Robotic assisted laparoscopic right nephrectomy
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this was the firsts robotic case done by me in Indore and was present in ASI, Indore meeting . Video can be found on youtube.
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This brief presentation highlights the major applications of surgical robots in addition to the most used models. It also briefs the current benefits and limitations of this technology.
Robotic surgery
Robotic surgery uses robotic systems to aid surgeons during surgical procedures. It was developed to overcome limitations of minimally invasive surgery and enhance open surgery capabilities. Some key systems discussed are da Vinci, ZEUS, and AESOP. Robotic surgery provides advantages like enhanced precision, decreased fatigue and pain, and telemedicine capabilities. However, disadvantages include safety risks if errors occur in the robot and high costs. Further research is still needed to evaluate robotic surgery's efficacy, safety, and cost-effectiveness.
INSIGHTEC for STARTUP NATION
A non-invasive, outpatient therapy which allows patients to return to routine immediately after treatment
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Robotic assisted laparoscopic right nephrectomy
- 1. Robotic assisted Laparoscopic Nephrectomy Dr. Santosh Agrawal ,MCh Robotic training at Roswell Park Cancer Institute, Buffalo, Newyork, USA Dr.Saurabh Chipde Dr.Jaisukh Kalathia/Dr Udit Mishra SRI AUROBINDO INSTITUTE OF MEDICAL SCIENCE and Mohak Hospital, Indore
- 2. The Da Vinci Surgical System
- 3. Da Vinci Surgical System • Master-slave system – the surgeon directly initiates all the movements of the robotic instruments in real time.
- 4. Da Vinci Surgical System • Since 2000, 1,370 U.S. hospitals have purchased at least one of the $1.5 million-to-$2.2 million robots, known as the da Vinci Surgical Systems, made by Intuitive Surgical Inc. of Sunnyvale, Calif • In US, <1% of the radical prostatectomy were done by robots in 2001, >40% of the radical prostatectomy were done by robots in 2006 • India – 27 robotic centers Product of the Intuitive Surgical & the most famous robotic surgery apparatus in world. FDA approved in human operations On July 11 in 2000.
- 5. Da Vinci Surgical System Human eye vision & beyond • Double lenses laparoscope • 3D, high definition, binocular view • 10-15X magnification Da Vinci system consists of 2 primary components: • A viewing & control console • A surgical arm unit - 3 or 4 arms (depends on the model)
- 6. Types of instruments used by dVSS 3 arms for tools that hold objects, act as a scalpel, scissors, bovie, or unipolar or dipolar electrocautery instruments. 4th arm - for a camera with two lenses - surgeon full stereoscopic vision from the console . Surgeon looks through two eye holes at console ,a 3-D image of the procedure, while maneuvering the arms with 2 foot pedals & 2 hand controllers.
- 7. Endowrist Instruments EndoWrist Instruments provide dexterity, precision and control: •7 degrees of freedom •90 degrees of articulation •Intuitive motion and finger-tip control •Motion scaling and tremor reduction
- 11. Index case • 45/M • C/C - On/ off Right flank pain x 3 mnths - H/O High grade fever before 1 mnth • Past H/O - No medical / surgical illness • Pers. H/O - Chronic alcoholic & smoker • O/E - Obese with BMI – 30.5 kg/m² • Vitals - Tº - Afebrile , P- 78/min , B.P.- 130/80 mmhg • P/A - Soft , Non-tender • Blood Investigations & Urine C/S - Normal • USG - Rt. Grossly hydronephrotic kidney with thinned out parenchyma - Lt kidney normal in position, shape & size • IVP - Non visualization of the right kidney - Left kidney normal excretion & function • DTPA -NON VISUALIZED right kidney, left kidney GFR 55ml/min
- 12. IVP
- 13. NCCT
- 16. Result Total operating time 180 minutes Docking – 40 minutes Blood loss – 200 ml Posoperative period – uneventful Drain removed on day2 Discharged on day 3
- 17. Thank