NEW ADVANCES IN LAPAROSCOPIC SURGERY
Limitations of traditional laparoscopic surgery
The major limitation of standard laparoscopic techniques have been the following:
New technologies for advance laparoscopic surgery
Development of new instruments and innovation in technique is required for widespread use of advanced laparoscopy for the treatment of abdominal conditions. New technologies may overcome many of the limitations (noted above) of standard laparoscopic techniques. We have utilized the new technologies to develop laparoscopic operations for the pancreas, liver and the bile duct.
Two new technologies that are particularly promising are: hand access devices and robotic surgery.
Hand access devices
The human hand performs many functions during surgery that are difficult to reproduce with laparoscopic instruments. The loss of the ability to place the hand into the abdomen during traditional laparoscopic surgery has limited the use of laparoscopy for complex abdominal surgery on the pancreas, liver and bile duct.
New laparoscopic hand-access devices that allows the surgeon to place a hand into the abdomen during laparoscopic surgery and perform many of the different functions with the hand that were previously possible only during open surgery. We have utilized this new device to develop a variety of laparoscopic pancreatic, liver and biliary procedures such as the Whipple operation, distal pancreatectomy and liver resection that were not possible previously by standard laparoscopic techniques.
Da Vinci™ is a computer-assisted robotic system that expands a surgeon's capability to operate within the abdomen in a less invasive way during laparoscopic surgery. Da Vinci™ system allows greater precision and better visualization compared to standard laparoscopic surgery.
The USC University Hospital is the first hospital in Southern California to perform robotically-assisted surgery using the da Vinci™ Surgical System.
The operations with the Da Vinci System are performed with no direct mechanical connection between the surgeon and the patient. The surgeon is remote from the patient, working a few feet from the operating table while seated at a computer console with a three-dimensional view of the operating field. The physician operates two masters (similar to joysticks) that control the two mechanical arms on the robot. The mechanical arms are armed with specialized instruments with hand-like movements which carry out the surgery through tiny holes in the patient’s abdomen. The arms eliminate any hand tremor by the surgeon and offer motion scaling – allowing extremely precise movements within the patient.
We are presently exploring the role of this new technology for complex operations on the pancreas, bile duct and the liver.
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