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Intuitive Surgical, Inc. Message Board

  • d341 d341 Jan 29, 2006 7:12 PM Flag

    Delivering Babies...

    Maybe just maybe someday a robot will assist in delivering babies...what an explosion of robotics that would be...good for ISRG

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    • "Am I correct in assuming that brachytherapy via long percutaneous needles exists because placement of radioactive seeds during open surgery would be dangerous to surgeons because their hands would be too close to the seeds while closing the surgical wound?"

      Placing of needles for seed deposition via an open approach to the prostate was abandoned 20 years ago and replaced by transperineal placement of needles guided by transrectal ultrasound. Open placement by feel was too imprecise creating "hot" and "cold" spots and ineffective treatment. Ultrasound guidance and intraoperative computerized planning results in a more even distribution of the dosing.

      There is a form of brachytherapy that gives very high doses intermittantly via needles left in place for a period of time and connected to long catheters. It is referred to as HDR brachytherapy for High Dose Radiation. A machine advances the sources along the catheters and into position then withdraws them. This is not often used in my experience. I think the advantage is that you can use very high doses for a very short period of time, but whether it is more effective or not I can't say. And, no, you don't want to be anywhere near that stuff unless you are the patient getting treated.

      Lengthy description of same follows (imagine lying around the hospital for 24 hours with those needles up your butt):
      http://www.brachytherapy.com/prostate-technique.html

    • <<< In the lung I doubt it is da Vinci. It may be done transbronchially. I don't know. As far as only robots allowing precise placement at a safe distance, I think a robot could be more precise but safety is not much of an issue, at least with brachytherapy in the prostate as the seeds are well shielded until they are implanted. >>>

      Am I correct in assuming that brachytherapy via long percutaneous needles exists because placement of radioactive seeds during open surgery would be dangerous to surgeons because their hands would be too close to the seeds while closing the surgical wound? If so, you could use davinci to place seeds EXACTLY where you want (instead of using ultrasound guidance) while you sit safely 10 feet away.

    • In the lung I doubt it is da Vinci. It may be done transbronchially. I don't know. As far as only robots allowing precise placement at a safe distance, I think a robot could be more precise but safety is not much of an issue, at least with brachytherapy in the prostate as the seeds are well shielded until they are implanted.

    • Hmmm. Is this new? Is this da Vinci?

      >>Only robotics can allow precise implantation of radioactive seeds at a safe distance from the radioactive source.<<

      micro

    • and also all kinds of pediatric surgeries.

    • i love all the info you folks provide; thanks. but i have to say, philosophically, i think robots actually "delivering" the babies will be a tough sell. I wouldn't have put any of mine in the "hands" of one at that exact moment! Maybe I can see a dr./rn getting all excited over the concept... but not a hormone-hopped-up mom LOL.

      GL & HE

      Dulch

    • d341 it appears you see what has made us like the da Vinci for a long time and why we think we will like it for a long time in the future. It is only a matter of time before the da Vinci concept, is the industry standard, for many procedures. Enjoy the ride.

    • Thanks guys...the more i read the more understand...but we all feel there is a lot potential prospects using a robotic system its just which ones are picked...cant wait til we have pure no-invasive method for all types of surgery...this is just a stepping stone to the next and the next...

    • The more I read, the more I think my estimate of 56 Da Vinci's for the 4Q maybe low.

    • <<< Maybe just maybe someday a robot will assist in delivering babies...what an explosion of robotics that would be...good for ISRG >>>

      The problem is that the incision still needs to be big enough for the baby to fit through. A hysterectomy on the other hand can be done robotically because the uterus can be shredded into several pieces so it will fit through the small incisions.

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