The da Vinci Machine: A Surgical Revolution

Jun 27, 2024

3 min read

158

By: Alexander Heredia

Imagine a device with 4 arms—each movement made by the arms independent and free-flowing; a science fiction dream come true. The da Vinci machine is an advanced step in biomedical engineering. This machine has brought enormous progress and knowledge to surgical advancements and laparoscopic procedures that were previously inaccessible.

The da Vinci Surgical System (Intuitive Surgical Inc, Sunnyvale, California) and it's later version, the da Vinci S, consist of a surgeon's console connected to the body of the da Vinci, a robotic manipulator unit with 4 instrument arms, including a central arm guided by the endoscope camera, to which the surgeon's movements are transmitted [1]. This device allows for a surgeon's precise movements to be mimicked to the finest degree. These units are equipped with something called EndoWrists; these contain the same function as human wrists and allow the physician to fully bend and twist the arms and tools that are in use.

When it comes to surgery, one thought typically comes to mind: using a scalpel to make a large incision. This is true for multiple surgeries, like sternotomies (a surgery to reach your heart and lungs) which require a wide incision. Beginning around the year 1901, one of the first laparoscopic surgeries was performed. Since then, laparoscopic surgeries have been performed when available, and by contrast, invasive procedures are done when medically necessary. Both major invasive procedures have now become minimally invasive. Appendectomies (the surgical removal of the appendix) are typically emergent surgeries due to rupture or inflammation. An appendectomy is usually carried out on an emergency basis to treat appendicitis (inflamed appendix). A ruptured appendix can cause peritonitis, which is a potentially life-threatening complication [2]. Cholecystectomies, although typically elective, can be done laparoscopically using the da Vinci.

The da Vinci machine isn't just used in general surgery; it can be used in many other specialties and types of surgeries. Da Vinci procedures are performed for a wide range of conditions in specialties including cardiac, urologic, gynecologic, pediatric, and general surgery. Roughly three out of four prostate cancer surgeries in the U.S. today are performed using da Vinci machine surgery [3].

The da Vinci System is a remarkable improvement over conventional laparoscopy, in which the surgeon operates while standing and uses hand-held, long-shafted instruments that cannot bend or rotate. With conventional laparoscopy, the surgeon must look up and away from the instruments to a nearby 2D video monitor to see an image of the target anatomy. The surgeon must also rely on their patient-side assistant to position the camera correctly. In contrast, the da Vinci System’s ergonomic design allows the surgeon to operate from a comfortable seated position at the console, with eyes and hands positioned in line with the instruments. To move the instruments or to reposition the camera, the surgeon simply moves their hands. By providing surgeons with superior vision, enhanced dexterity, greater precision, and ergonomic comfort, the da Vinci Surgical System makes it possible for more surgeons to perform minimally invasive procedures involving complex and delicate dissection or reconstruction [4].

The da Vinci Surgical System is one of the most revolutionary pieces of biomedical engineering. From helping millions of patients around the world to creating a segue to improve modern surgical technology, the da Vinci unit is one of the greatest surgical inventions of the 20th century.

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Author Alexander Heredia is an 9th grader from the Southern United States, passionate about current advancements in healthcare technology.

Works Cited