Central Florida surgeons practice remote surgery that may help war wounded
April 26, 2012
A research is being conducted at Florida Hospital's Nicholson Center for Surgical Advancement in Celebration that will potentially help doctors perform remote surgery across the state, country and even half a world away.
Officials are using a $4 million grant from the U.S. Department of Defense to learn how surgeons can compensate for the lag that happens when the distance between doctor, patient and robot stretches across an ocean. Those findings could lead to improvements in how wounded soldiers are treated on the battlefield by surgeons thousands of miles from the front. "We can discover ways to do this so the U.S. has a leg up on this type of surgery," said Dr. Roger Smith, chief technology officer at the center.
But so far, it has not been used across vast distances because of a risky quarter- to full-second lag time between the surgeon's movements and the robot's response. Federal regulators permitted the only true U.S. telesurgery procedure in 2001 when a team of French surgeons in New York operated on a patient using robots in Strasbourg, France, to test the procedure.
Doctors say it can take hundreds of attempts to master the da Vinci system. Some of the physicians trained in remote surgery who participated in the study were surprised at how their rigorous training did not prepare them for a one-second delay. "You think that a one-second delay isn't a big deal, but it's extremely frustrating," said Jacksonville obstetrician and gynecologist, Dr. Angela Martin, who took part in the study. "By the time the robot moves an arm, I'm already on my second movement, and there's a tendency to repeat the first action. By then, I could have poked a hole in the patient."......complete article
Robot Assisted Prostate Cancer Surgery Compares Favorably to Other Surgical Techniques
April 25, 2012
Outcomes from use of a robot to assist surgeons in removal of a cancerous prostate are at least as good, if not better, than the other two techniques used for a radical prostatectomy -- open or laparoscopic surgery -- according to a large meta analysis led by researchers at NewYork-Presbyterian/Weill Cornell.
The study, published February 24 online in European Urology, should help resolve some of the controversy regarding use of the robotic option, known as robot assisted laparoscopic radical prostatectomy (RALP), says the study's lead author, Dr. Ashutosh Tewari, director of the Lefrak Center for Robotic Surgery and director of the Prostate Cancer Institute at New York-Presbyterian Hospital/Weill Cornell Medical Center....read more
Open source medicine puts health above profits
April 24, 2012
Open source is powering a revolution in medicine and health care in multiple ways. Open source software and methods make large-scale collaborative research projects feasible, multiplying the brainpower applied to a project, expanding the data pool, and creating transparency and accountability. This is a huge win for the advancement of new treatments and cures, and cutting the costs of research. Open source practice and records software cut the costs of running medical practices, and puts practitioners in charge instead of software vendors.
Enter Raven the surgical robot:
The University of Washington Biorobotics Lab and the University of California, Santa Cruz Human Bionics Laboratory are jointly developing Raven the Surgical Robot. Raven is an amazing machine that provides a 3D real-time view inside the human body, performs surgical procedures, and operates remotely over a computer network. Raven uses a high-speed graphics processor, similar to the graphics processors in computer gaming systems, to stream a continual series of ultrasound images.
The original Raven came out in 2005. Raven II was released early this year (2012) in a smaller, more dextrous version.
Seven models were built and sent to seven different biorobotics labs (University of Washington, UC Berkeley, UC Santa Cruz, UCLA, Johns Hopkins, University of Nebraska, and Harvard) for collaborative study and development, including networked experiments over the Internet. Raven runs on a real-time Linux kernel and the Robot Operating System, and is designed to provide a common platform for collaborative research in robot assisted surgery.
Raven could also enable remote-control surgery over the Internet or other networks. Before Raven, surgery robots were very expensive and proprietary, and impossible to modify or build research on. The open Raven platform should result in significant progress....read more
The da Vinci Integrated Robotic Surgery Suite at Swedish
Posted: April 22, 2012
Dr. James R. Porter, the director of robotic surgery at Swedish Medical Center, talks about the da Vinci Integrated Robotic Surgery Suite and how it is used at Swedish. The four-armed robotic device is a minimally invasive surgical system that provides more dexterous surgery and better patient healing.
Dr. Porter discusses numerous specific elements of the Swedish da Vinci system, including the dual console, which allows two surgeons to be involved simultaneously in a procedure, and an internet transmission device, which allows live surgery to be transmitted anywhere in the world. For more information visit http://www.swedish.org/Services/Robotic-Surgery-Program.
