Frequently Asked Questions
Q. What is Minimally Invasive Surgery (MIS)?
A. MIS is surgery typically performed through small incisions, or operating ports, rather than large incisions, resulting in potentially shorter recovery times, fewer complications, reduced hospitalization costs and reduced trauma to the patient. While MIS has become standard-of-care for particular surgical procedures, it has not been widely adopted for more complex or delicate procedures – for example, prostatectomy and mitral valve repair.
Intuitive Surgical believes that surgeons have been slow to adopt MIS for complex procedures because they generally find that fine-tissue manipulation – such as dissecting and suturing – is more difficult than in open surgery. Intuitive Surgical's technology, however, enables the use of MIS techniques for complex procedures.
Q. Why do we need a new way to do minimally invasive surgery?
A. Despite the widespread use of minimally invasive or laparoscopic surgery in today's hospitals, adoption of laparoscopic techniques, for the most part, has been limited to a few routine procedures. This is due mostly to the limited capabilities of traditional laparoscopic technology, including standard video and rigid instruments, which surgeons must rely on to operate through small incisions.
In traditional open surgery, the physician makes a long incision and then widens it to access the anatomy. In traditional minimally invasive surgery – which is widely used for routine procedures -- the surgeon operates using rigid, hand-operated instruments, which are passed through small incisions and views the anatomy on a standard video monitor. Neither this laparoscopic instrumentation nor the video monitor can provide the surgeon with the excellent visualization needed to perform complex surgery like valve repair or nerve-sparing prostatectomy.
Q. What are the benefits of da Vinci Surgery compared with traditional methods of surgery?
A. Some of the major benefits experienced by surgeons using the da Vinci Surgical System over traditional approaches have been greater surgical precision, increased range of motion, improved dexterity, enhanced visualization and improved access. da Vinci Surgical System offers many potential benefits to patients facing surgery. To learn more about the benefits of specific da Vinci procedures, go to www.daVinciSurgery.com. Since surgery is unique to each patient and procedure, benefits cannot be guaranteed.
Q. Why can't surgeons perform complex procedures such as cardiac surgery through 1-2 cm ports today?
A. Complex procedures like cardiac surgery require an excellent view of the operative field and the ability to maneuver instruments within tight spaces with precision and control. Surgeons historically have used invasive approaches like "open sternotomy" for heart surgery, which means splitting the breastbone and pulling back the ribs and typically results in a foot-long incision. This provides visibility and allows room for the surgeon to get his or her hands and instruments very close to the operative site, but results in significant pain, blood loss and a long recovery for patients. More recently, smaller incisions have been used to perform a variety of cardiac procedures. However, many cardiac surgeons feel the reduced access may limit visualization and may impede access to the operative field.
Q: Where is the da Vinci Surgical System being used now?
A. Currently, The da Vinci Surgical System is being used in hundreds of locations worldwide, in major centers in the United States, Austria, Belgium, Canada, Denmark, France, Germany, Italy, India, Japan, the Netherlands, Romania, Saudi Arabia, Singapore, Sweden, Switzerland, United Kingdom, Australia and Turkey.
Q. Has the da Vinci Surgical System been cleared by the FDA?
A. The U.S. Food and Drug Administration (FDA) has cleared the da Vinci Surgical System for a wide range of procedures. Please see the FDA Clearance page for specific clearances and representative uses.
Q. Is da Vinci Surgery covered by insurance?
A. da Vinci Surgery is categorized as robot-assisted minimally invasive surgery, so any insurance that covers minimally invasive surgery generally covers da Vinci Surgery. This is true for widely held insurance plans like Medicare. It is important to note that your coverage will depend on your plan and benefits package. For specifics regarding reimbursement for da Vinci Surgery, or if you have been denied coverage, please call the Reimbursement Hotline at 1-888-868-4647 ext. 3128. From outside the United States, please call 33-1-39-04-26-90.
Q. Will the da Vinci Surgical System make the surgeon unnecessary?
A. On the contrary, the da Vinci System enables surgeons to be more precise, advancing their technique and enhancing their capability in performing complex minimally invasive surgery. The System replicates the surgeon's movements in real time. It cannot be programmed, nor can it make decisions on its own to move in any way or perform any type of surgical maneuver without the surgeon's input.
Q. Is a surgeon using the da Vinci Surgical System operating in "virtual reality"?
A. Although seated at a console a few feet away from the patient, the surgeon views an actual image of the surgical field while operating in real-time, through tiny incisions, using miniaturized, wristed instruments. At no time does the surgeon see a virtual image or program/command the system to perform any maneuver on its own/outside of the surgeon's direct, real-time control.
Is this telesurgery? Can you operate over long distances?
A. The da Vinci Surgical System can theoretically be used to operate over long distances. This capability, however, is not the primary focus of the company and thus is not available with the current da Vinci Surgical System.
Q. While using the da Vinci Surgical System, can the surgeon feel anything inside the patient's chest or abdomen?
A. The system relays some force feedback sensations from the operative field back to the surgeon throughout the procedure. This force feedback provides a substitute for tactile sensation and is augmented by the enhanced vision provided by the high-resolution 3D view.
Q. What procedures have been performed using the da Vinci Surgical System? What additional procedures are possible?
A. The da Vinci System is a robotic surgical platform designed to enable complex procedures of all types to be performed through 1-2 cm incisions or operating “ports.” To date, approximately 1.5 million procedures including general, urologic, gynecologic, thoracoscopic, and thoracoscopically-assisted cardiotomy procedures have been performed using the da Vinci Surgical System.
Q. Why is it called the da Vinci® Surgical System?
A. The product is called "da Vinci" in part because Leonardo da Vinci invented the first robot. He also used unparalleled anatomical accuracy and three-dimensional details to bring his masterpieces to life. The da Vinci Surgical System similarly provides physicians with such enhanced detail and precision that the System can simulate an open surgical environment while allowing operation through tiny incisions.
All surgery presents risk, including da Vinci Surgery. Results, including cosmetic results, may vary. Serious complications may occur in any surgery, up to and including death. Examples of serious and life-threatening complications, which may require hospitalization, include injury to tissues or organs; bleeding; infection, and internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Patients should understand that risks of surgery include potential for human error and potential for equipment failure. Risk specific to minimally invasive surgery may include: a longer operative time; the need to convert the procedure to an open approach; or the need for additional or larger incision sites. Converting the procedure to open could mean a longer operative time, long time under anesthesia, and could lead to increased complications. Research suggests that there may be an increased risk of incision-site hernia with single-incision surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci Surgery. Other surgical approaches are available. Patients should review the risks associated with all surgical approaches. They should talk to their doctors about their surgical experience and to decide if da Vinci is right for them. For more complete information on surgical risks, safety and indications for use, please refer to http://www.davincisurgery.com/da-vinci-surgery/safety-information.php.
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Content provided by Intuitive Surgical.
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