The fourth generation Da Vinci robot assisted minimally invasive endoscopy to help doctors complete highly difficult and complex operations

The fourth generation Da Vinci robot assisted minimally invasive endoscopy to help doctors complete highly difficult and complex operations

Robotic surgery system is a complex that integrates many modern high-tech means. It has a wide range of applications and has a large number of applications in clinical surgery. Surgeons can operate with machines far away from the operating table, which is completely different from the traditional concept of surgery. It is a revolutionary surgical tool in the field of minimally invasive surgery in the world.

The use of robots for surgery has become increasingly popular. When robots are used for surgery, doctors' hands do not touch patients. Once the incision position is determined, the mechanical arm equipped with cameras and other surgical tools will perform cutting, hemostasis and suturing. The surgeon only needs to sit on the console in the operating room to observe and guide the work of the mechanical arm.

Recently, the Shenzhen Third People's Hospital successfully completed the highly difficult and complicated pancreatoduodenectomy using the newly introduced fourth generation Da Vinci robot as a patient. The patient's wound only had five 8mm holes. Da Vinci robot is an advanced laparoscopic system, which can achieve 3D effect with naked eyes. It can not only complete most operations in hepatobiliary surgery, but also be applied to operations in departments such as urology, obstetrics and gynecology, cardiosurgery, gastrointestinal surgery, etc., covering almost all types of surgery.

Laparoscopy, similar to electronic gastroscope, is a kind of medical instrument with a micro camera. Laparoscopic surgery is an operation using laparoscope and its related instruments. Laparoscope consists of five basic parts: laparoscopic video surveillance system, CO2 pneumoperitoneum system, electric cutting system, flushing suction system, surgical instruments, etc. The laparoscope video camera monitoring system consists of laparoscope, light source and optical path, micro 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 pneumoperitoneum machine and a CO2 cylinder.

The flushing absorption system mainly includes two parts: 1) Flushing: it is used to observe and protect tissues, prevent adhesion, stop bleeding, repair tissues, etc. 2) Suction: use the catheter effect for suction, and sometimes use a filter. The surgical instrument system consists of the basic instruments for cholecystectomy: 2 10mm trocar, 2 5mm trocar, 1 10mm instrument converter, 2 non-invasive grasping forceps, 1 curved dissecting forceps, pneumoperitoneum needle, scissors, titanium clamp, flushing suction tube, electrocoagulation separation shovel, and separation hook. Special instruments include cholangiography tubes, needle holding forceps, suture needles, snares for ligation, and extraction nets.

Da vinci robot and its system

It is an advanced robot platform. Its design concept is to perform complex surgical operations by using minimally invasive methods. The Da Vinci robot consists of three parts: surgeon console, bedside mechanical arm system and imaging system. Da Vinci robot is an advanced laparoscopic system. The flexible "inner wrist" can eliminate the trembling of doctors' hands. The unique three-dimensional imaging system can enlarge the surgical field of vision 15 times during the operation, and increase the field of vision angle; Reduce hand tremor; The robot "inner wrist" is more flexible than the laparoscope, can operate around the target organs from different angles, is smaller than the human hand, and can work in a limited narrow space; The operator can work in a relaxed working environment to reduce fatigue and concentrate more; Reduce the number of surgical personnel. The accuracy and stability of the operation are greatly improved. Smaller trauma makes the indication of minimally invasive surgery wider; Reduce postoperative pain; Shorten hospital stay; Reduce blood loss; Reduce tissue trauma and postoperative adhesion caused by inflammatory reaction during operation. Minimally invasive treatment methods such as: thoracoscopy, laparoscopy, gynecological endoscopy, etc.

Components and operation mode

The Da Vinci robot consists of three parts: surgeon console, bedside mechanical arm system and imaging system. It mainly consists of a console and an operating arm. The console consists of a computer system, a surgical operation monitor, a robot control monitor, an operating handle, an input/output device, etc. During the operation, the surgeon can sit in front of the console far away from the operating table, lean his head on the field frame, receive complete images from different cameras with both eyes, and jointly synthesize the three-dimensional stereogram of the surgical field. The doctor controls the operating lever with both hands, and the hand movement is transmitted to the tip of the mechanical arm to complete the surgical operation, thus increasing the accuracy and stability of the operation. This is a new master slave remote operation mode.

1. Surgeon Console

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

2. Bedside mechanical arm system

The bedside mechanical arm system is the operating part of the surgical robot, and its main function is to provide support for the instrument arm and camera arm. The assistant doctor works beside the bedside mechanical arm system in the sterile area, is responsible for replacing instruments and endoscopes, and assists the chief surgeon to complete the operation. In order to ensure the safety of patients, the assistant doctor has higher priority over the chief surgeon in controlling the movement of the bedside mechanical arm system.

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. It can also place various auxiliary surgical equipment. The endoscope of the surgical robot is a high-resolution three-dimensional (3D) lens, which has more than 10 times the magnification of the surgical field of vision. It can bring three-dimensional high-definition images of the patient's body cavity to the chief surgeon, so that the chief surgeon can better grasp the operating distance, identify the anatomical structure and improve the surgical accuracy compared with ordinary laparoscopic surgery