Wilkes University Opens Metro Surgical Robotics Laboratory
April 20, 2012
Wilkes University has opened the Metro Surgical Robotics Laboratory, becoming the only northeast Pennsylvania institution to offer biomedical and engineering students the latest instructional and hands-on experience in robot-assisted, minimally invasive surgical procedures. The lab was dedicated in a ceremony on April 19.
Located in the Stark Learning Center, the laboratory features cutting-edge technology that allows students to remotely control intelligent robots within the abdominal cavity. These miniature devices perform dexterous manipulations while offering enhanced views from angles unavailable through traditional surgical methods. Highly–trained faculty members collaborate with Geisinger Medical Center surgeons to teach students a multitude of skills, including shortening incision lengths to reduce infection risks, vital for saving lives.
The Surgical Robotics Lab is outfitted with Mediascape technology, featuring Leapfrog and Stylist applications, which free students from work stations, facilitating learning. Other features include a smart white board, a mobile station fully-equipped with laptops, a surgical simulator station and modern cabinets to store miniature robotic parts.....complete article
Da Vinci Robot Surgical Risks Detailed
April 17, 2012
According to a study of 884 surgeries published this week in the Archives of Surgery, when something goes wrong after robotic surgery with the da Vinci surgical system, it's most likely due to co-morbidities in certain patients that make the procedure riskier, not flaws in the robot's technology itself.
"After reviewing all these cases, we can say for sure that there is no specific morbidity connected with the robot by itself, and that its mechanical failure is very, very rare," says lead author Pier C. Giulianotti, MD, of the Division of General and Minimally Invasive Surgery at the University of Illinois at Chicago. "We can now say that the morbidity and mortality that occurred in these patients was connected to the risk factors in the patients."
The authors determined that among these 884 robotic surgeries, the need to resort to non-robotic surgery techniques because of unanticipated complications was 2%; the re-operation rate was 2.4%; the mortality rate was .5%; the overall postoperative was 16.7%; and the mean length of stay was 4.5 days.
Giulianotti says that all the 884 procedures were done with the da Vinci system, and were assessed for complications that occurred within 30 days of hospital discharge. Giulianotti emphasized that robotic surgery is, across the board, "clearly superior" than procedures done with open incisions or laparoscopy. "You don't leave big scars and adhesions, you have less post-operative pain, recovery times are shorter, and infection rates almost non-existent."
The authors wrote that by understanding which patients are at greater risk for robotic surgery complications, surgeons eventually can develop a scoring system to measure quality of care among providers and hospitals.....complete article
Live cases from South Miami's Center for Robotic Surgery
Look In On Us: Live Cases from South Miami's Center for Robotic Surgery
Date: May 16, 2012
Time: 9.00 AM EDT
On Wednesday, May 16, watch three LIVE cases from first incision to closure from South Miami Hospital’s Center for Robotic Surgery. Procedures will feature advanced techniques in general, gynecologic and thoracic surgery. South Miami Hospital surgeons are paving the way for future generations of robotic surgery, and the Center is one of the busiest in the world in terms of volume.
Viewers are invited to e-mail discussion questions and comments during the procedures. All procedures will be available for live viewing via Flash, iPad and iPhone.
The robot has a special tip which can move in multiple directions at once. Image source: The Telegraph
British Man Has Kidney Cancer Removed With ‘Robotic Hand' Technique, A UK First
April 11, 2012
A hand-held robotic surgical tool has been used for the first time in the UK to remove a deadly kidney tumour.Doctors from the Manchester Royal Infirmary used the life-saving bionic device (called a ‘Kymerax robot’) to successfully remove a tumour from a 65-year-old grandfather.
The £90,000 hand-held robot, made by a Japanese company called Terumo, works by being inserted into the body via keyhole surgery. Once in, it precisely removes the tumour without damaging the kidney, enabling it to still function.
"Whilst this operation has been done before these new instruments allow greater accuracy and freedom of movement than the conventional keyhole surgery instruments,” Dan Burke, a consultant urological surgeon told "The Telegraph"
This isn’t the first time doctors from the Manchester Royal Infirmary performed a surgical first in the UK....read more
First Robotic Guided Surgery for Cervical Spine in the United States Performed at UC Irvine Orthopedic Spine Center
April 11, 2012
Dr. S. Samuel Bederman from The University of California at Irvine’s Orthopaedic Spine Center is the first surgeon in the US to perform robot-guided surgeries on the cervical spine. The cervical spine, which consists of the seven vertebrae in the neck closest to the skull, has special characteristics that distinguish cervical spine surgery from surgery of the thoracic or lumbar spine.
