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The Da Vinci Surgical Robot

Hôpital du Sacré-Coeur de Montréal was the first hospital in Canada to acquire a Da Vinci surgical robot. The use of robotics has become so popular that whenever technically feasible we use either laparoscopic or robotic surgical techniques.

Designed during the 1990s, this robot consists of a telemanipulator that is controlled from a distance. The surgeon sits at a console, far from the scalpel, and manipulates both camera and robot arms from a distance.

Unifying virtual reality and laparoscopy, stereoscopic camera-assisted microsurgery has brought on the advent of new tools, which are more precise and agile within the hands of the surgeon. The surgical robot is therefore particularly useful in bariatric surgery because it significantly increases the surgical options offered by laparoscopy, while making them safer procedures.

In conventional laparoscopy, a camera is used and offers a two-dimensional image. It does not, however, give any indication with regards to the distance between the instruments and the organs. Furthermore, another challenge is that each movement from the surgeon is displayed on a screen in an inversed fashion, which is not the same axis as his/her movements. Finally, the traditional laparoscopy instruments do not possess the same dexterity as the ones maneuvered by the robot. The robot instruments can be moved in a complete 360-degree axis, which greatly contributes to a successful surgical outcome.

The hands of the surgeon must therefore develop a new form of dexterity: the one of virtual reality. Using two remote controls, the surgeon will direct every minute movement with an incomparable precision because the camera offers a three-dimensional view of the images, as well as an enlargement of up to 8 times the actual size, without any inversion of the image seen. The robot also controls for potential shaking, which further increases the safety of the procedure.

In the last couple of years, the Da Vinci robot has been successfully used in hundreds of major surgery cases, including abdominal, thoracic, urologic, and cardiac surgeries. Robot-assisted surgery will not replace conventional or laparoscopic surgery. It will, however, most certainly reduce the limitations of these forms of surgical procedures. In addition, in a very near future, the Da Vinci robot will be involved in telesurgery, or surgery from a distance. A first case of telesurgery has already been undertaken during which the surgeon, who was in New York, performed a gallbladder ablation on a patient that was hospitalized in Strasbourg, in France.