhaps the most modern hospital unit in Europe”
        • G.Britain, Imperial College Medical School
    • 1.200 hospital bed
    • 3000 employees
    • Since 21-1-2009 agreement with another large private hospital “Errikos Dynan” for opening of Gynecologic Clinic of 147 beds, ICU, neonatal ICU, day-clinic
  • Surgical Clinic of Athens Medical Center K.M.Konstantinidis, MD,PhD,FACS Director of General, Laparoscopic and Robotic Surgery Athens Medical Center President of Greek Scientific Society of Robotic Surgery President of Greek Society for Bariatric & Metabolic Surgery
  • Versatility in General Surgical Applications General Surgery Bariatrics Roux-en-Y Gastric Bypass, Gastric Banding, Biliopancreatic Diversion Colon/Small Bowel Hemicolectomy, Sigmoid Colectomy, Ileocectomy, Abdominal-perineal resections, Low Anterior Resection, Small Bowel Stricturoplasties Esophageal/ Foregut Heller myotomies, Nissens, Gastric Resections, Gastric Pacing Wires, Esophagectomies (Transhiatal or Transthoracic), Hepatobiliary/pancreatic Lobectomies, Segmentectomies, Choledochal-jejunostomy, CBD Exploration, Distal Pancreatectomy, Whipple, Ampullectomy Other Live donor nephrectomies, adrenalectomy, Hernias Splenectomy, Aortofemoral Bypass, AAA
  • Robotic Telesurgery : the future of surgery ?
  • Year 2000: Dr.Konstantinidis introduces Surgical Robotics - Aesop Robot
  •  
  • 2002 Robotic Surgery Course Hackensack University Medical Center,USA
  • da Vinci ® Surgical System
    • Surgeons Console
    • Surgical Cart
    • Insite Vision System
    da Vinci Surgical System
  •  
  •  
  •  
  •  
  • First Robotic Surgical Operation in Greece
    • 26/9/2006
    • ATHENS MEDICAL CENTER
    • Robotic Cholecystectomy
    • Woman 35 years
    • Dr.K.M.Konstantinidis
  • 235 Robotic Operations over 500 with urologic procedures 3%
  • Stockholm – EAES 2008
  • Quebec – MIRA 2009
    • 2011 organization of MIRA assigned to Greece (Dr.K.Konstantinidis – Athens Medical Center)
    • New Instrumentation
    • New techniques
    • Investigational surgery
    • Training tools
    • Haptics
    • Navigation
    • Augmented Reality
    Interested in emerging surgical technologies Augmented Reality – aided Robotic Surgery
  • 3D reconstructions used intraoperatively for navigation
  • 3D reconstructions used intraoperatively for navigation
      • “ This is modern medicine at its very best”
    Thank you for your attention www.kkonstantinidis.com
    • Over the past two decades, both the
      • mortality
      • and the morbidity associated with pancreatic surgery
      • have been reduced substantially.
    • high-volume centers: perioperative mortality now < 3%
    Surgery of the pancreas for benign or malignant diseases
    • more careful patient selection,
    • better understanding of surgical anatomy,
    • advances in critical care medicine,
    • and improvements in the management of perioperative complications
    Decreased Mortality-morbidity
    • pancreaticoduodenectomy (the Whipple procedure),
    • distal pancreatectomy (open and laparoscopic),
    • longitudinal pancreaticojejunostomy (the Puestow procedure),
    • enteric drainage of pancreatic pseudocysts (open and laparoscopic),
    • and palliative bypass for unresectable periampullary cancer
    Procedures
    • noninvasive modalities
      • transabdominal ultrasonography,
      • computed tomography,
      • and magnetic resonance imaging
    • and invasive modalities
      • endoscopic retrograde cholangiopancreatography [ERCP]
      • and endoscopic ultrasonography [EUS].
    Preoperative Evaluation
    • can identify
      • changes associated with chronic pancreatitis,
      • biliary and pancreatic duct dilation,
      • and the presence of pseudocysts.
    • In the setting of malignant disease, it may demonstrate
      • dilated intrahepatic and extrahepatic bile ducts,
      • liver metastases,
      • pancreatic masses,
      • ascites,
      • and enlarged peripancreatic lymph nodes.
    • A malignancy of the pancreas typically appears as a hypoechoic mass; ultrasonography reveals a pancreatic mass in 60% to 70% of pancreatic cancer patients.
    Transabdominal ultrasonography
    • preferred noninvasive imaging test for pancreatic disease, having largely supplanted ultrasonography in this context.
    • Helical CT can delineate the anatomy of the pancreas and the surrounding organs in considerable detail, and it can easily define pancreatic calcifications, inflammation, necrosis, and masses.
    • Pancreatic cancer usually appears as an area of pancreatic enlargement with a localized hypodense lesion.
    • A triple-phase intravenous contrast study is ideal for the assessment of pancreatic lesions.
    • Thin cuts are obtained through the pancreas and the liver during both the arterial phase and the venous phase after the injection of I.V. contrast material.
    • Besides being used to determine the primary tumor size, CT is used to look for and evaluate invasion into local structures or metastatic disease.
    helical (spiral) CT
  • Laparoscopic Surgery of the pancreas
  • Robotic Surgery of the Pancreas
  • Robotic Surgery - NISSEN
  • Conclusions
    • Augmented reality technology is in its infancy
      • there are still many risks, difficulties, and limitations to be assessed.
    • Safety is of course paramount:
      • a minor miscalculation could result in the patient’s death.
    • Augmented reality relies upon an exact registration of virtual to real life,
      • and misalignment cannot be allowed.
    • It is important that the surgeon retains tight control and can monitor, evaluate,
      • and adjust factors throughout a procedure that depends on augmented reality.
    • Ergonomics and ease of use must also be considered.
    • Augmented reality uses a variety of monitors, cameras, and complex computing equipment, which must be of a high quality but also affordable.
      • The relatively high costs are likely to drop with increased demand and availability.
  • The future
    • Future developments for augmented reality may encompass the application of augmentation to other senses as well.
    • In particular, adding and removing sound might be useful.
    • Auditory signals could warn if a surgeon begins to stray from the augmented resection line,
      • and this could also help in preoperative planning and the training of surgeons.
  • References
    • http://medvis.vrvis.at/projects/aras/
    • http://www.ariser.info/projects/studierstube.php
    • http://jama.ama-assn.org/cgi/content/full/292/18/2214-b
    • http://www.se.rit.edu/~jrv/research/ar/index.html
    • http://student.bmj.com/issues/08/03/life/108.php
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