Dr. Bederman used Mazor Robotics’ Renaissance system to perform two cervical spine surgeries earlier this year. Together these cases are considered a ground breaking advance for robot-assisted spine surgery. The cervical application is expected to be released by the company towards the end of 2012.....read more
Sites touting surgeries are one-sided, says study
April 10, 2012
The drug industry gets a lot of grief over its online communications to consumers, but a study has found that sites posted by doctors and hospitals and touting surgeries are often dreadful—and far less tightly regulated.
Among the findings of the article "Direct-to-Consumer Internet Promotion of Robotic Prostatectomy Exhibits Varying Quality of Information" in the April 2012 issue of Health Affairs, is that many of the websites surveyed posed a number of problems. Among the findings were that 42% of the surveyed sites failed to mentions surgical risks, and the majority of the sites were written at college reading levels, when experts generally recommend consumer-facing information to be written for the typical eighth-grader, according to the Flesch-Kincaid scale. They also found that the majority of the websites included unsupportable medical claims.
The study, which used the procedure robotic prostatectomy as a test case, found the websites by Googling as a potential patient would. They also used the top search terms for the procedure, based on Google Insights Search Tool, and stuck to the first page of results to mimic typical patient behavior....read more
QUAN Spearheads New Initiatives in Explosive Medical Robotics Sector
April 10, 2012
Quantum International Corp. QUAN 0.00% , an emerging robotics innovation company, announced today that it is sharpening its focus and exploring new initiatives in the booming medical robotics sector.
The company is currently seeking out targets that are developing the next generation of computer-generated surgical tools and robots to market and distribute to medical centers around the world. QUAN is working to join a booming global robotics industry valued at an estimated $2.1 billion in 2011 and projected to reach $3.6 billion by 2016 (BCC Research).
The advantages of robotic surgery include better precision, smaller incisions, decreased blood loss, less pain, shorter healing time and articulation beyond normal manipulation. As of end-2010, only 1,752 robotic surgical systems have been installed globally. QUAN’s aggressive new initiative could lead to more advancements in this sector, as surgeons seek out newer, more affordable ways to perform complex medical procedures.
Ricardo Beira; From the article "Extending the Hands of the Endoscopic Surgeon"
DistalMotion’s Surgical Tool Combines the Best of Robotic and Endoscopic Surgery
April 6, 2012
Ricardo Beira, a student at Ecole Polytechnique Federale de Lausanne in Switzerland, and founder of DistalMotion, has developed a device that brings together benefits of both endoscopic and robotic surgery.
The device is completely mechanical and consists of a number of small joysticks, which allow the operation of surgical tools fixed to the end of a metal arm using endoscopic surgical techniques. The joysticks replicate the surgeon’s movements and allow for seven degrees of movement, including wrist rotation.
The mechanical nature of the device also provides the surgeon force feedback in his or her movements. As the device lacks the sophisticated electronic components found in other surgical robots, DistalMotion’s tool is only about one-tenth the cost of other devices.....complete article
Intuitive Surgical Shares May Be Pressured By Liability Lawsuit
Posted: April 6, 2012
For years Intuitive Surgical (ISRG) could do nothing wrong. Its revenues have grown at an average rate of 36.36% over the last 5 years. It has grown earnings yearly at an average growth of over 45% over the same period with growth forecast at a blazing 25% speed going forwards. However, with a trailing P/E of over 44 ISRG shares seem to be priced for perfection. The price assumes that the company can continue to execute as well at it has done historically.
However, a lawsuit filed yesterday by the father of a deceased 24 year woman after a procedure using an Intuitive Surgical system may be a potential roadblock, raising questions about future liability from similar suits.
According to the complaint filed in federal court in New York City, Gilmore McCalla's daughter died two weeks after undergoing a hysterectomy using the da Vinci in a Bronx hospital in August 2010. The complainant specifically alleges that the da Vinci robotic system was the cause of his daughter's death by causing burns to an artery and her intestines.
Filed by the firm of Rheingold, Valet, Rheingold, the complaint alleges design flaws in the da Vinci robot, including un-insulated surgical arms and use of electrical current which can jump to healthy internal organs and tissue. It also alleges that physicians are not properly trained on the device, and that Intuitive Surgical has failed to run randomized tests as to complications with its robot.....read more
Evergreen Healthcare Introduces Minimally Invasive Colorectal Procedure April 5, 2012
Evergreen surgeon is only one in state to perform procedure for removing challenging growths
Evergreen Healthcare today announced that it has successfully integrated a colorectal procedure called transanal endoscopic microsurgery to its growing suite of minimally invasive surgical options, reducing the need for major surgery and providing patients with faster recovery times.
