Robotic Surgery:The da Vinci mode

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Marty

Well-known member
Joined
Jun 10, 2001
Messages
1,597
Location
McLean, VA
They have had the robot at Inova Fairfax for over a year now.Dr. Paul Massimiano the mitral valve guru in our group of 10 heart surgeons( sort of a poor man's Dr. Cosgrove) allowed the Washington Post in to watch him do a mitral valve repair-his 38th with the robot.If interested, check in to Health Section Washingtonpost . com April 27. The article is long and detailed and has pictures-too long to post here.I was surprised to learn that the robot is particularly effective in mitral valve surgery, both repair and replacement.Its great advantage is the sternum does not need to be split and there is more rapid recovery. The patients usually are home the 2nd post op day.The surgeon operates at a comfortable console unscrubbed and the robot will correct any tremor the surgeon might have from too much coffee or being up all night.Disadvantages include increased operation time and consequently more patient time on the bypass pump.For even more info click www.intuitivesurgical.com
 
Marty, you killed me with "Poor Man's Cosgrove."

Gosh, I like the idea of having an intact sternum. Maybe this can be an option for me some day, if warranted.

Then again, I think of Arnold, and "I'll be back." Would hate that.

Cheers,
 
Ok, two things here.

First, I really think that if a surgeon's going to open you up and cut out parts to be replaced by other parts, he or she REALLY should be in the same room as you are during the procedure. There's just something wrong with a guy sitting in some room in some other part of the building playing with joysticks and knives on the ends of robotic arms go flying around inside your chest cavity.... Maybe that's just me.


Second, the advantage of taking out "tremors" in the hands of a surgeon who's had one too many cups of coffee before surgery really should be a RED FLAG to steer clear of.

Why the hell is your surgeon doing something that would impair his ability at the table before surgery????


Now, in saying all that, I think the REAL advantage to robotics in surgery is being able to do proceedures at great distances.

Imagine a surgeon like Dr. Cosgrove, a one of the kind sort of doctor, being able to perform surgeries in multiple hospitals in multiple countries all in one or two days. That's the key. There are really only a handful of top notch surgeons in the world for heart surgery and you've got to be pretty lucky ot be seen by one, to be near a facility or have the money (and health) to travel to such a surgeon.

Granted, hospitals that can't afford to attract such surgeons may not have the money for the robotic facilities either so...


I still would be uncomfortable if my surgeon was in another room with joysticks and TV sets while I was on a table in a surgical suite somewhere else in the building. If nothing else, the instant feedback and ability to totally change a plan because everyone's in the same room at the same time is preferable to fancy wizzbang androids...
 
Good comments, Harpoon. I'm looking at a picture in the Post that show a scrubbed surgeon(the assistant) standing right by the patient on the table. Apparently he's the one who pokes the instruments in. At the head of the table is the anesthesiologist checking everything, and near by is the perfusionist( the heart lung by pass guy) and in the same room close to the table sits the surgeon at the operating console. He's close by and if something goes wrong he can scrub and do the operation the old fashioned way. I was being a little sarcastic in my comments about surgeon tremor but I understand some very good surgeons have a tremor not caused by coffee or lack of sleep. The robot would help them and the patient. I am fascinated by your idea of a setup that would let Dr. Cosgrove( or Dr. Massimiano) operate on somebody at long distance while they stayed home. I can visualize this happening one day. Dr. Cosgrove in Cleveland operating on a patient in Afghanistan. Why not?
 
I can visualize it too, Marty. With the intro of the computer and the net, look at all the innovative things that have come along. It truly is an amazing and wonderful world that is developing all round us. And medical procedures are changing daily, as this proves.
 
For the sake of setting a precident, there ARE doctors that will teleconference on issues regarding patient care.


I don't know who or where, but I know it's done where one doctor can connect with another doctor half way around the world to discuss a patient's condition and options for treatment.

"Remote robotic surgery" might just become an extension of that.

Perhaps "Dr. Cosgrove from Cleveland Clinic" on the robot controls does the most delicate parts of the operation while other surgeons are in the OR in Afghanistan to handle prep and closing and other assisting type roles.

And now that I think of it, there are mobile surgery outfits that use customized commercial airliners to fly around the world performing surgery in needy countries. Right now the practice is mainly treating cosmetic type conditions, cleft pallates and the like. Why couldn't you have a flying heart surgery team with a chief surgeon based on land in his or her home hospital. The assistants on the team fly around to third world countries to work on patients who need the expertise of a world class surgeon but coudln't possible get to one.


You'd have to have all KINDS Of redundancies built into the communications links....
 
Dr. Jaggers (my surgeon) flies around the world and performs heart surgery for those in need who can't afford it.
 
Hi Al
I don't know if you remember or not..but Alicia had her Mitral Valve repair done by the Di Vinci Robot over a year and a half ago.It was being done up in Greenville North Carolina and her surgeon was one of the first to use it. I am sure if she sees this..she will chime in here and post.I wonder if it's little hands are cold are :D
Joan
 

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