The da Vinci robotic surgery system was first used at the Epworth ten years ago. Now superseded, this first da Vinci has been donated to MV by Epworth Healthcare for Think Ahead at Scienceworks, an upcoming permanent exhibition about the future. This robot is a great example of how technology is shaping our lives… and, in this case, saving lives.
This is what robotic surgery looks like: an operating room featuring the da Vinci Si Surgical System.
Source: Intuitive Surgical, Inc.
Like many robots, the da Vinci needs a highly-skilled human controller – surgeons like Dr Daniel Moon, Director of Robotic Surgery at Epworth. He’s a urologist who specialises in cancers of the prostate, the treatment of which has transformed since the introduction of robotic surgery.
Surgeon Daniel Moon sitting at the console of a da Vinci surgical system.
Source: Daniel Moon
Treating this cancer involves removing the prostate (prostatectomy). It has always been a very delicate operation because this little gland, buried deep in the pelvis, is very close to important tissues that control urinary and reproductive functions. "With this operation," says Dr Moon, "if you get it wrong by millimetres, you can cripple someone."
So why is a robot so useful in this instance? Firstly, it can operate using much smaller incisions because its 'hands' – or robotic instruments – are much smaller than human hands. Smaller, less invasive incisions mean shorter recovery times. The instruments can perform very tiny, tightly-controlled movements beyond the range of usual human dexterity. Very high-definition footage is sent back to the surgeon which means he or she can see what's going on, and carefully avoid damaging any healthy tissues. "We see anatomy better than we've ever seen it before," says Dr Moon.
The surgeon sits at a console away from the operating table and controls the surgical instruments with sensitive thumb and finger grips. Foot pedals control the camera which, in the new generation of the da Vinci, can include ultrasound. The system is calibrated to the surgeon so that his or her hand movements are robotically scaled down and translated into minute adjustments of the instruments working inside the patient.
The surgeon operates the robotic arms with finely-calibrated finger controls.
Source: Daniel Moon
This medical advance coincided with the increasing prevalence of the prostate-specific antigen (PSA) test, which detects potential prostate cancers very early in their development. Previously, prostate cancers usually reached a more advanced stage before medical intervention. "Surgery to remove the prostate before PSA testing was risky and really interfered with quality of life," says Dr Moon. "We'd take those risks when you had a bulky and aggressive tumour, but not, for example, when you have a patient in his mid-50s with early cancer and no symptoms." The da Vinci offers a surgeon the best possible vision, dexterity, and ergonomics to reduce the operative risks.
From the first da Vinci operation in Melbourne ten years ago, surgeons performed over 3500 prostate operations robotically in 2012, and da Vinci systems are used in dozens of hospitals across Australia. The types of operations are increasing, too – Dr Moon lists removing tumours from the uterus, bowel and kidneys, and repairing cardiac valves, as other kinds of operations suited to this tool. An added benefit is that the ergonomics of operating is much kinder on the bodies of the surgeons; instead of many hours on their feet, bending awkwardly, the surgeon sits comfortably at the console.
This kind of machine was born from technology developed for two similar, yet different, purposes: the need for astronauts to repair satellites from within the safety of a space shuttle, and an idea to operate on wounded soldiers in the battlefield without placing surgeons on the front line. Both applications require instruments that can be minutely controlled from a distance, and excellent images of the procedure sent back to the operator. These space-age developments are now benefitting Earth-bound civilian people too, and one day a robot might help to keep you healthy.
Think Ahead at Scienceworks