Da Vinci® surgery

What defines a da Vinci® operation?

The da Vinci® Surgical System belongs to the most advanced technologies in the area of minimally invasive surgery. Using a robot-assisted technique, the surgeon operates a surgical unit made up of three components: a control panel, a robotic unit on the patient's body and a video system with a 3D camera and light technology. At the control panel, the surgeon can see the surgical field in three dimensions and control the robotic unit. Specialized surgical instruments are mounted on the robotic arms which execute the surgeon's movements coming from the control panel.

Which procedures can be performed with robotic-assisted surgery?

Da Vinci surgery of the prostate

In urology, robot-assisted surgical technique is widely applied for complete removal of the prostate (radical prostatectomy) in prostate cancer patients as continence and potency can be preserved. Also surgery of the urinary bladder can be done with this method.

Da Vinci surgery of the kidneys

Furthermore, urology centers are also able to operate on the kidneys by means of the da Vinci® Surgical System. For instance, minimally invasive kidney removal (" nephrectomy ") or partial kidney removal and the so-called renal pelvoplasty ("pyeloplasty") for narrowing of the renal pelvis can be carried out.

Da Vinci Surgery in gynecology

As of 2014, the da Vinci® Surgical System is also available in gynecology in Europe. Following the first removal of the uterus with da Vinci Surgery in the USA, it is nowadays implemented in many procedures:

• unilateral/bilateral adnexectomy
• myoma enucleation(s)
• tubal anastomoses
• partial/complete excision of Douglas pouch
• partial resection of ureter in ureteral endometriosis
• removal of ovarian endometriosis
• colposacropexy
• uterosacropexy
• fistula surgery
• Lymphadenectomy for surgical staging of tumor disease

Da Vinci Surgery of the Pancreas

Pancreatic cancer belongs to most aggressive of tumor diseases and its surgical removal is very challenging. The da Vinci® system only requires a four centimeter incision and four smaller incisions measuring one centimeter each, as opposed to the conventional method that entails opening the abdominal cavity with a large incision. The hospital stay following this surgery used to average 18 days but by avoiding open surgery, patients can leave earlier. Nowadays, pancreas transplantation can be done with da Vinci®, for instance in patients suffering from diabetes mellitus.

Robotic-assisted bypass surgery

Coronary artery disease (CAD) patients who require an arterial bypass are now indicated for da Vinci® surgery (robotic-assisted bypass surgery). It is advantageous because rather than having to split the breastbone to gain access to the heart as in conventional open surgery, only small incisions are needed for access between the ribs.

Additional indications for robot-assisted surgery

In visceral and general surgery, robotic-assisted surgeryis performed in the following:

• rectal carcinoma
• rectal prolapse
• sigmoid carcinoma
• colon cancer
• gastroesophageal reflux disease (GERD)
• esophageal cancer and diverticula

Also in otolaryngology as well as head and neck surgery, da Vinci is used:

• malignant tumors of the tonsils
• at the base of the tongue
• in the throat
• at the lateral wall of the throat
• non-toxic goiter
• hyperthyroidism with diffuse goiter

Process of a robot-assisted operation

Since the da Vinci® method covers numerous areas of modern surgery, its sequence of events differs depending on the area. First, five small incisions on the abdominal wall are carried out, which are positioned around the belly button. These incisions represent the access portals into the abdominal cavity. Three of the five incisions serve as access portals for instruments and camera mounted to the robotic arms, while the other two incisions are designated for the assisting surgeon, who stands directly at the operating table. After establishing the accesses, the abdominal cavity is filled with carbon dioxide so it can enlarge and allow for a better workflow.

Advantages and disadvantages associated with da Vinci® surgery

Advantages for the patient:

• tiny surgical scars
• minor blood loss
• decreased demand for painkillers
• speedy recovery
• shorter hospital stay

Also surgeons can benefit from this technique as tissues of the surgical field can be magnified up to 10 times. Especially nerves need to be spared as much as possible. More precise surgery is possible as the robot supports the surgeon's hand movements. Last but not least, surgeons operating with the da Vinci Surgical System sit comfortably and have a better posture so that they tire and exhaust less quickly.

Which doctors and clinics are specialists in operating with the da Vinci Surgical System?

The da Vinci® Surgical System is already established in German clinics for gynecology, urology, visceral and general surgery as well as ENT. Nevertheless, surgeries with da Vinci® method are often more expensive than conventional laparoscopic surgery, so the decision to operate with robotic assistance must be made individually.

Let us help you find an expert for your condition. We have reviewed all listed doctors and clinics for their exceptional expertise in da Vinci surgery and they are looking forward to your inquiry or your request for treatment.