My name is Shaw Zhou, I am with Advanced Urology Institute.
Robotic surgery is truly precise, for example, the magnify [goes] up to ten times so the doctor can see better and if your doctor has a hand tremor [it’s still] very steady. You got four arms instead of two arms, so you have two arms to grab for you and so on and so forth. And you have three dimensional [view], you can see much better. The traditional labs got surgical screens which are two dimensional so you don’t have that sense of depth. However the drawback is first of all, the doctor sits 10 feet away, so God forbid if something happened, your doctor will have to go in, wash your hands and you are not by your patient
Also you lose the tactile sensation, cause you don’t feel it no more. When you tie a knot or whatever you know, the tactile sensor feed gives how much force you use now, [before] it’s purely by experience. Although the new robot that we’re talking about that has tactile sensationin other words you can visually see it. They see how much force [is needed] if its red or green. So it’s getting better and better, eventually new robots keep on coming out but in the future I think we can overcome all these shortcomings for robot surgery.
If you are facing surgery, you want the most effective and least invasive approach to the operation. You can rest easy when you hear that your procedure will be done with the da Vinci® robotic surgery technology.
The da Vinci approach has transformed minimally invasive surgery, enabling patients to get back to what matters sooner. Over the past 20 years, da Vinci platforms have offered consistent and superior outcomes, pioneering new capabilities in the operating room. The da Vinci robotic surgery has virtually revolutionized the field of minimally invasive surgery.
Surgical Approach with da Vinci Robotic Surgery
Surgeons and operating room staff who use the da Vinci system are given comprehensive training by the manufacturer. Their professional education includes simulation for skills and procedures, along with practice and peer guidance.
The da Vinci robotic surgical system offers a minimally invasive alternative to laparoscopy and also to open surgery. (Laparoscopy surgery is a procedure that uses fiber-optic instruments inserted through the abdominal wall to see and repair internal organs.)
Because robotic surgery offers greater precision and control for the surgeon, and is performed by just a few tiny incisions, patients generally recover sooner.
Less scarring because of smaller incisions and fewer sutures
Briefer hospital stays/faster recovery
More rapid return to normal activities, including urinary continence, sexual function, and more.
Benefits of da Vinci Robotic Surgery for Surgical Professionals
To understand more about the benefits of the da Vinci system, consider these advantages. Aided by the da Vinci system’s ergonomic design, your surgeon is able to get a magnified 3-D view with high-definition while operating from a comfortably seated position. Your surgeon can operate precisely with these advantages:
Wider range of motion
Enhanced visualization including areas that are not visible by the naked eye
Improved access to otherwise almost inaccessible areas
Improved outcomes, sparing healthy tissue not impacted by cancer
The superior results with a da Vinci robotic surgery procedure are ideally suited for urologic conditions. At the Advanced Urology Institute, urologists such as Dr. Rolando Rivera perform minimally invasive robotic surgeries for prostate cancer, vasectomies and more complex surgeries such as reconstruction. For more information, visit the Advanced Urology Institute website.
The use of robots in surgery, also called robotic surgery or da Vinci surgery, is an impressive fusion of medicine and engineering that has transformed the medical field. It involves the use of miniaturized robotic instruments inserted into the body through a small incision and guided through the operation by a surgeon sitting at a console. It has brought the following advantages:
1. Increased visibility and precision
The surgeon views the entire anatomy, with specific focus on the surgical site, through a 3D high definition camera. This means even the smallest blood vessels are visible and the surgeon can follow the movement of the instruments with pinpoint accuracy. The surgeon has a clear view of what they are working on and the incidence of human error is cut down dramatically. The smaller instruments also can access tight spots that otherwise would be impossible or extremely difficult for a surgeon to reach.
2. It is a minimally invasive procedure
The incisions made in robotic surgery are only done to accommodate the tiny instruments. There is a world of difference between this procedure and open surgery where a surgeon has to make large incisions on skin and sometimes even cut through muscle to reach the surgical site. The minimally invasive nature of robotic surgery means numerous additional benefits, such as:
a. It causes only a little bleeding;
b. It results in minimal scarring;
c. The patient requires a short recovery period;
d. The patient suffers less pain and physical discomfort, both during and e. after the surgery;
f. There is a very small chance of post-surgery infections;
g. Overall there is less surgical trauma; and
h. There is a rapid return to normal everyday activities.
