Friday, March 7, 2003

Test-driving the da Vinci device



By Tim Bonfield
The Cincinnati Enquirer

The da Vinci Surgical System is so advanced that even a newspaper reporter can drive it.

While it was set up in a laboratory at Good Samaritan Hospital, I was treated to a test drive on a robotic surgical system that will be used on patients a week from now.

$1.2 MILLION ASSISTANT
What: The da Vinci Surgical System, made by California-based Intuitive Surgical Inc
Features: Three-armed robot holds a camera that provides 3-D images and a variety of pincers, cutters, cauterizers and other tools. Some models now have a fourth arm.
Cost: $1.2 million, including training.
History: da Vinci is based on a system developed in the 1980s for the U.S. Department of Defense, which wanted a remote-control system for treating battlefield casualties. The robot was approved by the FDA in 1997 for assisting in surgery and has been approved for wider applications since.
Other locations: About 130 da Vinci systems are in use in the United States, Europe and Japan, including Ohio State University, the Mayo Clinic, Johns Hopkins Hospital and the Cleveland Clinic.
With less than a minute of coaching from Dr. J. Michael Smith, director of robotic surgery, I was seated in my stocking feet at the controls of the $1.2 million system.

My head was tucked in a viewing console that worked like a high-tech View-Master. I had one finger and a thumb from each hand inside ring-like grips that sensed pinching motions and twists of my wrists.

At my feet were pedals to switch camera controls, a clutch to shift hand positions without moving instruments, and a cauterizer control.

The three-armed robot hovered over an operating table. The table was stocked with beads, a curved needle and a length of suture, a small plastic tube and some pipe cleaners to mimic arteries.

It was easy to guide the robot pincers to a bead, pick it up, then place it on another tray.

Grabbing the suture thread was easy, too. So was moving it from hand to hand. But tying a knot takes practice.

In his first practice surgery, it took Smith an hour and a half to complete sutures that would take him 10 minutes by hand. After seven sessions, he was down to less than 30 minutes.

The robot's arms and wrists moved swiftly, silently and in concert. There were no clunky one-joint-at-a-time movements. The computer even compensates for the natural tremor in human hands.

The controls are hard-wired to the robot by about 12 feet of cable. But it was easy to imagine the commands coming from much longer cables - like say a fiber-optic telephone wire - or even beamed by satellite halfway around the world.

Tim Bonfield is the Enquirer's medical reporter.




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