robot assisted laparoscopic surgery with zeus system preliminary results and technical aspects
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ROBOT-ASSISTED LAPAROSCOPIC SURGERY WITH ZEUS SYSTEM : PRELIMINARY RESULTS AND TECHNICAL ASPECTS. Hurng-Sheng Wu Department of Surgery, Show-Chwan Memorial Hospital, Changhua , Taiwan, R.O.C. 台北秀傳醫院. ( 30 床). ( 500 床). 竹山秀傳醫院. 彰濱秀傳健康園區. ( 700 床). 籌設中. ( 731 床). 秀傳紀念醫院. 台南市立醫院.

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robot assisted laparoscopic surgery with zeus system preliminary results and technical aspects

ROBOT-ASSISTED LAPAROSCOPIC SURGERY WITH ZEUS SYSTEM: PRELIMINARY RESULTS AND TECHNICAL ASPECTS

Hurng-Sheng Wu

Department of Surgery, Show-Chwan Memorial Hospital, Changhua, Taiwan, R.O.C

slide2

台北秀傳醫院

(30床)

(500床)

竹山秀傳醫院

彰濱秀傳健康園區

(700床)

籌設中

(731床)

秀傳紀念醫院

台南市立醫院

(全國第一家公辦民營)

高雄縣立岡山醫院

(公辦民營)

difficulties of laparoscopic surgery
Difficulties of laparoscopic surgery
  • Unstable camera platform
  • Loss of degrees of freedom
  • Two-dimentional imaging
  • Poor ergonomics for the surgeon

Ballantyne G. H.

Surgical laparoscopy, endoscopy

Percutaneous techniques

Vol. 12, No. 1, pp.1-5, 2002

decades of changes in surgical education
Decades of Changes in Surgical Education

<1950 Operating room theaters

1960 Experimental surgery and motion picture films

1970 Industry-research laboratories

1980 Endoscopic surgery

1990 Laparoscopy

2000 Robotics

Alberto Peracchia,

Annals of Surgery

Vol.234, No. 6, 709-712, 2001

space medicine
Space Medicine
  • ZEUS
  • da Vinci
    • Master-slave manipulator
    • Simplicity
    • Lightness
    • Range of freedom
    • Motion scaling
    • Real-time high-resolution 3D vision
    • Physiological tremor elimination
slide10
The key component of the Zeus Surgical System is the microwrist technology. It allows the surgeon to roll, pitch, yaw and grip laparoscopic tools.

It also provideds a real benefit for the surgeon with a 3-D view of the operative field.

Microwrist

zeus robotic system
Zeus Robotic System
  • AESOP
  • HERMIS
  • SOCRATES
  • Surgeon Console& Three Roboyic Arms
limitations of robotic surgery
LIMITATIONS OF ROBOTIC SURGERY
  • Ports and/or robotic arms placement
    • eg: lithotomy position
    • Cosmetic
  • Depth perception
    • No haptic feed back

eg: needle and suture breaks

  • Size
  • Set up
slide18

Robotic Surgery in Show Chwan Memorial Hospital

BETWEEN MARCH,2002 AND NOVEMBER, 2004

endo acab
Endo-ACAB

Definition :

A less invasive bypass procedure on the beating heart where all steps are performed endoscopically with the exception of a manual anastomosis.

technique of endo acab
Technique of Endo-ACAB
  • Endoscopic IMA Harvest
  • voice-activated robotic-assisted
  • and a 5mm thoracoscope under
  • single lung ventilation and CO2
  • insufflation
technique of endo acab1
Technique of Endo-ACAB
  • Atrumatic Thoracotomy
technique of endo acab2
Technique of Endo-ACAB
  • Direct vision anastomosis
slide25

Robotic-Assisted Laparoscopic Surgery in Difficult Common Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital

Hurng-Sheng Wu

Department of Surgery,

Show Chwan Memorial Hospital, Changhua. Taiwan

background
Background
  • Common bile duct stones are a frequent problem (10-15%) in patients with symptomatic cholecystolithiasis
  • Laparoscopic techniques have expanded the options for their treatment
  • Difficulty in laparoscopic surgery
slide27
Aims
  • Compare the results in patients with CBD stones by Laparoscopic to robotic-assisted CBD exploration
patients
Patients

Between January 2000 and November 2003

  • 919 patients with GB stones and/or CBD stone
  • 772 patients(84%) – LC (including 55 robotic-assisted )
  • 55 patients(6% )- Open Cholecystectomies
  • 92 patients(10%) with CBD stone

IHS excluded

42 patients(45%) – open CBDE

22 patients(24%) – LCBDE

28 patients(31%) – Robotic-assisted

slide30

Mr. Ker. 43/yrs male

C.C. : RUQ pain

tea-color urine

Lab. : GPT:65

Alk-P:368

slide36

(min)

Person

Robot Set time

(min)

Person

Robot Suture Time

slide38

ZEUS suture=37.76±24.33min (stitches=3.84)

LCBDE suture=24.65±10.82min (stitches=2.05)

slide41

CIMIT

Center for Integration of Medicine and Innovative Technology

Founding Members:

CIMIT facility in Cambridge, Massachusetts

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