I.Horbachevsky Ternopil State Medical University Delegation on Robot Surgery Probation in Czech Republic.

This year in January the delegation from I.Horbachevsky Ternopil State Medical University has been to Prague (Czech Republic) to get acquainted with the robot surgery system Da Vinci at the invitation of Martin Kalosh from Hospimed Company which proves to be the famous European distributor of the robot systems Da Vinci.

The aim of the visit was to get acquainted with the system and to be trained on the robot systems Da Vinci which are used in operative urology and abdominal surgery.

The agreement has been concluded concerning further cooperation in that field.

The da Vinci Surgical System is a robotic surgical system made by Intuitive Surgical and designed to facilitate complex surgery using a minimally invasive approach. The system is controlled by a surgeon from a console. It is commonly used for prostatectomies and increasingly for cardiac valve repair and gynecologic surgical procedures.

The da Vinci System consists of a surgeon’s console that is typically in the same room as the patient and a patient-side cart with four interactive robotic arms controlled from the console. Three of the arms are for tools that hold objects, act as a scalpel, scissors, bovie, or unipolar or dipolar electrocautery instruments. The fourth arm is for an endoscopic camera with two lenses that gives the surgeon full stereoscopic vision from the console. The surgeon sits at the console and looks through two eye holes at a 3-D image of the procedure, meanwhile maneuvering the arms with two foot pedals and two hand controllers. The da Vinci System scales, filters and translates the surgeon's hand movements into more precise micro-movements of the instruments, which operate through small incisions in the body.

According to the manufacturer, the da Vinci System is called "da Vinci" in part because Leonardo da Vinci invented the first robot. The artist Leonardo also used anatomical accuracy and three-dimensional details to bring his works to life.

To perform a procedure, the surgeon uses the console’s master controls to maneuver the patient-side cart’s three or four robotic arms (depending on the model), which secures the instruments and a high-resolution endoscopic camera. The instruments’ jointed-wrist design exceeds the natural range of motion of the human hand; motion scaling and tremor reduction further interpret and refine the surgeon’s hand movements. The da Vinci System incorporates multiple, redundant safety features designed to minimize opportunities for human error when compared with traditional approaches.

The da Vinci System’s ergonomic design allows the surgeon to operate from a seated position at the console, with eyes and hands positioned in line with the instruments. To move the instruments or to reposition the camera, the surgeon simply moves his/her hands.

By providing surgeons with superior visualization, enhanced dexterity, greater precision and ergonomic comfort, the da Vinci Surgical System makes it possible for more surgeons to perform minimally invasive procedures involving complex dissection or reconstruction. For the patient, a da Vinci procedure can offer all the potential benefits of a minimally invasive procedure, including less pain, less blood loss and less need for blood transfusions. Moreover, the da Vinci System can enable a shorter hospital stay, a quicker recovery and faster return to normal daily activities.

The da Vinci System has been successfully used in the following procedures: Radical prostatectomy, pyeloplasty, cystectomy, nephrectomy, ureteral reimplantation; Hysterectomy, myomectomy and sacrocolpopexy; Cholecystectomy, Nissen fundoplication, Heller myotomy, gastric bypass, donor nephrectomy, adrenalectomy, splenectomy and bowel resection; Internal mammary artery mobilization and cardiac tissue ablation; Mitral valve repair, endoscopic atrial septal defect closure; Mammary to left anterior descending coronary artery anastomosis for cardiac revascularization with adjunctive mediastinotomy.

The robot surgery probation was fruitful and useful.

The participants of the delegation are very much obliged to the Rector of Ternopil Medical University prof. L.Kovalchuk for the promotion and organization of the project.

We believe that the acquired knowledge and experience will contribute to further development of an international cooperation and improvement of professional skills of our health care workers.