Cutting Edge

WRITTEN,

DESIGNED

AND

PHOTOGRAPHEDBY MICHELLE STAUFENBIEL

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Table Of Contents

DEDICATION......................................................................... Pg. 3

FOReWARD............................................................................. Pg. 4

Introducion....................................................................... Pg. 6-111

Chapter 1................................................................... Pg. 13

Chaper 2............................................................................. Pg. 15-17

Chaper 3.......................................................................... Pg-18-25

Chaper 4 ........................................................................... Pg. 27

Conclusion.......................................................................... Pg. 28

Works Cited................................................................... Pg. 29-30

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I would like to dedicate this book to Mr. Manke,

throughout this whole project you have been a huge

help. My partner Nick and I do appreciate it. I would

also like to thank the freestyle staff, Mr. Greco,

Mrs. Parkinson, and Mrs Kefauver, for their patience

and understanding whenever I hit a huge barrier during

this project. Honestly your patience is outstanding,

though I am sure you guys have had plenty of

practice.

Dedication

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Forward

Surgery is such a common and often complex process that involves almost everybody in their lifetime. Wheather it is your best friend that is getting surgery done on a torn ACL. Or maybe your mom is getting a tumor removed tomorrow from her kidney. Regardless to say , surgery is a typical procedure that should not be feared but practiced and advanced to not only improve life for our memebers of society but to save lifes. When the Da Vinci was first introduced it was such a drastic and different change. Can somebody really trust their life to a robot? That is the question that will be adressed. I wanted to write about the Da Vinci robotic surgery because it relates to our future. This book will adress the advantages of robotic surgery but also the negative aspects as well. Hopefully at the end of this book, you the reader will be able to have a better understanding of the Robotic system that has changed surgery for the better.

Forward

Surgery is such a common and often complex process that involves almost everybody in their lifetime. Wheather it is your best friend that is getting surgery done on a torn ACL. Or maybe your mom is getting a tumor removed tomorrow from her kidney. Regardless to say , surgery is a typical procedure that should not be feared but practiced and advanced to not only improve life for our memebers of society but to save lifes. When the Da Vinci was first introduced it was such a drastic and different change. Can somebody really trust their life to a robot? That is the question that will be adressed. I wanted to write about the Da Vinci robotic surgery because it relates to our future. This book will adress the advantages of robotic surgery but also the negative aspects as well. Hopefully at the end of this book, you the reader will be able to have a better understanding of the Robotic system that has changed surgery for the better.

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IntroductionImagine, for hundreds of years our ancestors climbed stairs,

and then a new innovation emerges: the elevator. This

novelty saves time and proves to be easier than walking up

stairs. Who wants to trudge up stairs after a long and hard

day of work? The elevator gives humans another option.

However, the elevator is a bit foreign and frightening. The

stairs seem like a safer option because humans have

acclimated to them. They are a tradition. The thought of

branching out to try something new is unnerving, but it can be

beneficial. Robotic surgery is very similar to an elevator because it is a more

efficient technological advancement as opposed to the traditional route.

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In 1985, during a successful neurosurgical biopsy, a robotic arm

was used for the first time to assist in the surgery itself (1980s

Robotic Advancements). At that time, many people thought of

Robotic Surgery as a groundbreaking but frightening concept.

In 2000, the Da Vinci robotic surgery was FDA approved to

begin operating on patients (Frequently Asked Questions).

Thirteen years ago, a traditional doctor was the only way to

have open-heart surgery, but when Robotic surgery was

invented, it proved that times were changing, technology was

progressing, and surgical options were improving.

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Since the Da Vinci released its first robot, 2,585 have been sold

worldwide in 2,025 hospitals (Frequently Asked questions). The Da

Vinci robot assists in many surgeries such as: open-heart surgery,

prostate surgery, and general surgeries (Manke). Many people are

faced with hard and important questions: Do they choose traditional

surgeons or the newly advanced Robotic surgeon? Intuitive Surgery,

the company that patents the Da Vinci robot, is now a successful

company, but their ride to success was a not a smooth one. Over the

years the robotic system has faced many criticisms and harmful no

toriety, but all critics aside, the Da Vinci robot is still a thriving sugery system that is loved by many.

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Chapter 1: But Rosie the Robot did not have Four Arms

Robots have four arms? Rosie the Robot did not have Four Arms. Upon hearing about robotic surgery, I immediately pictured the clas-sic cartoon show, the Jetsons and their robot maid Rosie. However, during class, my peers and I watched a presentation about robotic surgery, and much to my surprise, it was not even close to my child-hood friend Rosie. The Da Vinci robot has a surgeon console. During an operation the Doctor looks through a telescope in the console. The doctor and surgeon console are placed a few feet away from the Da Vinci robot and the patient in the same room. The Da Vinci robot itself has four arms. The first arm is a 2D camera that is held in place to let the doctor and his assistants view the surgery. The other three arms hold and operate small instruments used to work directly on the patient (Frequently Asked Questions). The Da Vinci is designed to give doctors better access to the problem area that

requires operation.

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Chapter 2: The Evolution of the Da Vinci

When the Da Vinci robot was invented, it worked on making the procedures for its patients cleaner, quicker, and more pain-less than traditional surgery. Over time the Da Vinci robot has evolved to indeed make procedures cleaner and has reduced the blood loss (Manke). James Manke, who works for Intuitive sur-gery and films the surgery in person claims, “Patients heal faster and typically they go home in a day or two after the proce-dure. Its virtually bloodless because the instruments are per-forming microsurgery and the ability of the surgeon to control the bleeding with the instruments is much more advanced.” The instruments are smaller and refined, which allows the operat-ing surgeon to make smaller cuts on the patient. The robot en-abled surgeries to be less painful than the traditional surgeries and heal faster with a smaller incision rather than a big cuts.