3. It is less strenuous on surgeons
Most surgeries take two to three hours but complex procedures go on for longer. Surgeons must stay sharp and focused, and in the case of open surgeries, on their feet for as long as the surgery takes. It is only fair to expect that they might suffer from fatigue. In robotic surgery, the surgeon sits can view the anatomy of the patient and control the surgical instruments while sitting at a console. This is definitely easier on the surgeon, who should be able to better maintain better concentration during long surgeries. It also makes it less likely for a mistake to occur.
Robotic surgery is available for almost all surgical procedures. A patient should see a specialist to discuss the applicability of robotic surgery to his or her case. For prostate, kidney and other urinary system problems for instance, the highly specialized urologists and doctors at Advanced Urology Institute can help you with a diagnosis as well as explain the best procedures for you, including robotic surgery. For more information about robotic surgery, visit the “Advanced Urology Institute” site.
Prostate cancer is cancer of the gland that produces seminal fluid for the nourishment of sperm. Some cases are slow developing and do not affect the patient significantly. These can be managed by watchful waiting and constant monitoring. Others are aggressive and must be addressed immediately. As with most cancers, early diagnosis increases the chances of successful treatment.
Developments in the treatment of prostate cancer
1. Multiparametric MRI (MpMRI) in diagnosis
Determining which cancer is life threatening and which one is not is a critical issue. In order to carry out a more efficient diagnosis, doctors now are using an MRI guided biopsy instead of the more traditional transrectal ultrasound guided biopsy. The MpMRI provides better results determining if the prostate is infected and if the cancer has spread outside the prostate. It can help a doctor decide whether or not a patient should undergo a biopsy. And the MpMRI can be used to monitor the cancer growth, making it a very useful tool when watchful waiting is adopted.
2. Use of immunotherapy in treatment
Until recently, it was thought that immunotherapy was ineffective against prostate cancer. Prostate cancer treatment was primarily limited to surgery, hormone therapy and radiotherapy. In recent years, however, researchers have found that immunotherapy, specifically a drug called pembrolizumab, may be effective in treating aggressive cases of prostate cancer that have advanced beyond the other forms of treatment.
3. Robotic surgery
Like most other areas of surgery, the treatment of prostate cancer has benefited from the use of robotic or the da vinci surgical system that is guided by a surgeon operating from a console. Patients who undergo prostatectomy to remove the prostate may avoid open surgery by opting for robotic surgery. Benefits of robotic surgery include reduced bleeding, reduced pain, low risk of post surgery infections and fast recovery rates.
Medical advancements have improved cancer treatment outcomes and changed lives for the better. At Advanced Urology Institute, the team of specialists uses the latest techniques and technology for treating prostate cancer. They are available to offer consultation, diagnosis and treatment best suited for the individual patient.
For more information, visit the Advanced Urology Institute website.
The da Vinci surgical system is an advanced and effective tool for performing minimally-invasive surgeries. It is a state-of-the-art tool that makes the most of the surgeon’s skill, expertise and experience in conducting urologic procedures. Known as da Vinci because Leonardo da Vinci devised the first robot and used three-dimensional detail and incomparable anatomical accuracy to give life to his masterpieces, the surgical system gives physicians such precision and detail that it effectively simulates an open surgical environment while allowing the use of tiny incisions.
How does the da Vinci system work?
The da Vinci surgery is robot-assisted and minimally-invasive, done via small incisions. The robot’s hands offer a high degree of dexterity, which enables surgeons to operate in the very tight spaces and delicate tissues of the genitourinary tract that otherwise would only be accessed through the longer incisions of open surgery. The da Vinci robot is a self-empowered, computer-controlled device that has been programmed to help in the positioning and maneuvering of surgical instruments. It gives surgeons better precision, flexibility, accuracy and control over surgical procedures.
When using the da Vinci system:
1. The urologist operates from a computer console situated in the operating room, directing and manipulating miniaturized instruments mounted on 3 robotic arms to create small incisions in the patient.
2. During the procedure, the doctor looks through a 3D camera attached to a fourth robotic arm that magnifies the surgical site.
