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The fourth-generation Da Vinci robot-assisted minimally invasive endoscopy helps doctors complete difficult and complex operations
 

Date£º[2020/9/23]
 

The robotic surgery system is a complex integrating a number of modern high-tech methods. It has a wide range of uses and has a large number of applications in clinical surgery. Surgeons can operate machines away from the operating table to perform operations, which is completely different from traditional surgical concepts. It is a well-deserved revolutionary surgical tool in the world of minimally invasive surgery.

The use of robots for surgery has become increasingly popular. When using robots for surgery, the doctor's hands do not touch the patient. Once the position of the incision is determined, the robotic arm equipped with cameras and other surgical tools will cut off, stop bleeding, and suture. The surgeon only needs to sit on the console, which is usually the operating room, to observe and guide the work of the robotic arm.

Recently, Shenzhen Third People¡¯s Hospital used the newly introduced fourth-generation Da Vinci robot as a patient, and successfully completed the highly difficult and complicated pancreaticoduodenectomy. The patient¡¯s wounds were only five 8 mm small. hole. Da Vinci Robot is an advanced laparoscopic system that can achieve naked eye 3D effects. It can not only complete most operations in hepatobiliary surgery, but also can be applied to operations in departments such as urology, obstetrics and gynecology, cardiac surgery, gastrointestinal surgery, etc., covering almost all surgical procedures.

Laparoscopy is similar to electronic gastroscope. It is a medical device with a miniature camera. Laparoscopic surgery is an operation performed using a laparoscope and related instruments. Laparoscopy is composed of five basic parts: laparoscopy video surveillance system, CO2 pneumoperitoneum system, electric cutting system, irrigation-suction system, surgical instruments, etc. The laparoscopic video recording monitoring system consists of a laparoscope, light source and light path, miniature camera, camera converter, monitor (TV), automatic cold light source, and video recorder. The CO2 pneumoperitoneum system consists of a spring pneumoperitoneum needle (Veness needle), an inflation catheter, an insufflator and a CO2 cylinder.

The flushing-absorption system mainly includes two parts: 1) Flushing: The function is to observe and protect tissues, prevent adhesion, stop bleeding, and repair tissues. 2) Attraction: The duct effect is used to attract, and sometimes a filter is used. The surgical instrument system consists of the basic instruments for cholecystectomy: 2 10mm trocars, 2 5mm trocars, 1 10mm instrument converter, 2 non-invasive grasping forceps, 1 curved dissecting forceps, insufflation needle, Scissors, titanium clamps, flushing-suction tube, electrocoagulation separation shovel, separation hook. Special instruments include cholangiography tubes, needle holders, snares for ligation and ligation, and nets.


Da Vinci robot and its system

It is an advanced robotic platform whose design concept is to perform complex surgical operations by using minimally invasive methods. The Da Vinci robot consists of three parts: the surgeon console, the bedside robotic arm system, and the imaging system. The Da Vinci robot is an advanced laparoscopic system. The flexible "inner wrist" can eliminate the tremor of the doctor's hand. The unique three-dimensional imaging system can magnify the surgical field of view by 15 times during the operation and increase the field of view angle; reduce hand tremor; the robot "inner wrist" is more than laparoscopic Flexible, able to operate around the target organ at different angles, smaller than a human hand, and able to work in a limited and narrow space; enable the surgeon to work in a relaxed working environment, reduce fatigue and concentrate more energy; reduce the number of surgical personnel. Greatly improve the accuracy and stability of the operation. Less trauma makes the indication for minimally invasive surgery wider; reduces postoperative pain; shortens hospital stay; reduces blood loss; reduces intraoperative tissue trauma and postoperative adhesions caused by inflammatory reactions. Minimally invasive treatment methods such as: thoracoscopy, laparoscopy, gynecological laparoscopy, etc.

Components and operation methods

The Da Vinci robot consists of three parts: the surgeon console, the bedside robotic arm system, and the imaging system. It is mainly composed of a console and an operating arm. The console is composed of a computer system, a surgical operation monitor, a robot control monitor, an operating handle, and input and output devices. During the operation, the surgeon can sit in front of the console away from the operating table, rest his head on the field of view, and receive the complete images from different cameras with his eyes, and synthesize a three-dimensional image of the surgical field together. The doctor controls the operating lever with both hands, and the hand movements are transmitted to the tip of the robotic arm to complete the operation, thereby increasing the accuracy and stability of the operation. This is a newly proposed master-servant remote operation mode.

1. Surgeon console

The surgeon sits in the console, outside the sterile area of ​​the operating room, and uses his hands (by operating the two main controllers) and feet (by the foot pedal) to control the instruments and a three-dimensional high-definition endoscope. As seen in the stereo eyepiece, the tip of the surgical instrument moves in sync with the surgeon's hands.

2. Bedside robotic arm system

The bedside robotic arm system is the operating part of the surgical robot. Its main function is to provide support for the instrument arm and camera arm. The assistant doctor works by the bedside robotic arm system in the sterile area, is responsible for changing instruments and endoscopes, and assisting the surgeon to complete the operation. In order to ensure patient safety, the assistant doctor has a higher priority to control the movement of the bedside robotic arm system than the chief surgeon.

3. Imaging system

The imaging system is equipped with the core processor of the surgical robot and image processing equipment. It is located outside the sterile area during the operation and can be operated by itinerant nurses, and various auxiliary surgical equipment can be placed. The endoscope of the surgical robot is a high-resolution three-dimensional (3D) lens, which has a magnification of more than 10 times for the surgical field of view. It can bring three-dimensional and high-definition images of the patient's body cavity to the surgeon, making the surgeon more common laparoscopic surgery It can better grasp the operating distance and identify the anatomical structure, which improves the accuracy of the operation.