Key Terms
The following list of key terms may help you in your search for information about robotic-assisted surgery.
Atrial septal defect
The septum is a wall that separates the heart’s left and right sides. Septal defects are sometimes called a “hole” in the heart. A defect between the heart’s two upper chambers (the atria) is called an atrial septal defect (ASD).
Atrial fibrillation (atrial flutter)
An irregular, and at times very rapid, heart rhythm caused by reentrant electrical circuits in the upper chambers (atria) of the heart. When many of the electrical signals are transmitted to the lower pumping chambers (ventricles), the heart rate (pulse) becomes irregular and fast.
Coronary bypass
Also known as revascularization or coronary artery bypass grafting (CABG), coronary bypass is a surgical procedure that restores blood flow to the heart beyond a blockage in a coronary artery. Coronary bypass reroutes the blood around the blockage, creating an alternative pathway for blood to reach the heart muscle.
Cystectomy or radical cystectomy
Removal of the bladder.
da Vinci Surgical System
Robotic-assisted surgery system made by Intuitive Surgical. Based on a master-slave paradigm, the system cannot be programmed or make decisions on its own. Instead, it continuously receives input from the surgeon and, in real time, translates the input into action. The system is composed of a surgeon console, patient-side cart, EndoWrist® Instruments, and the InSite® Vision System.
Degrees of freedom
Refers to axes of movement or the flexibility to achieve given positions and orientations of an instrument tip. Six degrees of freedom are required to reach, position and orient an instrument at any point in space. The seventh degree of freedom is the function of the operation itself (e.g., grasping or cutting).
Robots are typically capable of movement along a number of axes; these movements can be rotational or translational (the motion of a body in which every point of the body moves parallel to and the same distance as every other point of the body).
The number of axes of movement (degrees of freedom), their arrangement and their sequence of operation permits movement of the robot to any point within its envelope.
Robots have three arm movements (up-down, in-out, side-to-side). In addition, they can have as many as three wrist movements on the end of the robot's arm, similar to a human wrist: yaw (side to side, left and right), pitch (up and down), and roll or rotational (circular rotation/twisting).
Epicardial lead placement
Placement of leads on the surface of the heart during pacemaker and defibrillator implants.
Endoscope
A small tubular lens device, usually attached to a video monitor, and video camera, and used to visualize the inside of the body.
Endoscopy
The use of a telescopic viewing device inserted into a body cavity via a small incision together with specialized surgical tools, enabling the surgeon to see the inside of the body cavity on a television screen and identify and repair the defect. Endoscopy is often done to diagnose gastric ulcers, locate the source of upper gastrointestinal bleeding, and examine the lower esophagus, stomach and lower colon.
EndoWrist® technology
Tiny, computer-enhanced mechanical wrists near the end of the instrument tip that provide all the flexibility of the human wrist and forearm at the operative site, through 1 cm ports.
Gleason score
A number from two (best) to 10 (worst) that helps evaluate the prognosis of men with prostate cancer. Together with other parameters, it is incorporated into a strategy of prostate cancer staging which predicts prognosis and helps guide therapy.
Laparoscope
A type of endoscope consisting of an illuminated tube with an optical system.
Laparoscopy
A type of surgery using a laparoscope, which is inserted into one or more small incisions, to examine the abdominal cavity. This technique uses small cylindrical tubes called trocars.
Lobectomy
Removal of a portion of the lung.
Maze procedure
Correction of atrial fibrillation or atrial flutter. Atrial fibrillation is a disorder characterized by the heart’s two small upper chambers (the atria) quivering instead of beating effectively. Blood isn’t pumped completely out of them, so it may pool and clot. If a piece of a blood clot in the atria leaves the heart and becomes lodged in an artery in the brain, a stroke results. About 15 percent of strokes occur in people with atrial fibrillation.
Minimally invasive surgery
Minimally Invasive Surgery (also known as MIS, minimal access, keyhole surgery, laparoscopic, or endoscopic surgery) is a major advance in bringing to patients the excellent results of traditional surgical procedures, while eliminating the most physically and emotionally traumatic elements: the pain and lengthy recovery from “open” surgery.
Minimally invasive surgery means having a minimum of interference with the patient's normal physiological function. Advances in laparoscopic surgery allow surgeons access to complex patient anatomy through very small incisions instead of the large incisions associated with conventional “open” surgery. Patients experience less pain and shorter recovery times.
Mitral valve prolapse
A condition in which the heart's mitral valve leaflets cannot tightly seal the left ventricle. With mitral valve prolapse, some blood flows back into the atrium – a condition called regurgitation. Regurgitation can make the heart work harder, leading to further valve damage and increasing the risk of heart failure.
