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Robotic Surgery

Robotic Surgery. Presented by Katie McAleer. Objectives. Robotic Surgery using the da Vinci Surgical System Components of the system Nursing Roles in robotic surgery Legal and ethical issues Does robotic surgery benefit nurses?. What is robotic surgery??.

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Robotic Surgery

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  1. Robotic Surgery Presented by KatieMcAleer

  2. Objectives • Robotic Surgery using the da Vinci Surgical System • Components of the system • Nursing Roles in robotic surgery • Legal and ethical issues • Does robotic surgery benefit nurses?

  3. What is robotic surgery?? • Surgeon controls movement through robotic arms • One arm controls the camera and scopes • The other arms control robotic surgical instruments • Trocars are inserted through tiny incisions • Can be used for: • Cardiac surgery • Gynecologic and Urologic surgery • Weight loss surgery Tabor (2007)

  4. Robotic Surgery vs. Traditional Methods ROBOTIC sURGERY Traditional/ Laparoscopic surgery • Greater dexterity, precision, and control • Three dimensional view • Better camera stability • Improved ergonomics • Limited dexterity, precision, and control • Two dimensional view • Camera instability • Poor ergonomics Tabor (2007)

  5. Hardware Components • Surgeon console • Patient side cart with robotic arms • EndoWrist Instruments • Vision System • Assistant Monitor Intuitive Surgical (2005)

  6. The 3D Vision System • High resolution 3D endoscope • Two independent vision channels • Two high resolution monitors • Surgical camera repositioned with foot controls. • Noise reduction equipment Intuitive Surgical (2005 )

  7. Software • 3-Dimensional video software • Allows the physician to conduct surgery. • Robotic hardware is driven by proprietary software. • The software was developed in 1994. • Currently uses version 11. Intuitive Surgical (2005)

  8. Is this software user friendly? • Preference for design • Focus of use is on the physician and healthcare team. • Software version 11 • Studies showing effectiveness

  9. System Review • Dedicated special purpose system • Used by trained physicians • What surgeries can the da Vinci be used for? • Stand alone system using proprietary software • American National Standards Institute Intuitive Surgical (2005)

  10. Advantages of the da Vinci • Reduced body trauma • Reduced blood loss and need for transfusion • Less pain and discomfort • Less risk of infection • Shorter hospital stay and quicker recovery • Smaller scars

  11. Advantages for Healthcare Workers • Greater surgical precision • Improved dexterity for the surgeon • Excellent visualization • No fulcrum effect

  12. Disadvantages • Expensive capital and running cost • No tactile feedback • Reduced trainee experience • Lengthy set-up times • Large layout • May require extra storage space Murphy et al. (2008)

  13. Informatics • Half day training session at the hospital • Hands on practicum for surgeons and nurses • Off site training at regional training center • Live procedure observation • Clinical support with laboratory sessions • Staff training includes software and hardware. Intuitive Surgical (2005)

  14. Legal Issues • Injury from the machine • Patient choice • Possibility of machine malfunctions • Physician preparation Murphy et al. (2008)

  15. Nursing Roles in Robotic Surgery • Ensure the patient has given informed consent • Check all cords and equipment are off of the patient • Patient positioning • Thorough understanding of the hardware and software • Trouble- shooting Tabor (2007)

  16. da Vinci Surgical System • Technology advances allows for improved patient outcomes • Minimal disadvantages • Low risk • Reliable training • Higher output with staff efficency • Continued software improvements.

  17. Reliable Technology • Recommended by many physicians • Improved patient outcomes • Thorough training • Cost offset • 19 training centers in the U.S. • Ease of use • Clinical collaboration Intuitive Surgical (2005)

  18. References • Intuitive Surgical, Inc. (2005). The da Vinci surgical system. Retrieved November 12, 2008 from http://www.intuitivesurgical.com/products /davinci_surgicalsystem/index.aspx • Murphy, D. G., Hall, R., Tong, R., Goel, R., & Costello, A.J. (2008). Robotic Technology in surgery: Current status in 2008. ANZ J. Surg. 2008; 78: 1076–1081. • Tabor, W. (2007). On the cutting edge of robotic surgery. Nursing2007, 37 (2), 48-50.

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