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Someday, if I were burdened with a surgery, I would prefer a system

where the healing process is quicker and less painful. Most people are

likely to be frightened when they first hear they may have to undergo

an operation. To be sure, surgery is a burden but often times the best

option. When a person is faced with this burden, they have to make a

decision in which the costs will outweigh the benefits. Many people are

still weary of the Da Vinci robot surgery, but some see it as the right

path. The robotic surgery horror stories only add to the hesitation of

some patients.

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Chapter 3: The Drawbacks of a Robot

In 2010, a survey was sent out to 176 doctors that used robotic

surgery. The conclusions of the survey found that one hundred of the

doctors reported experiencing a failed system even before the system

and procedure was started (Kaushik). However, few doctors claimed

that the Da Vinci failed during the actual procedure. As such, there

have been over twenty lawsuits filled against Intuitive Surgery, over

the past few years. This may be alarming for anybody considering

robotic surgery.

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Some of the filed lawsuits claim: wrongful death, punctures

arteries, blood vessels, organs, burns or tears of arteries, and

etc. (Da Vinci Surgical Lawsuits). The company who manufactures

the surgical robot claims that these alleged injuries are a

product of inexperience within the practicing surgeon (Da Vinci

Surgical Lawsuits).

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Manke makes a suggestion to a worried patient: “Its always good

to ask surgeons how many procedures have you done because there

are varying degrees of experience... Not saying that less experi

ence robotic surgeons would do a bad job, but they would tend to

work on simpler cases and less complex procedures. So as

a surgeon becomes more experienced they will take on the

more complex procedures and do a good job (Manke).” There is no

promise that the most experienced doctor will avoid making a

mistake, but it cannot hurt to ask questions.

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Due to the lawsuits, Intuitive Surgery has taken a huge publicity

hit. However, Intuitive Surgery and all of its employees are hard at

work trying to clean up the mess. The Da Vinci robot has lost some

credibility in the public’s eyes from these lawsuits as well. Since the

beginning of March 2013, Da Vinci stock has dropped drastically by

sixteen percent, which in affect harms Intuitive Surgery who is one of

the leading companies in the Dascent Industry (Sumagaysay). In

2002, the Da Vinci Robot racked up roughly 2.1 billion of Intuitive

surgery’s revenue (Sumagaysay). Each system costs 1.5 million dollars,

which is a pricy cost for each hospital (Sumagaysay). Critics still

question if this system is worth the price.

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Chapter 4: The Know and the Future of the Da Vinci

James Manke explains the Da Vinci robot’s surgical ability, “Right now the surgical system is only designed to work on soft tissue. Because the in-struments are so small they can’t cut into tougher tissue like bone and car-tilage. Its just for organs and blood vessels. There will be a time were the instruments became stronger and will be able to take on spine surgery anything involving the cranium, thats in the future. Right now its best for anything within the torso anything to do with urology and gynecology.” The future goal for robotic surgery is to cut through the bone in order to perform more complex surgeries.

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ConclusionYes, robotic surgery has it skeptics, but in such a risky market, it is bound to hit walls. Some doctors prefer traditional surgery to this new inno-vative surgery. This creates even more adversity for the robot. As the criticisms and questions multiply so do the success stories. Dr. Hyung Kim, an urologist who uses the Da Vinci system, advocates his loyalty. He claims that he will never go back to traditional surgery (Dance). Much like the elevator, robotic surgery is an innovation that will take some get-ting use to.

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ConclusionYes, robotic surgery has it skeptics, but in such a risky market, it is bound to hit walls. Some doctors prefer traditional surgery to this new inno-vative surgery. This creates even more adversity for the robot. As the criticisms and questions multiply so do the success stories. Dr. Hyung Kim, an urologist who uses the Da Vinci system, advocates his loyalty. He claims that he will never go back to traditional surgery (Dance). Much like the elevator, robotic surgery is an innovation that will take some get-ting use to.

Bibliography

“Da Vinci Surgical Lawsuits”. Fight for Victims. Web 10 Janu-ary 2013. http://fightforvictims.com/medical-devices/da-vinci-surgical-robot-injury-lawsuit

“Frequently asked questions” Intuitive Surgical. Intuitive Sur-gical, August 2010. Web. 11 March 2013. http://www.intuitive-surgical.com/products/products_faq.html

Kaushik. “Malfunction of the Da Vinci robotic system during robot-assisted laparoscopic prostatectomy: an international survey.” US Na-tional Library of Medicine National Intuitive of Health. April 24 2010. Web Feb-ruary 2 2013. http://www.ncbi.nlm.nih.gov/pubmed/20192613

Manke, James. Personal interview. 24 March 2013.

Samadi, David B. “History of Robotic Surgery.” Robotic Oncol-ogy. Robotic Oncology, 2005. Web. 11 March 2013. http://www.roboticoncology.com/history/ 29

Sumagaysay, Levi. “The Rise of Lawsuits Against Intuitive Surgical Robots”. The Mercury News Silicons News, March 15 2013. Web 19 March 2013. http://www.siliconbeat.com/2013/03/15/the-rise-of-the-lawsuits-against-intuitive-surgical-robots/ury-lawsuit

1980s Robotic Advancements. Intuitive surgical. Web, January 8 2013. http://www.intuitivesurgical.com/company/history/http://www.heart-valve-surgery.com/heart-surgery-blog/2008/09/16/how-much-does-the-da-vinci-surgical-robot-cost/

Dance, Amber. “Use of Robotic Surgery Grows, But so do Questions”. Los Angelos times. October 17 2011. Web, Januarty 26. http://articles.latimes.com/2011/oct/17/health/la-he-robotic-surgery-20111017

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