Da Vinci Surgical System
Report
Group
Members
Avian
Lukman Setya Budi 2216100055
Satria
Bhaskara Adinugraha 2216100081
Rafi Rasyid
Putra 2216100106
Qaedi Aufar
Saifuddin Bantasyam 2216100133
Witri
Andini 2616100017
Muhammad
Daffa Abiyyu Rahman 2916100010
Introduction
As time passes by, the development of technology in
the world grows. This growth includes all aspects, such as communication,
transportation, health, and so on. In health field, the development of
technology is mandatory to face sickness, especially the new, complex and far
more complicated to handle than the predecessors. Practice of surgery to human
body has been done a lot as of late and these practices are not easy, which
means only those with the knowledge and the experience in surgery field are
permitted to do surgeries. The operations that needs to be done become more
complicated and dangerous because the body part that needs surgery are the
vital ones such as liver and heart. Because of that, the mistake in surgery
must be minimalized and if possible, not to occur at all. Researchers in
biomedical engineering field then create technologies that can optimize the
work performance of doctors to get the maximum result for the patients.
On the start of twenty first century (2000), da
Vinci Surgical System is made by an American company, Intuitive Surgical, with
approval from the United States Food and Drug Administration. Da Vinci Surgical
System is a system that makes the human as an operator and the robot will do
the surgery to the patient. Da Vinci Surgical System makes the operator control
a console, similar to PS console. The console also already has the surgical
tool that wants to be used for the surgery and the robot already has an
operating system that is capable of minimalizing the error or mistake done on a
surgery. Da Vinci Robotical Surgery is used to do a surgical operation on a
vital part of body or other parts. By June 30th , 2014, there was a
total of 3,102 units worldwide with the following details : 2,153 units in the
United States, 499 units in Europe, 183 units in Japan, and the last 267 units
in the other parts of the world. The da Vinci system however, has been
criticised for its cost and for a number of issues related to its performance.
Da Vinci Surgical System also used to have a rival system called ZEUS Robotic
Surgical System, which is discontinued on 2003.
Overview
Da Vinci Surgical System is designed to improve
laparoscopy. The system changes the old method where surgeon needs to use
hand-held long-shafted instruments with a nearby 2D monitor to see an anatomy
in image form to a new style where the new method is that surgeon can operate
from a seated position at the console with eyes and hands positioned in line
with instruments and using controls to move the instruments and camera.
By providing the surgeon superior visualization,
enhanced dexterity, better precision and ergonomic comfort, the da Vinci
Surgical System makes it possible for more surgeons to perform minimally
invasive procedures. For a patient, the system offer the benefits of minimal
invasive procedure such as less blood loss, less pain, and less time at the
hospital after surgery.
Legality
As a health related item, da Vinci Surgical System
already met approval from United States Food and Drug Administration (U.S.
FDA). The item has been cleared for use in surgical procedures as following :
urological, general laparoscopic, gynelogic laparoscopic, transoral
otolaryngology restricted to benign and
malignant tumors (T1, T2) and general thorascoscopic, as well as
thoracoscopically assisted cardiotomy procedures. In conjunction with
adjunctive mediastinotomy, it can be used to perform coronary anastomosis
during cardiac revascularization. In all surgical use mentioned above, the
system is exclusive for adult and pediatric use with exception of transoral
otolarynology surgical procedures.
The da Vinci Surgical System is intended to be used
by physicians in an operating room environment, with accordance to
representative, specific procedures in Professional Instruction of Use.
While clinical studies supports the da Vinci
Surgical System, individual results may apply. Therefore, risks of
complications exist in surgeries. Before going to do surgery, asks all possible
treatments to the doctor. Understanding the risks of each treatment allows one
to make the best decision for their health case. Da Vinci Surgical System may
not be applicable to everyone, which means it might not be applicable to one’s
condition.
With the above, the da Vinci Surgical System has
attained legal permission to be produced in mass and used for public in health
field, to be precise the surgeon field.
Mechanism
As like any other surgical devices, da Vinci
Surgical System has it’s own system that required the surgeon’s console to be
as the exact same room with the patient. The console equipped also with a
patient-side cart and forue interactive robotic arms controlled by the surgery
leading doctor from the console. The arms are the tool that can hold an
objects, also can working as a scalpels, scissors, bovies, and etc. the surgeon
use the controller on getting the arm to maneuver as well as what we saw on a
video game, but it’s on real life and death condition. Also the instruments
(the arms) are imitating what do the surgeon hands are doing.
