San Giovanni Rotondo, January 18, 2021. In the IRCCS House for Relief of Suffering The latest version of the “da Vinci” surgical robot, called “Xi”, the most advanced tip of minimally invasive technology currently in circulation. A few days after testing, the robotic platform has already been used for several minimally invasive surgery.
The “da Vinci Xi”, like its predecessors, is mainly composed of 3 components: the console surgery, the patient cart and the vision cart.
The first is the operations center of the robot and is placed outside the sterile field, a few meters from the patient. Using two manipulars, right and left, and the pedal, the surgeon remotely controls the endoscope and the surgical instruments introduced into the patient’s body. The operating field is visible thanks to an immersion viewer that returns the three-dimensional and magnified anatomical image.
The patient cart it is made up of four arms remotely controlled by the surgeon who performs the surgery, assisted by the second operator, who is responsible for inserting the instruments into the patient and taking care of their positioning. At the rear of the trolley, thanks to a touchpad, the positioning of the arms is set according to the anatomical part that will be affected by the surgery: mouth, neck, chest, heart, upper abdominal, lower abdominal, kidney and pelvis.
The intervention is projected on the third component, the viewing cart, which also houses an electronic processor capable of merging preloaded diagnostic images to be superimposed with the anatomical part on which to intervene.
The surgical instruments of the “da Vinci” – including those for grasping, cutting, demolishing, aspirating, irrigating, suturing – are called EndoWrist, have a diameter of only 8 mm and are about 60 cm long. Thanks to a mechanical component that acts as a wrist, they are able to move on 7 axes with a rotation of almost 360 degrees.
«We can also install the fourth generation of the surgical robot continue an innovative path that began in February 2010, when we were the only hospital in the Central South to have developed a robotic platform used by different operating units – has explained Antonio Cisternino, director of the Urology Unit of the IRCCS House for Relief of Suffering -. By investing in surgical robotics, in these 11 years, we have increased our skills of surgeons, anesthetists, instrumentalists and operating room nurses to form a group capable of becoming point of reference in the territory for minimally invasive surgery methods, increasingly requested by patients. Only in the urological field, for example, is it enough to think that now more than 90% of prostatectomies are performed with the surgical robot, with excellent results. It is essential to continue on this path as the indications for surgical intervention with the robot are increasing more and more, for different pathologies and in different specialties. And then because, in the not too distant future, when telemedicine will finally have taken hold, with these technologies and high-capacity data connection systems, we could even perform surgical interventions with the patient several kilometers away».
«The advantages of this technology are numerous – points out Marco Taurchini, thoracic surgeon e director of the Department of Surgical Sciences of the Hospital of San Pio -. With the help of the robot, the surgical gesture is more precise: yes eliminates physiological tremor of the hand, yes reduces bleeding e the aesthetic impact of the engravings. The risks of post-operative infection decrease, with much shorter hospitalization and recovery times. The anatomical knowledge, experience, competence and manual skills of the surgeon using the machine remain fundamental. For this reason it will be important to continue on the training of surgeons and health professionals who work in the team, to increase an already numerous and qualitatively relevant caseload. To date – concluded the surgeon – the “da Vinci” robot is used by the Units of Urology, Gynecology, Abdominal Surgery, Thoracic and Otorino-Maxillofacial Surgery, but there are already manifestations of interest on the part of Cardiac Surgery and Breast Surgery».
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IRCCS House for Relief of Suffering
Casa Sollievo della Sofferenza is a highly specialized hospital, owned by the Holy See, recognized since 1991 as a Scientific Hospitalization and Care Institute for the recognition theme “Genetic diseases, innovative therapies and regenerative medicine”. The hospital – which in 2019, with 884 beds, performed about 54,000 hospitalizations providing more than one million outpatient services in the year – has about 2,700 employees, of which 164 researchers including biologists, doctors, biotechnologists, statisticians, engineers, bioinformaticians and technicians; 60% of the researchers is made up of personnel under the age of 35. Since the second half of 2015, the new ISBReMIT Regenerative Medicine Research Center has been operational, a state-of-the-art facility in terms of concept and equipment in the field of translational medicine for genetic, degenerative and oncological diseases. The structure houses, among the highly technological laboratories, a cell factory and laboratory for the production of biopharmaceuticals under the Good Manufacturing Practice regime, i.e. for clinical use, to include somatic and iPS stem cells, vectors for gene therapy and biomaterials.
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