Medical robotics is a big step in the development of medicine. The Da Vinci Robot is a technological innovation named after the artist and inventor Leonardo da Vinci. The use of this robot-assisted surgical system has become an essential stage in the development of minimally invasive surgery, primarily in cancer treatment. Thanks to the tools controlled by an experienced specialist’s hands, it is now possible to perform interventions with minimal blood loss and injury to the surrounding tissues. This advantage allows to get high results and, at the same time, reduce the period of recovery and rehabilitation.
In the United States, the technique quickly gained popularity, and from the two thousandths, after being approved by the Food and Drug Administration, installations appeared in half of the hospitals. The Da Vinci system consists of three blocks: a video stand, a patient console, and a surgeon console – the doctor’s workplace. The surgical console is a specially designed surgeon’s workplace that allows seeing the surgical field in three dimensions through a 3D viewfinder and controlling the instruments using two manipulators. The patient console consists of three working manipulators with instruments and one with a camera for transmitting the image to the surgeon. EndoWrist technology gives tools with a diameter of only five and eight millimeters, seven degrees of freedom of movement, and natural dexterity, allowing performing manipulations inaccessible to the human hand (Desai, 2018). Working with the patient takes place in a sterile area, so during the entire operation, the robotic manipulators are covered with disposable sterile covers. A touch-screen video stand allows one to visualize the operating field for team members.
Today, Da Vinci operations are used in cardiovascular surgery, gynecology, thoracic surgery, and urological surgery. The doctor performs several incisions in the operated area with a size of one centimeter during use. A miniature video camera and surgical instruments are inserted through them, after which the doctor proceeds directly to the operation. While at the console, doctor controls the tools and his actions visually, receiving an image from the camera. The system transmits the doctor’s movements, “turning” them into precise actions of instruments inside the patient’s body. The high efficiency of the performed surgical interventions is due to the greater accuracy and smoothness of the machine movements, eliminating natural human errors and providing easier access. Some patients are not yet ready to entrust their lives to robots. Nevertheless, in this case, the machine does not act independently; it only transmits the human operator’s movements. There are also an anesthesiologist, a nurse, and an assistant surgeon; they monitor the machine and the patient’s condition.
One of the main advantages for the surgeon when using it is excellent volumetric visualization from high-tech optics, that transmits the image to the doctor and reduces physiological tremors during the manipulation, which cannot be excluded when performing other types of interventions. The mobility of working tools exceeds the human wrist’s capabilities and allows performing the necessary manipulations even in conditions of limited access (Desai, 2018). Besides, the Da Vinci technology has the most comfortable ergonomics, which reduces the doctor’s fatigue, crucial for long-term interventions, which could last from two to four hours and sometimes even more.
The use of the technology also has several advantages for the patient. Among them, the reduction of tissue trauma and pain intensity in the postoperative period minimizes blood loss, the need for blood transfusions, and, subsequently, the need for blood transfusions. Furthermore, this technology reduces risk of infection and other complications, does not leave large incisions and postoperative scars, resulting in a short period of rehabilitation, allowing patients to return to everyday activities quickly are considered significant advantages (Desai, 2018). Numerous positive results of the operation by the Da Vinci robot surgeon confirm its effectiveness and safety for health.
The disadvantages of this system can be attributed to the high cost of use for both the patient and the hospital. Not everyone can afford the installation and maintenance of this complex device. It is also important to note that risks can arise when performing any intervention and no competent specialist can guarantee complete safety (Desai, 2018). Experts mention some of the robot’s shortcomings, saying that the equipment is not yet perfect. In particular, there is no tactile feedback, which is so important for the surgeon when working with body tissues. However, the use of the Da Vinci robot helps to increase the probability of a favorable outcome due to the presence of the above advantages. Moreover, all manipulations are performed with jewelry accuracy, so the probability of negative consequences is extremely small.
The main disadvantage of robotics is the training of medical personnel, which can reach several thousand dollars. Many organizations train specialists to perform operations using this technology. Using proven advanced training methods, each surgeon can gain knowledge and skills in performing both standard operations and narrow-profile procedures. A clear understanding of existing medical practices, the apparent need to train medical personnel to use such systems, and the knowledge of various information required for development are critical factors in creating a system suitable for further implementation. An essential aspect of a successful operation is the proper training of the staff and the patients. It is essential to allow people to have as much information as possible about the technology and the risks that may arise during and after invasive surgery.
Analyzes show that, despite recent advances in robotic surgery, there is insignificant progress in automated surgery safety. There is an urgent need for such measures and the legal and technical requirements for automated surgical intervention. The interoperable telesurgical protocol is the only available protocol that meets the safety requirements for using robot technologies in medicine (Iqbal et al., 2019). While this protocol addresses authentication and privacy, there is an absence of focus on developing and realizing security policies in national and international settings. Solutions should be practical in terms of their use and provide noticeable benefits for the user. In this case, the inclusion of technology is necessary to motivate patients to do as much as possible for themselves while maintaining safety. Implementing such systems will not be viable and in demand, if they do not provide the ability to reduce the burden on staff, create an economic justification for implementation, and ensure reliability and safety of use.
On the Internet there is a large amount of information about the use of Da Vinci technology in medicine. Information ranges from books and various articles to educational mobile apps and online courses. To get the most up-to-date information on medical centers equipped with the Da Vinci robot, specialists performing operations, and the possible consequences and advantages of this method, it is enough to make a simple request on the Internet. Obtaining new information about the work and usefulness of robotic technologies helps expand the knowledge of medical personnel and can also be successfully applied in everyday activities to find more effective ways to treat various diseases.
Robotic technologies provide a vast future in the further development of entire areas of clinical medicine. Da Vinci is a sophisticated robotic platform designed for various surgical fields with a minimally invasive approach. This surgical system is gaining more and more popularity around the world every year, continually expanding the boundaries of its application. Particular attention should be paid to the great success in the treatment of such diseases as cancer.
References
Desai, J. (2018). The encyclopaedia of medical robotics. In R. Patel (Ed.), Minimally invasive surgical robotics (pp. 1-436) World Scientific Publishing Company.
Iqbal, S., Farooq, S., Shahzad, K., Malik, A. W., Hamayun, M. M., & Hasan, O. (2019). SecureSurgiNET: A framework for ensuring security in telesurgery. International Journal of Distributed Sensor Networks, 15(9), 1-12.