Transanal endoscopic microsurgery, or TEMS, allows for the removal of challenging colorectal tumors without an abdominal incision, allowing patients to avoid colostomies as part of the procedure, as well as reducing local cancer recurrence, pain and the risk of complications.
Evergreen's Dr. Harry Kahn began utilizing TEMS in August 2011 and is currently the only surgeon in Washington state to employ the breakthrough technique. The procedure targets precancerous or early-stage tumors or lesions of the rectum that are difficult to reach through traditional surgical methods and would typically require open abdominal surgery.
TEMS is especially valuable for elderly or at-risk patients who benefit from an alternative to the risks of major rectal surgery.....read more
Courtesy photo Charlston Daily Mail
Attachment enables single-site surgery for gallbladder
Posted: April 4, 2012
Surgeons at Thomas Memorial Hospital will soon be able to perform gallbladder surgeries with incisions no bigger than a silver dollar, thanks to a new "single site" attachment for the hospital's da Vinci surgery robot.
The hospital is one of only 100 hospitals nationwide, and the only hospital in West Virginia, to get the new device.
The $101,000 attachment, when coupled to the $1.5 million surgery robot, allows surgeons to install a silver-dollar-size port in a patient's navel and perform the entire surgery through that port. The resulting incision can be closed with just two stitches.
Other Da Vinci surgical procedures require multiple ports in a patient's torso. Though the incisions are usually much smaller than in traditional surgeries, patients still are left with minimal scarring.
So far the FDA has only approved the single-site surgery for gallbladder procedures but gynecological surgeries with the single-site attachment are currently working through the FDA's approval process.....read more
Brain tumors removed through nose, mouth
Brain tumors removed through nose, mouth
April 3, 2012
Tumors growing at the base of the skull, next to vital structures such as the optic nerve or carotid artery, are notoriously difficult to remove. Operations historically required making large incisions in the head or face and cutting away bone and other tissue.
But doctors at Ohio State University’s Comprehensive Cancer Center are removing them without leaving visible scars. For almost two years, a team there has been removing tumors through the nose, maneuvering tools through the sinuses and back to the base of the skull.
Recently, OSU surgeons tackled two tumors that stretched too far down — past the hard palate — for surgeons to reach everything through the nasal approach. So a head and neck surgeon went in through the mouth as well, removing the rest of the tumor with the help of a robot.
The procedures are helping patients avoid large incisions and the removal of large pieces of bone. In some cases, this technique helps them recover more quickly, said Dr. Daniel Prevedello, director of Ohio State’s minimally invasive cranial surgery program.....read more
Manchester Royal Infirmary surgeons first to use 3D
April 2, 2012
Surgeons at Manchester Royal Infirmary claim to be the first in the UK to use a full 3D projection during an operation.
They used the equipment during an operation on John Green, 62, from Openshaw, to remove his prostate.
The team wore special glasses in order to view the procedure in 3D. Doctors said the combination of robotic and 3D technologies allows for greater surgical mobility with keyhole techniques.
During the operation, a high definition screen carried a 3D image of a hand-held robotic arm developed to carry out intricate surgical techniques.
The arm was used for the first time at Stepping Hill Hospital in Stockport last month.....read more
Study Finds Fewer Deaths, Complications with Robotic Surgery for Bladder Cancer; But It’s More Expensive
April 2, 2012
Newswise — With technological advancements opening the door to less invasive medical procedures, robotic-assisted surgery is becoming increasingly popular, despite being more expensive than traditional surgery. Robotic-assisted surgical removal of the bladder due to cancer is a new approach to the traditional "open" — or more invasive — operation called a radical cystectomy.
Bladder cancer is the fourth most commonly diagnosed cancer in men, and the American Cancer Society estimates that 73,500 people will be diagnosed with bladder cancer in 2012. A third of those will require a radical cystectomy.
Since the robotic surgery field is fairly new, only now are larger, more comprehensive studies being published that compare hospital and patient outcomes of traditional open surgeries to robot-assisted procedures.
A new study currently online in the journal European Urology has found that compared to open surgery for bladder cancer, robotic surgery results in fewer deaths and in-patient complications and reduces the need for intravenous nutrition after the procedure. The procedure, however, is more costly.....complete news release
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