Da Vinci Robotic Surgery system is an advanced tech-nology product, the foundations of which were laid in the 1970s for the first time by NASA to perform surgical procedures that may be needed by astronauts work-ing in space, by a surgeon from Earth. With this idea, the prototype of da Vinci Robotic System was revealed and FDA (American Food and Drug Administration) approval was obtained in 2000.
Robotic surgery system is basically a closed surgical technique. The system, which allows the surgeon to perform the operation with the least possible incision, is a laparoscopic surgery system with a three-dimensional superior image, advanced technology, very thin and sensitive instruments having a lot of movement capabilities. In urology surgeries, the ends of the ro-bot’s arms are connected to metal or plastic structures called trocars, which are opened in the patient’s ab-domen and inserted into the abdomen through 4 or 5 holes, the sizes of which vary between 8 mm and 12 mm. The surgeon, on the other hand, controls all robot arms without touching the patient and performs the operation by sitting on the control panel (console) where he performs the operation.
The latest point of technology and surgery
Da Vinci Robotic Surgery System basically consists of 3 parts.
Surgical console: The console is located in the same room as the patient, but at a distance from the operat-ing table where the patient lies. The operating doctor sits on this console and sees the tissues in high resolu-tion, 3D and 10-12 times larger, and controls the robot with console arms and foot pedals.
Robotic arms: Robotic unit has 4 arms that are com-pletely under the control of the surgeon. While one of them is managing the camera, the other 3 arms are the ones that perform the surgery in the abdomen, which are controlled by the surgeon. Surgical instruments at-tached to the arms of the robot can move in 7 angles. In other words, it has a much greater range of motion than the human wrist. These surgical instruments are quite small and can easily reach even the most sensi-tive points. The arms of the robot have a rotation angle of 540 degrees.
Tower: It is the part where robotic arms, light and gas source and high-resolution 3D telescope are located. This special telescope has two high-resolution cam-eras that transmit images to each eye separately. The image is three-dimensional and the quality of the im-age is high.
Advantages of robotic surgery
There is no need to make large incisions in surger-ies performed with the robotic surgery system. Holes are drilled in the abdomen of the patient, only large enough for the robot’s arms to enter, and these holes are between 8 millimeters and 12 millimeters.
The clear images obtained with the robotic surgery system allow the intervention to be performed on the relevant area effectively.
Surgical instruments at the ends of the arms of the ro-botic surgery system have greater mobility than the hu-man wrist. In this way, it reaches many parts of the body and provides important conveniences such as cutting, holding and suturing in critical surgical interventions.
The human hand may tremble more or less physiologically; however, the precise mobility of the arms of the robotic surgery system eliminates this vibration.
With the very small incisions and superior image quality, the visualization of even the smallest vessels reduces blood loss.
In robotic surgery, since the surgeon manages the operation from the console in a sitting position, the stress due to physical fatigue decreases and the surgeon does not lose concentration.
Robotic surgery can be performed with very small in-cisions.
After robotic surgery, hospital stay of patients and fast-er return to daily life are shortened.
With robotic surgery, obese patients can be operated much more easily.
Robotic Surgery performs all surgical procedures that can be performed by laparoscopy in most of various branches. In general, Urology, Obstetrics and Gyne-cology, General Surgery, Cardiovascular Surgery, Thoracic Surgery are branches that use da Vinci Ro-botic Surgery System.
Areas of usage of robotic surgery in urology; In urology, robotic surgery is used in certain surgeries such as prostate cancer, bladder cancer, kidney can-cer, renal outlet stenosis and ureterovesical stenosis (stenosis of the urinary canal into the bladder). It is widely used in the treatment of prostate cancer. Ap-proximately 90% of prostate cancer surgeries in the USA are performed through robotic surgery.
The most important advantage in prostate cancer surgeries is that it allows for a much more effective tumor control, almost elimination of urinary inconti-nence, which has become a nightmare for patients, and a lower incidence of postoperative sexual dys-function.
In prostate cancer (Radical prostatectomy)
- Urinary control is achieved earlier in robotic pros-tatectomy compared to open radical prostatec-tomy. Better visualization, less bleeding, and a longer urethral length are factors that enable early urinary control.
- In the appropriate patient, the preservation of the nerve-vascular bundle around the prostate can be performed better in robotic prostatectomy and the sexual life returns to normal earlier in these pa-tients.
- In kidney cancer
- In bladder cancers
- In the treatment of ureterovesical stenosis or vesi-coureteral reflux in both children and adult patient groups
- Pyeloplasty surgery to correct the narrowing of the kidney outlet
- Retroperitoneal LND surgery in testicular tumors
We performed 1200 robotic surgery operations
Since 2012, every surgery that can be performed with robotic surgery has been successfully performed in the Urology Clinic of Koru Hospital. In this context, we have performed a total of 1200 robotic surgical opera-tions since 2012.