The method that’s use in here is something called
haptic feedback. Which like we already explain before, is the condition where
the arms are imitating what are the surgeon’s hands are doing. This kind of
feedback will make the surgeons feels like he really directly operating the
patients with his own arms, therefore the “human touch” for the surgery will
never be distinguished.
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Figure 1. haptic feedback
|
In order to supporting the mechanism, we need more
equipment that collaborating each other on making the console work
successfully. As you could saw on the figure above, there is something called
haptic user interface (master). This interface is able on providing a surgeon
with force sensation, regarding to surface roughness, the tissue texture and
any other thing. The interface can elevating within the radius 180°, including
forward and backward.
|
Figure 2. Haptic user interface (master)
|
On the other hand,
The
sensor works on giving multiple of data towards the surgeon, so the surgeon can
now the status of the patient. This also a crucial equipment, since this will
effect the surgeons act on determining what to do and what is not supposed to
do.
|
Figure 3. Sensorized robot
|
From all of the text above, we can conclude that
this da Vinci Surgical System really helps human on doing surgery since it will
minimize the wound surgery, also minimize the error done by human and
so on.
Medical Use
This biomedical devices contribute a lot in
surgical. It could make a long distance operations between the doctor and
his/her patient becomes possible. However, Da vinci surgical system needs the
patient access first, then the doctor will give command to this devices from a far distances to do some
operations. In other word Da vinci
surgical system could allow the doctors to perform telesurgery to the patient
even they are in the different country.
In fact Dr. Marescaux and a
team from IRCAD have done telesurgery in 2001. They succesfully perform
telesurgery between New york and Strasbourg. This event was called “Operation
Linbergh” and considered as a milestone of global telesurgery. To get this achievement they used a
zeus telemnipulator and advanced asynchronous transfer mode (ATM) combining
with a high speed fiber optic connection with
an average delay of 156 ms.
In addition, the da Vinci Surgical System has
shown numerous successful result in surgeries.
Future
Application
Da vinci surgical system cannot perform surgery
autonomously. Even though the name is ‘robotic surgery’ that usually represent
an advanced technology which can perform on its own. It was not designed as an
autonomous system in the first place. It’s controlled by human operator for all
input, so it lacks of a decision making software. In other words to do some
operation it still depends on human intervention. This devices equipped by weak
Al software, which means it can not attempt to perform cognitive abilities of
human in full range. However in principle the da Vinci Surgical System could
still perform in partially or even completely autonomously. In simple words,
this devices can not work by itself. Da Vinci Surgical System will replicate
the movement of surgeons hands through surgeon’s direct input with the
combination of micro instruments on its tips.
Criticism
Despite being useful to the surgeon field, it’s not
without issue. This has led to critics that goes into multiple aspects. First
is the difficulty to learn the item, which is pretty difficult to learn. Second
is the fact that it uses proprietary software which hinders freedom in system
modification. The cost is also another issue, where each one costs 2 million
dollars.
The manufacturer also received critic for
short-cutting the Food and Drug Administration approval using a process called
premarket notification, which claims the product is similar to already approved
ones. They’re also accused of providing insufficient training. Patients also
reports that they get injured by the system having stray electrical current
released from inappropriate parts of the surgical tips of the system.
From a social side, the disadvantage of the system
is that it has potential to dissolve the creative frrodoms of surgeons, as
stated by Timothy Lenoir, one of the most professional individual autonomous
occupation ever exist.
In addition to all above, Food and Drug
Administration also running checks related to da Vinci Surgical System,
including death from surgeries with the device. A number of lawsuit related to
the system is also underway.
Reference
https://web.archive.org/web/20130116100318/http://intuitivesurgical.com/specialties/regulatory-clearance.html accessed
on December 4th , 2016
http://link.springer.com/article/10.1007/s00464-005-0582-y accessed
on December 4th , 2016
https://www.ohcare.com/what-is-da-vinci-robotic-surgery/ accessed
on December 4th , 2016
http://www.davincisurgery.com/da-vinci-general-surgery/ accessed
on December 4th , 2016
https://en.wikipedia.org/wiki/Da_Vinci_Surgical_System#Future_applications accessed
on December 4th , 2016
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