Mitral valve repair
A heart procedure to treat stenosis (narrowing) or regurgitation (leakage) of the mitral valve. The mitral valve is the “inflow valve” for the left side of the heart.
Motion scaling
A software-based feature of the da Vinci® Surgical System that increases surgical precision and fine motor control by: 1) scaling hand movements so that large motions by the surgeon are reduced to micro-movements at the operative site, and 2) eliminating natural hand tremors.
Myasthenia gravis
A chronic disease affecting neuromuscular transmission that typically results in debilitating muscle weakness.
Myxoma
A myxoma is a tumor inside the heart, often in one of the upper chambers (atria).
Nephrectomy
Removal of a kidney or a section of a kidney.
Open surgery
Cutting the skin and tissues during surgery to expose a full view of the structures and organs involved in the procedure. Surgeons work under direct visualization with full incision.
Port
A tiny (1- to 2 cm) incision, into which a cannula (hollow, rigid tube) is inserted to act as a conduit for an endoscope or minimally invasive surgical instruments, including EndoWrist® instruments.
Prostatectomy or radical prostatectomy
Removal of the prostate to treat prostate cancer.
Pyeloplasty
Treatment for ureteropelvic junction obstruction or poorly flowing urine.
Radical hysterectomy/lymph node dissection
A surgical treatment for cervical cancer that includes removal of the
the uterus, the tissue on both sides of the cervix and the upper part of the vagina (radical hysterectomy), and the lymph nodes (lymph node dissection).
Reliability-Controlled™ reusable instruments
Intuitive Surgical® instruments that are used multiple times before being discarded, ensuring consistent high performance. They are completely sterilizable via standard methods.
Robot
An automatic device that performs functions normally ascribed to humans. More technically, a reprogrammable, multifunctional manipulator designed to move material, parts, tools, or specialized devices through various programmed motions for the performance of a variety of tasks. The word ‘robot’ was coined by the Czech playwright Karel Capek, from the Czech word for forced labor or serf.
For a machine to qualify as a robot, it usually needs five parts:
- A controller – the computer
- Arm(s) – the part of the robot that positions the end-effector and sensors
- The drive – the “engine” that moves the links – the sections between the joints into their desired position
- End effector(s) – the “hand” connected to the robot’s arm
- Sensor(s) – technology that sends information, in the form of electronic signals back to the controller
Robotics
A branch of engineering that involves the conception, design, manufacture, and operation of robots. This field overlaps with electronics, computer science, artificial intelligence, mechatronics (the synergistic combination of precision mechanical engineering, electronic control and systems thinking in the design of products and manufacturing processes); nanotechnology (the science and technology of building electronic circuits and devices from single atoms and molecules); and bioengineering (the application of engineering principles to the fields of biology and medicine, as in the development of aids or replacements for defective or missing body organs).
Sternotomy
A
surgical procedure in which a vertical incision is made along the sternum, or breastbone, after which the sternum itself is divided, or "cracked". This procedure provides access to the heart and lungs for certain cardiothoracic surgical procedures.
Supracervical hysterectomy
Removal of the uterus.
Surgical robotics
Remote activated or user-manipulated motion control, imaging and communication devices, operated via computer hardware and software to enable physicians to conduct an increasing array of surgical procedures in a minimally invasive manner.
Telesurgery
A term for robotic surgical technologies that are programmed with commands and then move autonomously, without human touch. The da Vinci Surgical System, by contrast, is based on servo-assisted technology that consistently updates critical performance inputs approximately 1500 times per second, simultaneously transferring the surgeon’s exact hand and finger movements made at the console to precise microsurgical movements of the instruments in the operative field.
Thymectomy
Surgical removal of the thymus gland. The thymus has been demonstrated to play a role in the development of autoimmune myasthenia gravis (MG). It is removed in an effort to improve the weakness caused by MG, and to remove a thymoma (a usually benign tumor of the thymus), if present.
Total hysterectomy/bilateral salpingo-oophorectomy/lymph node dissection
A surgical treatment for endometrial cancer that includes the removal of the uterus and the cervix (total hysterectomy), ovaries and fallopian tubes (bilateral salpingo-oopherectomy), and lymph nodes (lymph node dissection).
Video-assisted surgery
Any surgical procedure utilizing a visualization device, such as an endoscope.
Visual immersion
Refers to the sense of being inside the body, or present at the operative site, which the surgeon typically experiences while using the da Vinci System. Seated at the console, the surgeon is able to look into the video display and see a high-resolution, 3-D image of the surgical field, with hands and instruments in a natural line of sight – brighter and clearer than it would even appear in open surgery. 3-D visualization that allows eye-hand instrument alignment and coordination promotes maximum immersion at the surgical site, eliminating the spatial disorientation and disconnected hand/eye coordination inherent in traditional laparoscopic technology. |
