The da Vinci
surgical system _

Originally created to fulfil an order from the American Army to operate soldiers remotely, the da Vinci® robot is nevertheless not an autonomous system. In fact, this piece of equipment can neither be programmed not make decisions. Every surgical manoeuvre is driven by the surgeon who is comfortably installed in the operating theatre managing the machine’s controls.

 

The advantages

For the patient

• Increased safety
• Reduced post-operative pain
• Reduced blood loss
• Reduced post-operative stays
• Faster recovery and return to normal daily life

 

How does it work?

The da Vinci® surgical robot consists of two parts. 

The first is a robot positioned above the patient. This is equipped with four operating arms with surgical instruments on the end - micro pincers, scissors, needle-holders, etc…

The second part is a console, or sometimes a double console, located away from the patient. It is here that the surgeon sits and operates the surgical instruments using the controls. The robot only does what the surgeon tells it and reproduces the movements of the console operator with its arms. 

The camera is installed on the fourth arm and makes it possible to zoom at any time. The fact that there are two cameras provides the surgeon with 3D vision through a stereo view, with each eye receiving a slightly misaligned image in the console.

Always positioned next to the patient, a multidisciplinary team with thorough knowledge of the procedure is present throughout the operation and assists the surgeon. 

 

Medical specialisations

At La Source, the robot is limited to operations involving urology, visceral surgery, gynaecology and ENT surgery.

 

Visceral surgery

Tri-dimensional vision, which is more accurate and more natural, the flexibility and mobility of instruments and the filtration (or absorption) of involuntary shaking increases the safety of the operatory actions of da Vinci interventions. This allows for precise movements, such as dissections of fragile organs; the preservation of certain important and sensitive elements such as the nerves; and finally, fine, complicated sutures.

Gynaecology

A great many benign – non-cancerous – pathologies can affect feminine reproductive organs to the point that removal of the uterus (a hysterectomy) is recommended. 

Doctors often recommend a hysterectomy when no drug treatment or change in lifestyle results in a cure and does not alleviate symptoms.

Currently, many women manage to avoid the large incision and four to six week convalescence that goes with a conventional open surgery hysterectomy by opting for mini-invasive surgery. The da Vinci robot allows an optimal three dimensional view, a higher level of precision, an ergonomic position and image stability. In addition, this system facilitates accessibility and dissection.

Urology

This speciality involves the urinary tracts (kidneys, ureters, bladder and urethra) as well as the male reproductive system. Amongst the various pathologies, cancer of the prostate, which affects one out of every six men, is at the top of the list. In Switzerland, this cancer is the most common in men and has the second highest mortality rate after lung cancer.

While the advantages of robotic surgery are obvious for most urology laparoscopies, it is mostly used to remove the prostate (radical prostatectomy). Radical prostatectomy is one of the options for treating localised cancer of the prostate.

The da Vinci guarantees great precision of gesture in dissection. It makes it possible to preserve the neurovascular structures and facilitates the recovery of urinary continuity with tiny and precise sutures.