I had the privilege of seeing the da Vinci Surgical System in action during one of Dr. VanKoevering’s surgeries at the James Cancer Hospital. This is a minimally-invasive device which allows surgeons to freely operate in narrow or closed spaces where doing so with the naked eye and with the hands would require larger surgical incisions and probably less refined surgical technique.
Even though I had heard about this device, I had never seen it being used in the operating room. The device consists of surgical arms supported by a robotic device which is located right over the operating site. Simultaneously, this robot is operated by the surgeon, who uses manual controls located in another component of the da Vinci Surgical System, that’s across the operating room. This control station allows the surgeon to visually zoom into the surgical site with the help of a camera, and his hand/finger movements are repeated in real time on the robotic arms. The surgeon’s module also has a microphone, which allows the surgeon to speak at a normal volume while the device magnifies the sound of his voice, allowing for better communication across the OR. The device is very versatile, as it even makes corrections in movement, in the event the surgeon makes an accidental hand movement which could harm the patient. The two modules of the device are connected by cables across the OR. There was no use of WiFi to connect the surgeon’s controls to the robotic arms.
The surgeries most commonly performed with the da Vinci robot include, most commonly, gynecologic, renal, and cardiac valve surgeries. This time, though, I had the opportunity to see a tonsillectomy on a tonsillar cancer patient. The procedure lasted about an hour, and it included extraction of local lymph nodes for pathology studies, to test for metastasis.
As one would expect, this device can be used to operate at a distance. For example, patients in rural and isolated parts of a country could benefit from having a surgery without the surgeon being present. The surgeon could be operating from a different city, or even a different country. This technology, however, has not yet become reliable enough to permit this to happen, in part due to concerns regarding loss of wireless signal to maintain the real-time nature of the intervention. A minimal lapse between the movements of the surgeon’s hands and the robotic arm movements could lead to mistakes during the surgery, which may be catastrophic for the patient.
I think this technology, even though it’s already twenty-five years old, has a lot of potential and a bright future, in the field of telemedicine and long- distance surgery.