Laparoscopic Procedures: Robot-assisted Laparoscopic Procedures
Guest: Dr. David Adams – Surgery
Host: Dr. Linda Austin – Psychiatry
Dr. Linda Austin: I am Dr. Linda Austin, talking with Dr. David Adams, Professor of Surgery at the Digestive Disease Center of the Medical University of South Carolina. Dr. Adams, one of the new techniques that people are very interested in these days are the robot-assisted laparoscopic procedures. Just what are these robots like?
Dr. David Adams: These robots are very friendly and they are very easy to use and to work with. There have been some wonderful technological developments. One of the main assets in doing robot-assisted laparoscopic surgery is that it takes away limitations that occur when you are doing normal laparoscopic surgery, working through small tubes, and having instruments that have limitation in their rotation and flexibility. So, what the robot does is, it allows you to look at a television image to see exactly where you are working under well lit, well exposed conditions and then to have instruments in the abdomen working in small, difficult to get to, areas that have very precise and accurate movements. For example, if you wanted to just do an operation and work around a very important nerve and keep that nerve out of harm’s way, the robot can be very accurate and precise in translating the movements that you want to use right next to that nerve so that it keeps it out of the way.
If you needed to sew together two very small structures, you have very accurate instruments that can produce all kinds of different angles that would be necessary to sew two things together. It has a lot of great potential in current uses in a broad area of abdominal surgery, and chest surgery as well. It is one of the first areas it was developed in, to do heart surgery, to sew in heart valves, to sew new blood vessels to the heart.
Dr. Linda Austin: Now, when most people think of a robot, they think of C3PO or R2D2, but this robot actually looks very different from that. Can you describe what it looks like?
Dr. David Adams: It has a great name. It is called da Vinci, so, appropriate for an inventor. It is a very large, heavy piece of equipment that would look to be about the size of a dishwasher. It has various connections that are attached to the instruments that are placed in the patients. Separate from that is an area where the surgeon sits and is fitted with gloves or instruments that he attaches to his fingers. What the robot does that is so wonderful and makes the surgeon’s work so easy is that the robot transmits the actions that the surgeon’s finger is doing in front of him onto the TV screen and into the instruments that are inside the patient.
There are amazing things it can do. It can be synchronized with, say, the beating heart so that the movement of the heart is taken out of the equation. If a surgeon has had too many cups of coffee and his hand is shaking, it can figure out the tremor in the surgeon’s hand. So, there are a lot of current and potential uses that make it very suitable.
It was developed through a lot of effort by the military because they were interested in using it in battlefield surgery or outer space, which have problems of a practical nature that make it ineffective in those situations. But, in the controlled atmosphere of an operating room where there are very precise and specific tasks to be done, it has advantages for many surgeons.
Dr. Linda Austin: What is the status of our robot use here at MUSC?
Dr. David Adams: We have a group of surgeons here, pediatric surgeons, urologists, gynecologic surgeons, who have made the necessary preparations to acquire a da Vinci. We are currently developing an operating room that will be dedicated to the robot and will be used for specific purposes.
Dr. Linda Austin: So, that will happen in our new hospital?
Dr. David Adams: Yes.
Dr. Linda Austin: Very exciting.
Dr. David Adams: It is.
Dr. Linda Austin: Dr. Adams, thanks so much.
Dr. David Adams: Thank you, Linda.
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