Transcript Robotic Surgery
Slide 1
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 2
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 3
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 4
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 5
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 6
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 7
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 8
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 9
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 10
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 11
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 12
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 13
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 14
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 15
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 16
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 17
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 2
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 3
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 4
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 5
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 6
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 7
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 8
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 9
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 10
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 11
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 12
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 13
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 14
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 15
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 16
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?
Slide 17
The IPEG Annual Congress joins with:
• II World Congress of the World Federation of Associations of Pediatric Surgeons (WOFAPS)
• VII Congress of the Federation of Pediatric Surgical
• Associations of the South Cone of America (CIPESUR)
Robotics – Where Are We?
George W. Holcomb, III, MD, MBA
Surgeon-in-Chief and
Director, Center for Minimally
Invasive Surgery
Children’s Mercy Hospital
The Changing Face of Surgery
1. Traditional (open) Surgery
2. Minimally Invasive Surgery
3. Robotic Applications
Robotic Applications
• AESOP (Hermes)
• Robotic Surgical Systems
BAPS 2002
J Pediatr Surg. 38:111-5, 2003
Operative Times
Group
# of patients
Mean operative
time
A
10
108 min
B
34
110 min
C
39
93 min
D
71
69 min
P Values
A vs B = 0.058, A vs C <0.05,
A vs D < 0.05
J Pediatr Surg. 38:111-5, 2003
Hermes/AESOP
IDEAL CASE
• Common operation
• Operation centered in
one anatomic area
• Little movement of
telescope/camera
required
• Operation performed
similarly each time
• Duration greater than
1 hour
Robotic Surgical Systems
• NASA, U.S. Military
• Limitations of laparoscopy/thoracoscopy:
microsurgery
small workspace
reduced degrees of freedom
• Master slave concept
• 3 arms
• Scaling - 1:1
1:15
• Haptics problematic
Degrees of Freedom
Talamini M, et al: J Laparoendosc Adv Surg Tech 12:225, 2002
Robotic Surgical Systems
• Zeus – Computer Motion, Inc.
Santa Barbara, CA
• da Vinci – Intuitive Surgical, Inc.
San Jose, CA
da Vinci
• Surgeon immersed in
console, controls
robotic arms
• 12 mm 3-D telescope
da Vinci
Motion of fingers mimics motion of
instruments
da Vinci
Foot pedal
•
•
•
•
clutch
cautery
camera
other - ?
Why Did Robotics Develop Now?
Is Robotics The Wave Of The Future?
Current Status
• Radical prostatectomy – most common
operation by far
• Mitral valve replacement – used by some
cardiac surgeons
• Used by some general surgeons and a few
pediatric surgeons
Disadvantages
• Cost (1.5 M)
Limited instrument uses
• Not really useful for many common
surgical problems
• Somewhat difficult to use for the
occasional patient
• 8-10 mm instruments
? ? ?