University Hospital of Antwerp to invest in joystick surgery for minimally invasive procedures

Edegem 29 May 2002The University Hospital of Antwerp (UZA) in Belgium, is the very first hospital in Flanders to acquire a da Vinci robotic surgery system from Intuitive Surgical for minimally invasive interventions. Since a few weeks, the system has been installed in the operating theatre. In a first phase, the da Vinci robot will be used for abdominal procedures including gall-bladder, esophagus, and stomach. In a later stage, the robot will assist the surgeons in cardiac interventions, transplantations, gynaecology, and urology, such as, for instance, prostate operations.

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Two years ago, Professor Guy Hubens, Chief-Assistant in the Department of Abdominal and Paediatric Surgery, discovered the revolutionary robot system at a medical congress in Chicago, Illinois. After a profound study round and a long deliberation, the UZA hospital management decided to invest one million euro to buy the system. For safety reasons, the instruments have to be replaced each time a cycle of ten operations has been performed, which makes the huge investment still heavier.

"Still, the financial effort can be wholly justified because this system will radically change the future of surgery", stated the Department Chief, Professor Vaneerdeweg. The robot system consists of three parts. The surgeon is sitting in a half-opened cabin from which he handles the instruments through a set of "joysticks" while he is watching the entire operating field on a monitor. The images are three-dimensional and have been magnified up to ten times. The instruments are provided with flexible joints which automatically neutralise all tremblings and shaking movements. As a result, it is possible to perform the most subtle micro-surgical actions.

The robot arms are mounted near the operating table. One arm is manipulating the endoscope with two built-in cameras. The two remaining robot arms are holding the instruments. "The system combines the advantages of minimally invasive surgery and conventional open surgery", as Professor Hubens explained. "Minimally invasive surgery is patient-friendly because there is less pain involved, allowing a faster recovery with shorter hospital stays and fewer lesions for the patient than in traditional surgery."

"The major problem with minimally invasive surgery is that the surgeon has no visual control of the operating field and freedom of movement is restricted. Tying knots becomes extremely difficult in these circumstances", added Professor Hubens. The da Vinci robot solves all these problems, according to Dr. Hubens. "It is like operating in a classical way for the surgeon is provided with a three-dimensional view. In addition, he can manipulate the tools in a natural fashion."

Professor Vaneerdeweg noted that the robot will pay back the investment from the moment that surgeons are building routine using the system. Yet, he expected no direct cost savings. "The most important aspect is that patients are far better helped with robot surgery but this does not imply a definite farewell to classical surgery. On the contrary, appendix removals will still be performed in the old-fashioned way." More details on the da Vinci system performances in minimally invasive procedures are available in the VMW January 2000 article No kingdom for a horse, but a lancet for a joystick in Robodoc's realm.


Leslie Versweyveld

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