South Africa’s first robotic surgery system was recently launched at The Urology Hospital in Pretoria. The R20 million Da Vinci Robotic Surgical System is set to take surgery to the next level as it is ideal for both complex and delicate surgeries.
In a theatre at the hospital, urologist, Dr Lance Coetzee, sits about two metres away from a patient under the machine, his face firmly planted into a control panel and his hands working controls in what looks like a virtual reality video game arcade cabinet from the future. The robot’s four arms are equipped with instruments such as forceps and miniature scissors, as well as a camera. The instruments are inserted into the patient’s abdomen through small cuts. A small movement from his hand on a control is translated into a movement for one of the robot’s arms, including the snipping of a tiny scissor at the end of one of the arms.
The precision of the system is no coincidence. DC motors from maxon ensure accurate transmission of the operator’s movements to the instruments. The Da Vinci robot has a total of 39 drives. These include RE 40 motors, RE 13 motors with maxon planetary gearheads and encoders, as well as RE-max 29 motors.
A special feature of this application is that the motors process both input and output signals. Some drives are in the control console, where they forward operator movements as signals to the computer. From there, these signals are forwarded to the motors in the manipulators, which then move the arms. Because of their ironless windings, the maxon motors have no cogging torque. As a result, they feature outstanding positional accuracy. Another advantage is the excellent dynamics, which make these drives perfect for the surgical robot.
There are many benefits:
• The instrument heads at the end of each robotic arm can be rotated 540° degrees and reach into any corner. Any hand jitter is compensated for electronically.
• The control movements are reduced by the transmission. If the operator moves the joystick by 15 mm, this translates to a motion of only 5 mm.
• 3D imaging with tenfold magnification gives the operator a perfect overview.
The real-time diagnostic imaging capabilities can assist surgeons on many levels. “For example, if surgeons need an image such as an MRI scan while operating, they can plug an information source into the consul which can aid them in real time,” explains Dr Coetzee. “Technically, one could use the controls on the other side of the country or in another country.”
MD of the Urology Hospital, Sarel van der Walt says the technology will result in less blood loss, less pain, a shorter hospital stay and a quicker return to normal daily activities.
Dr Coetzee has currently done over 200 urological robotic surgeries, while the hospital itself has nearly 400 on the machine. The countrywide figure for urology related robotic surgeries is around 600. He says that robotic surgery technology has grown to such an extent across the globe that in the US, around 83% of prostate surgery is now undertaken with this technology. In the UK, there are 36 such surgical robots.
US company, Intuitive Surgical, introduced the da Vinci robot to the market 14 years ago. Since then it has been used in more than 1,5 million operations. The trend is clearly upwards. The da Vinci robot is not only used in urology but also in gynaecology, and increasingly in ear, nose and throat surgery. It has even been used in cardiovascular bypass surgery. “This is a highly specialised skill but state-of-the-art technology has made it routine. The possible applications of this system are almost endless”, says Dr Coetzee. “There is no stopping the trend towards robot-supported surgery.”
For more information contact Hans Burri, DNH Tradeserve, +27 (0)11 468 2722, [email protected], www.dnhtrade.co.za
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