Traditionally, the best surgeons have a keen eye, a steady hand, and an unparalleled ability to keep track of their wristwatch. Now it seems that the best surgeons of tomorrow will also need to be able to use robotics. Intuitive Surgical, a company that has been paving the way in developing robots for use in surgery, has just been granted FDA approval for their newest device: the da Vinci Xi System.
Why use robots in surgery? In order for a human surgeon to see what he is doing, he needs have a clear path to the patient's problem area. Typically, this involves making an incision that can be pushed open wide enough to dig down to the problem -- which can be taxing for the patient. With robots, the incisions can be much smaller because scopes and narrower tools can be used to accomplish the same job. Procedures that are less invasive allow the patient to heal faster and have the cosmetic advantage of creating smaller scars. There are also fewer complications, shorter hospital stays, and reduced risk of infection or need for blood transfusion.
The da Vinci Xi System builds on IS’s previous successful devices. The Xi System has greater ease of use, as surgeons can just “plug it in and go” as opposed to spending time draping the patient and calibrating the machine. While looking through a monitor and using controls, the surgeon is able to perform the operation without physically looking at the patient. The monitor displays high resolution 3D images and four surgical arms with extraordinary range of motion. Narrower tools allow the surgeons to go deeper in the patient with greater control.
Additionally, the controls allow the surgeon to zoom in and view cells on the microscopic level, which could give a considerable advantage when removing tumor cells or dealing with small blood vessels that can’t be seen as closely with the naked eye. Intuitive Surgical also hopes to integrate their Firefly™ technology into the monitor, allowing the surgeons to combine white light and near-infrared wavelengths while operating on biliary ducts.
Of course, not everyone is enthralled with the idea of using robotics in surgery. Because the equipment is specialized and very few facilities have it, they are expensive. Not surprisingly, this translates into higher surgical fees. According to a study published in the Journal of the American Medical Association, robot-assisted hysterectomies cost a little over $2,000 more than laparoscopic surgeries, and using the robotic surgeon didn’t seem to confer any long-term advantages. To be fair, this particular argument only applies to hysterectomies, and does not consider other procedures, such as the removal of cancer cells, which require a bit more finesse and stand to have better long-term outcomes.