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


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


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


What is about space medicine
What is about space medicine? microwrist technology. It allows the surgeon to roll, pitch, yaw and grip laparoscopic tools.


Robot computer enhanced humanistic device
ROBOT microwrist technology. It allows the surgeon to roll, pitch, yaw and grip laparoscopic tools. : computer-enhanced humanistic device


Zeus robotic system
Zeus Robotic System microwrist technology. It allows the surgeon to roll, pitch, yaw and grip laparoscopic tools.

  • AESOP

  • HERMIS

  • SOCRATES

  • Surgeon Console& Three Roboyic Arms


Limitations of robotic surgery
LIMITATIONS OF ROBOTIC SURGERY microwrist technology. It allows the surgeon to roll, pitch, yaw and grip laparoscopic tools.

  • Ports and/or robotic arms placement

    • eg: lithotomy position

    • Cosmetic

  • Depth perception

    • No haptic feed back

      eg: needle and suture breaks

  • Size

  • Set up


Robotic Surgery in Show Chwan Memorial Hospital microwrist technology. It allows the surgeon to roll, pitch, yaw and grip laparoscopic tools.

BETWEEN MARCH,2002 AND NOVEMBER, 2004


Endo acab
Endo-ACAB microwrist technology. It allows the surgeon to roll, pitch, yaw and grip laparoscopic tools.

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 microwrist technology. It allows the surgeon to roll, pitch, yaw and grip laparoscopic tools.

  • 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 microwrist technology. It allows the surgeon to roll, pitch, yaw and grip laparoscopic tools.

  • Atrumatic Thoracotomy


Technique of endo acab2
Technique of Endo-ACAB microwrist technology. It allows the surgeon to roll, pitch, yaw and grip laparoscopic tools.

  • Direct vision anastomosis


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 Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital

  • 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


Aims Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital

  • Compare the results in patients with CBD stones by Laparoscopic to robotic-assisted CBD exploration


Patients
Patients Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital

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


Criteria of difficult common bile duct stone
Criteria of difficult common bile duct stone Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital


Mr. Ker. 43/yrs male Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital

C.C. : RUQ pain

tea-color urine

Lab. : GPT:65

Alk-P:368


Results 1
Results(1) Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital


Result 2
Result (2 ) Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital


Result 3
Result (3) Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital


(min) Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital

Person

Robot Set time

(min)

Person

Robot Suture Time


Op time learning curve
OP TIME & Learning Curve Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital

Time

Person


ZEUS suture=37.76±24.33min (stitches=3.84) Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital

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


The future of robotic surgery
THE FUTURE OF ROBOTIC SURGERY Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital


CIMIT Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital

Center for Integration of Medicine and Innovative Technology

Founding Members:

CIMIT facility in Cambridge, Massachusetts


Thank You Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital


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