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 PowerPoint PPT Presentation


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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

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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


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

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-slavemanipulator

    • Simplicity

    • Lightness

    • Range of freedom

    • Motion scaling

    • Real-time high-resolution 3D vision

    • Physiological tremor elimination


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

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?


Robot computer enhanced humanistic device

ROBOT: computer-enhanced humanistic device


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


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

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


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

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


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

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


Criteria of difficult common bile duct stone

Criteria of difficult common bile duct stone


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

Mr. Ker. 43/yrs male

C.C. :RUQ pain

tea-color urine

Lab. : GPT:65

Alk-P:368


Results 1

Results(1)


Result 2

Result (2 )


Result 3

Result (3)


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

(min)

Person

Robot Set time

(min)

Person

Robot Suture Time


Op time learning curve

OP TIME & Learning Curve

Time

Person


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

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

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


The future of robotic surgery

THE FUTURE OF ROBOTIC SURGERY


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

CIMIT

Center for Integration of Medicine and Innovative Technology

Founding Members:

CIMIT facility in Cambridge, Massachusetts


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

Thank You


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