3. The hand, wrist and finger movements of the surgeon are transmitted straight through the computer console and to the instruments attached to the robotic arms, resulting in mimicked movements with the same range of motion as that of the surgeon and allowing maximum control.
4. The robot is supervised by the surgical team at the patient’s bedside.
What are the advantages of the da Vinci surgical system?
1. It ensures that surgeries are more precise by providing better visualization, improved dexterity and greater accuracy.
2. It enables surgeons to conduct complex surgical procedures using tiny incisions.
3. It replicates the surgeon’s technique and movements in real-time, with the surgeon seated just a feet away from the patient viewing an actual image of the operating field while performing the procedure in real-time by manipulating a miniaturized instrument and using tiny incisions.
4. It transmits force feedback sensations from the operating field to the surgeon, which are then used as a substitute for tactile sensations and are augmented by the superior vision offered by the high-resolution 3D view to deliver better visualization, accuracy and precision.
The da Vinci is designed to ensure that both simple and complex procedures are done using incisions of 1-2 cm (also called operating ports), potentially resulting in:
1. Reduced trauma, pain and discomfort to patients
2. Fewer complications
3. Shorter recovery time and quicker return to routine activities
4. Minimal scarring
5. Reduced blood loss and need for transfusions
6. Minimal hospitalization costs
At Advanced Urology Institute, we have incorporated the da Vinci surgical system into our practice. Over the years, we have been able to use the increased range of motion, improved visualization, enhanced dexterity and greater surgical precision offered by the robotic system to deliver improved treatment outcomes to our patients. We are also proud of the skilled and experienced professionals at AUI whose training, fortitude, passion and expertise in the use of advanced technologies have enabled us to provide the best possible care to our patients. For more information on our services, visit the “Advanced Urology Institute” site.
The da Vinci Surgical System is a minimally invasive procedure where the operation is performed with the help of robotic instruments inserted through minor incisions. The surgeon sits at a console that offers a three dimensional view of the patient’s anatomy and full control over the surgical instruments.
The da Vinci system provides a suitable alternative to the more traditional open surgery where a surgeon has to make large incisions through skin and muscle to reach the affected organ. It also is an improvement to other minimally invasive procedures, such as laparoscopy. Now a patient has the opportunity to choose robot assisted laparoscopy over conventional laparoscopy.
Advantages of the da Vinci Surgical System
1. Increased precision
The precision with which miniaturized robotic instruments move through the body is comparable to that of a scalpel in a surgeon’s hand. Robotic instruments can access parts of the anatomy that are delicate or hard to reach with no risk of accidental puncture or laceration. The margin of error is very low because precision increases accuracy.
2. Reduced blood loss, pain and scarring
Blood loss, pain and scarring are incidental to any surgical procedure. Blood loss is especially critical and it is a significant contributor to mortality rates in procedures such as hepatic and thoracic surgery. The da Vinci Surgical System requires very little cutting and the incisions made are very small. Advantages of the smaller incisions include less pain, smaller amount of blood loss and a shorter healing period after the surgery. The high definition cameras and the 3D view in the da Vinci Surgical System also offer increased visibility, which reduces the chances of puncturing blood vessels or any other part during the surgery.
3. Faster recovery
Patients who undergo surgery using the da Vinci system report faster recovery. They require less after care and the risk of post surgery complications is remarkably reduced. This is especially the case with post surgery infections, which are a concern in cases of open surgery because of the larger wounds. Patients undergoing this kind of surgery realize the objectives of their treatment quickly and they can return to their normal activities with no problems.
The da Vinci Surgery System is available for almost all forms of surgery, including gynecological, kidney and colorectal. Areas such as urology are known to have been at the forefront of adopting this system to urological surgeries and to date, most urologists, including the members of the Advanced Urology Institute, champion the use of the da Vinci Surgery System.
For more information about the da Vinci Surgery System, visit the “Advanced Urology Institute” website.
Robotic partial nephrectomy involves using an advanced surgical robot to remove part of the kidney, usually the portion with a tumor. Initially, robotic surgery enjoyed tremendous success with surgical removal of the prostate (prostatectomy), but in recent years its usage in kidney operations also has yielded remarkable results. In fact, robotic partial nephrectomy has become the preferred treatment option for most patients with benign kidney tumors, small renal masses and early-stage cancer. During the procedure, tumors are removed with the least possible disruption of the rest of the kidney — a nephron-sparing approach that maximizes post-operative kidney function.
