Da Vinci Robotic Surgery – How Does It Work?

The Da Vinci robotic surgery system is designed to replace traditional surgery with a minimally invasive procedure. It allows the surgeon to perform precise, controlled movements through a small incision by using robotic technology.

How Does the da Vinci Robotic Surgery Work?

The da Vinci surgical system uses robot-assist technology to perform complicated surgical procedures through a small incision.  The system is operated by the surgeon through a console which controls the robot arm. After a small surgical incision is made, the surgeon inserts long, delicate instruments into area to be operated on.  The tools include an endoscopic camera with magnification, lighting and temperature control on a control arm which allows the surgeon to see inside of the body. The camera along with other instruments such as a scalpel are manipulated through small hand movements on the control panel.

Because the surgery is being performed through a small incision rather than a large, open wound, there is much less bleeding and trauma than traditional surgery procedures.  When compared to open surgery, da Vinci robotic surgery leaves a much smaller scar, may reduce the risk of infection through exposure to air, hands and surgical devices like suction and sponges and may reduce the overall recovery time after surgery.

Device:da Vinci Robotic Surgery
ManufacturerIntuitive Surgical Inc.

Sunnyvale, California

Uses:Robotic-assisted surgery used for complex, minimally-invasive procedures

  • Urology
  • Gynecology
  • General Surgery
  • Cardiothoracic Medicine
  • Head and Neck
Complications:
  • Increased anesthesia time
  • Increased surgical time
  • Device malfunction
  • Bleeding
  • increased recovery time

 

What Are the Drawbacks of da Vinci Surgery?

Da Vinci surgery may have revolutionized invasive surgery, but it has also created unique problems.  With the only vision allowed through the endoscopic camera, the surgeon’s field of vision may be limited.  This may impede the surgeon’s ability to maneuver and may result in a failure to identify additional issues that may have been obvious in another type of surgery.

The da Vinci robotic surgery system requires a period of training and may be difficult for some surgeons to become proficient at.  This may be particularly true of older surgeons who are not accustomed to technologic advances. Consequently, the vast experience that more established surgeons have may be lost to the patient.

Da Vinci Surgery Complications and Side Effects

Da Vinci robot-assisted surgery requires internal use of electronics, all of which require electrical current to operate.  This may pose a risk for electrocution and electrical burns which may increase the risk for infection, organ damage and bleeding.

The device may also malfunction during the procedure, rendering it useless and requiring a mid-surgery change of approach.  With device failure, the patient will be forced to undergo additional incision to perform a traditional open-surgery procedure.  While most surgeons are proficient at traditional surgery, the da Vinci surgeon may be forced to operate under less-than-ideal conditions outside of his normal procedures.

Procedures performed under da Vinci robot technology may require longer anesthesia time, particularly if the surgery does not go as planned.  In many cases, longer anesthesia time poses additional risk to the patient and may increase the discomfort and recovery time.

Read more about da Vinci Robotic Surgery Complications and Side Effects

What Procedures Can Be Done with da Vinci Robotic Surgery?

The Da Vinci robotic surgery system is used for conditions that affect the soft tissue and organs.  The FDA approval for the Da Vinci robotic surgery system includes: general laparoscopic surgery, gynecological surgery, urological surgery, general non-cardiovascular thoracic surgical procedures, and thoracoscopically assisted cardiotomy procedures.

Da Vinci can be used to treat:

  • Kidney disorders
  • Kidney cancer
  • Bladder cancer
  • Coronary artery disease
  • Colorectal cancer
  • Uterine disorders
  • Gynecologic cancer
  • Endometriosis
  • Prostate cancer
  • Throat cancer
  • Mitral valve prolapse
  • Uterine prolapse
  • Uterine fibroids

FDA Recalls and Concerns About da Vinci Robotic surgery

In July of 2013, the Food and Drug Administration (FDA) issued a warning letter regarding the da Vinci robotic surgery system.

The letter stated that Intuitive Surgical, Inc. was subject to a number of violations including:

  • Misbranding of device components due to improper labeling
  • Refusal or failure to provide certain information
  • Failure to submit reports regarding corrective actions

In 2015, the FDA noted that an increased number of adverse event reports had been received by the agency.  Most of the reports involved complaints about device malfunction, mechanical issues, component breakage and computer display issues, however a number of the reports indicated severe injuries or even deaths that had been caused by the devices.

Da Vinci Robotic Surgery Cost

The cost of using the da Vinci robotic surgery system can be high.  For the patient, it is not less expensive than other, but is generally $3,000 to $6,000 more than laparoscopic procedures.  It becomes even more expensive if complications arise and additional procedures such as open surgery are required.

For the hospital or surgical center, the da Vinci system is a large expenditure.  Each machine may cost upwards of $2 million, with yearly maintenance costs of $100 thousand or more and each surgeon is required to undergo extensive training which may be costly.  It can take years for hospitals to recover the costs for investment in a da Vinci system. In addition, many of the surgical procedures which resulted in patient injury have cited improper training of the operating surgeon as a cause, making the hospital and surgeon at least partially liable for potential lawsuits.

Despite the challenges regarding costs and liability for injuries, Intuitive Surgical, the da Vinci manufacturer is selling more units and has upwards of $700 million in annual revenue.  The company is still facing a number of lawsuits regarding injuries caused by the devices and as the number of da Vinci procedures continue to rise, additional lawsuits may be expected.