ВТОРОЕ МЕДИЦИНСКОЕ ЗАКЛЮЧЕНИЕ
Robotic Heart Surgery

Robotic heart surgeries performed through an 8 mm incision without cutting the sternum allow rapid recovery.

540 degree rotating arms and 10 times magnified image quality

Robotic surgery is a method applied on the basis of minimally invasive surgery (creating the least damage to body integrity). Surgical procedures performed with da Vinci are also defined as 'robot-assisted surgery'. The only example of robotic surgery systems in the world, da Vinci is known for its precision features as well as its three-dimensional vision technology and advanced mobility.

When the word "surgeon robot" is mentioned, although the operation is followed and awakened as the robot performs, this is not the case. The surgeon robot acts only under the control of the surgeon and with his/her directives.

Da Vinci Robotic Surgery Systems, which provide a much shorter recovery compared to open surgery, are applied in Urology, Gynecology, General Surgery, Otorhinolaryngology, Cardiovascular Surgery, Thoracic Surgery and Pediatric Surgery. In robotic surgery, instruments that have human hand and wrist movements and can rotate 540 degrees are used. Thanks to these instruments, the surgeon can easily work in narrow areas where he cannot work easily with his own hands.

History of Robotic Surgery

The first documented robot-assisted surgical intervention was in 1985. Neurosurgical biopsy was performed with the support of PUMA 560 robotic surgical arm in this first use outside the abdomen, that is, non-laparoscopic. Gallbladder surgery performed in the abdomen in 1987 was the first laparoscopic procedure. The next year, the PUMA system was used in robotic surgical transurethral resection. The AESOP system, which carries the optical system used in closed surgeries and acts according to the surgeon's voice commands, was produced by Computer Motion and offered to surgeons in 1990.

In 2000, the da Vinci robotic surgery system received FDA approval as the first integrated robotic surgery system that includes a camera and different surgical instruments. Unlike its predecessors, it became the first robotic surgical system that did not require many assistants to complete the operation. With its commercialization, it has been used by surgeons in many developed countries and in leading hospitals in a short time. 

10 Times Magnified Image

Thanks to the real-time image obtained with three-dimensional and 10 times magnification, it enables the tumor to be cleaned with precision, especially in cancer patients. In addition, due to the closed method of the surgery, smaller incisions are made and it also provides cosmetic advantages with less scarring. Since each of the incisions are about 8 mm, the patient recovers much faster and returns to his social life in a short time. Due to its minimal invasiveness, the risk of infection is also significantly reduced. 

In which heart diseases is it applied?

Robotic heart surgery can be used in the repair or replacement of mitral and tricuspid valve diseases, in the treatment of atrial fibrillation that causes heart rhythm disorders, cryoablation also called freezing. In addition, robotic surgery is also used in coronary artery surgery, in the treatment of intracardiac tumors called myxoma, and in the treatment of congenital heart holes called atrial septals. 

Details of Surgeries Performed with da Vinci

-At the beginning of the operation, an incision is made on the skin and a telescope is inserted into the body with the help of a trocar. Three more 8 mm long holes are drilled in the body for the other arms of the robot. The doctor performing the operation sees the organs in 3D from the console located far from the operating table. The 3-dimensional image gives the surgeon a sense of depth. The small hand movements of the surgeon are transferred to the robotic arms by the fiber optic cables in the console. Thus, instruments such as surgical scissors, tissue and needle holders are provided to make the desired movements. The surgeon performs the operation by directing 4 arms placed inside the body, 2 control arms and pedals under her/his feet. 

Faster Healing, Fewer Incisions, Successful Surgery

Comfort for the Patient and the Physician

Robotic surgery aims to reduce the surgical side effects that may occur in patients, while not compromising surgical success. Therefore, in robot-assisted surgeries, the skin incisions are shorter, the operating areas are smaller, and the surgical field is made suitable for more precise work under three-dimensional magnification. As a result, the possible blood loss is further reduced by shrinking the surgical field and making it more controlled, blood donation rates are reduced accordingly, the risk of infection is minimized due to the closed application of the surgery, less pain, faster healing, less scarring, less scarring thanks to short skin incisions. Good cosmetic results can be achieved by returning to daily life in a shorter time, with fewer complications and successful surgery.

The most important comfort that robotic surgery gives to the surgeon is the opportunity to perform surgery in accordance with body ergonomics. The surgeon sits in the unit, which we call the console, where the movements of the robotic arms are controlled throughout the operation, and performs the operation by following the image that the system carries 10 times larger than the inside of the body. Robotic arms perform operations such as cutting, separating, burning, sewing with finger and wrist movements. In this way, the surgeon completes the operation by providing the highest level of field control, without being distracted and without physical fatigue in his body despite operating for a long time.

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