Why is the da Vinci surgical system suited for partial nephrectomy?
The da Vinci surgical robot provides superior maneuverability that is suited for the delicate slicing, cutting and stitching involved in the removal of a portion of the kidney. The surgical robot offers a three-dimensional view of the targeted area, allowing for a broader range of motion of the surgical devices. Urologists using the robot find it much easier to make the complex maneuvers required during the procedure.
Since it uses smaller incisions and doesn’t involve making cuts through bone or muscle, the da Vinci partial nephrectomy causes less scarring and minimal trauma to patients. The recovery time is typically only 2 weeks compared to the 6-8 weeks recovery time after open kidney surgery. Likewise, blood supply to the kidney is blocked for a shorter duration, leading to less overall blood loss and quicker recovery compared to laparoscopy.
How is the robotic partial nephrectomy performed?
During robotic partial nephrectomy, the surgeon makes a series of tiny incisions in your abdomen. The camera and robotic surgical instruments are inserted through these incisions. To create enough room for manipulation of the surgical instruments and enable easy access to the cancerous tissue, the abdomen is inflated with gas (carbon dioxide gas). The doctor then moves the colon away from the kidney and trims off the fat covering the kidney to expose the kidney surface.
With the kidney exposed, the surgeon halts the blood flow to the kidney temporarily to prevent potential bleeding as the tumor is cut and the remaining portion of the kidney sutured together. At the end of the procedure, the urologist reconstructs the kidney, restores blood flow and then inspects the kidney carefully to make sure there is no bleeding.
Who should undergo robotic partial nephrectomy?
The da Vinci partial nephrectomy is the surgical treatment of choice for patients with smaller kidney tumors, usually not bigger than 4 cm in size. However, even patients with tumors ranging from 4 cm-7 cm also may undergo the procedure if they are to be treated in certain areas. Similarly, robotic partial nephrectomy is appropriate in cases where removing the whole kidney could trigger kidney failure or the need for dialysis.
At Advanced Urology Institute, we perform hundreds of robotic partial nephrectomy every year with amazing results for our patients. The procedure takes a short time, reduces the problems caused by benign or small kidney tumors and is effective in helping patients recover from kidney cancer. The minimally-invasive nature of the procedure guarantees less scarring, minimal trauma and quicker recovery for our patients. But we always ensure that patients are closely monitored for post-operative pain and complications, accomplishing cancer-free and happier lives for our patients. For more information on treatment of kidney cancer and other urological problems, visit our “Advanced Urology Institute” site.
Robot-assisted (robotic) surgery uses small instruments attached to a robot’s arm to conduct surgical procedures. A qualified, highly-skilled surgeon controls the robotic arm, using it to enhance surgical precision. In fact, contrary to popular beliefs, it’s the surgeon behind the robot and not the robot itself that performs the procedure. The robot improves surgical outcomes and boosts patient safety by enabling the surgeon to use very tiny incisions and to achieve unmatched precision.
Robotic surgery in urology
Robot-assisted surgery has become very popular in urology, particularly in the United States. In urology centers where it is used, it’s extensively applied in surgery to excise prostate cancer as it enables access to anatomical areas that are difficult to reach. Other urologists use it for kidney cancer surgeries and to some extent in bladder surgeries. Through robot-assisted procedures, urologists are able to use the surgical assistance, enhanced precision, systems networking, dexterity and image-guidance made possible with robots. Urologists are able to easily perform complex procedures that are often difficult to do using conventional laparoscopy.
While robotics are excellent tools that improve the outcome of surgical procedures, they are not ideal for every situation. The need and value of robot-assisted surgery varies from case to case and it’s important to discuss this with your urologist before undergoing surgery. Being clearly informed of the benefits and risks associated with robotic surgery ensures that you can make an informed decision before the procedure.
Advantages of robot-assisted surgery
Robotic surgery is typically minimally invasive. So the patient suffers less pain, slight blood loss and minimal scarring, and requires only a short recovery time. With the robotic arm eliminating the natural limits of human wrists, surgery can be performed with more delicate, precise and efficient movements. The 3D imaging and endowrist technology of robots ensure surgery is more accurate, nerve bundles are dissected more precisely, erectile function is preserved, and there is a better chance of cure than with non-robotic surgery. The surgeon also enjoys more strength, dexterity, flexibility, control and a better view of the operated area. Robotic surgery allows the surgeon to get more comfortable, perform the procedure with increased concentration and focus, and can undertake complex procedures that are tougher or impossible with other techniques.
Disadvantages of robot-assisted surgery
With robot-assisted surgery, there is not only the risk of human error when operating the robotic system, but also the potential for mechanical failure. For instance, system components such as robotic arms, camera, robotic tower, binocular lenses and instruments can fail. In other cases, the electrical current in the robotic instrument can leave the robotic arm and be misapplied to surrounding tissues, resulting in accidental burn injuries. Likewise, robot-assisted surgery can cause nerve palsies due to extreme body positioning or direct nerve compression that may occur when using robots. It also takes longer to perform robotic surgery than non-robotic surgery in surgical centers with lower robotic volume or by less experienced surgeons.
Ways of improving robot-assisted surgery
It’s important that centers applying robotics follow standardized training, improved reporting and enhanced patient education to reduce errors related to robotic surgery. Robotic surgery should be conducted by urologic surgeons trained in robotics and have extensive robotic and laparoscopic surgical experience. It also must be remembered that adding robots to the surgical equation may create room for error in an already risk-fraught and complex arena. So proper steps must be taken to guarantee safe and effective robot-assisted procedures. Robotic surgery is getting better and better as more advanced robots are developed to overcome existing shortcomings. So patients should expect better outcomes with robot-assisted surgery as advanced machines are applied.
At Advanced Urology Institute, we believe that surgical outcomes are a direct manifestation of the experience and skill of the surgeon, and less about the approach or technology used. That’s why we have assembled a team of qualified, skilled and experienced urologists to offer surgical procedures for different urological disorders. Our urologists perform hundreds of laparoscopic and robotic surgeries every year and have achieved great success rates in terms of efficacy, cure and improved quality of life. Our approach to robotic surgery guarantees that you will get the best possible surgery with remarkable outcomes. For more information, visit the “Advanced Urology Institute” site.
Urology has always been one of the leading medical specialties in the adoption and application of the latest cutting-edge technologies. For many decades urology has been one of the areas of medicine that has often readily embraced new technologies and incorporated them into everyday practice for the benefit of patients. Urology was the first medical field to espouse and use scopes for various procedures. And then with the invention of robotic systems, urologists quickly adopted and integrated the da Vinci system in their practices, using it for prostate surgery and making the da Vinci prostatectomy one of the first mainstream
surgical procedures to be performed using robotic technology.
Influence of robotic surgical systems
The introduction of robotic systems in urology has quickly enabled urologists to overcome the limitations of open prostatectomy (traditional laparoscopy) such as limited instrument movement, difficult suturing, complex reconstruction and two-dimensional vision. Likewise, the introduction and quick assimilation of robotic technology has helped to solve the problem of surgeon fatigue in laparoscopic urology. Robotic systems have enabled urologists to perform complex reconstruction and dissection in less than 2 hours delivering excellent outcomes.
Overcoming limitations of open prostatectomy
Before the emergence of robotic surgical systems, men suffering from prostate cancer had very few treatment options. The principal surgical option available was open radical prostatectomy, a procedure that involved large incisions and serious post-operative side effects. For example, when using open prostatectomy, the removal of the entire cancerous prostate resulted in increased risk of post-operative infections, excessive blood loss, considerable pain and longer hospital stays. Open prostatectomy also may lead to loss of sexual function and bladder control due to cutting of the delicate nerve plexus around the prostate. The da Vinci robotic surgery is a minimally invasive procedure that uses smaller incisions, reduces blood loss and ensures a shorter hospital stay, making things better for the patient.
Utmost precision, great outcomes
The intuitive nature of the movement of robotic instruments results in highly precise, accurate, effective and safe prostatectomy. While laparoscopic surgery’s precision is reduced by the fulcrum effect (movement of the instrument tip in the direction opposite to the surgeon’s hands), the da Vinci robotic system has no fulcrum effect, offers three-dimensional visualization, boosts degrees of freedom, eliminates tremor, reduces fatigue and provides motion scaling and ergonomic positioning. Robotic surgery is a remote controlled process in which the surgeon’s movements are precisely translated through sensitive fibers to the instrument’s tip. When applied in prostatectomy, robotic systems have been found to offer several advantages over traditional laparoscopic surgery, including minimal scarring, diminished risk of complications, clinically superior results and quicker recovery.
State-of-the-art prostatectomy at Advanced Urology Institute
Want to be treated by a highly trained and experienced team of surgeons, technicians and nurses? At Advanced Urology Institute, we have urologists who are specialists in robot-assisted surgery for prostate cancer and other urological conditions. We perform dozens of surgical procedures every month using the da Vinci robotic system. This minimally invasive, high-precision robotic technology delivers great results with complex and delicate surgeries such as prostatectomies, where the target site is surrounded and confined by the nerves regulating erectile function and urinary flow. At AUI, we use the robotic system as an exacting tool to avoid damaging these nerves, shorten recovery time and ensure quick return to normal activities.
For more information on exceptional, world-class treatment using robotic technology, visit the “Advanced Urology Institute” site.
The da Vinci system is a revolutionary, minimally-invasive surgical robot for treating prostate cancer. Designed by Intuitive Surgical to help overcome the shortcomings of both the traditional laparoscopic prostatectomy and open prostatectomy, the da Vinci system enables a surgeon to conduct highly precise, nerve-sparing surgery using several dime-shaped incisions. With the da Vinci surgical procedure, entire cancerous tissue or prostate can be removed, cancer completely eradicated and internal repair achieved without interference with sexual function, potency and bladder control.
Also called robotic prostatectomy, the da Vinci uses a finely-controlled robotic apparatus, including micro-surgical instruments and high-resolution cameras, to perform prostate surgery safely, achieving faster patient recovery and better treatment outcomes.
During da Vinci robotic surgery, urologists use the “motion scaling” feature on the system to convert subtle hand movements made outside the body into extremely precise and accurate movements inside the body. The urologist controls the robotic arms of the da Vinci console by applying natural wrist and hand movements. Through motion scaling, filtration and seamless translation of hand-and-wrist movements, the urologist can achieve greater precision that is normally not achievable during traditional laparoscopic and open surgery procedures. The da Vinci system not only provides urologists with enhanced dexterity, range of motion and flexibility, but also enables surgeons to safely access difficult-to-operate areas of the pelvis, abdomen and closed chest. The robot also filters and eliminates unpredictable hand movements and hand tremors that may occur during the operation.
Computerized 3-D Visualization
The da Vinci system dramatically improves visualization by providing a sharper and brighter view than can be seen during traditional laparoscopic endoscopes and by the eye during open surgery. The robotic system comes with a proprietary camera, enabling the surgeon to zoom in, rotate and even change image visualization. As a result, the 3-D image produced is clearer and brighter, and with no flickers as seen in traditional laparoscopic systems.
Even though the da Vinci robotic prostatectomy is a remote procedure, urologists have the feeling that their hands are fully immersed in the body and are able to complete all the necessary procedures efficiently. With the 3-D visualization and robotic hand simulation, the da Vinci system enables urologists to perform highly complex procedures more effectively than traditional laparoscopic surgery or open surgery.
Getting da Vinci Prostatectomy at Advanced Urology Institute
At Advanced Urology Institute, the da Vinci prostatectomy patients are usually discharged 24 hours after their operation. The system is used at AUI because it has superior benefits to traditional laparoscopic prostatectomy or open prostate surgery. The benefits of the da Vinci prostate surgery include:
Reduced pain and higher nerve-sparing rate.
Shorter hospitalization, with most patients going home the next day.
Minimal blood loss, fewer transfusions and reduced risk of complications (such as impotence and incontinence).
Quicker return to pre-surgery erectile function and urinary continence.
Faster return to routine activities.
Are you looking for a da Vinci urologist near you? You can check out this life-changing technology at Advanced Urology Institute. For more information, visit the “’Advanced Urology Institute” site.