The da Vinci Si HD Surgical System

The da Vinci® Si surgical tower
(photo courtesy of Intuitive Surgical)

The da Vinci® robotic surgical system in use at NYU consists of a surgical tower and a console.

The tower has four robotic arms: one with a pair of small video cameras attached to a fiber optic cable, and three with specialized adapters for the attachment of quarter-inch-wide surgical instruments.

The surgical console, where the surgeon sits, has a stereoscopic 3-D monitor that projects images from the camera in real time, and two joysticks controlled by the surgeon. Any motion that can be done by a surgeon’s hand or wrist can be translated into a precise movement of the robotic surgical instruments, analogous to miniaturizing the surgeon’s hands and eyes and placing them inside the body.

NYU Langone is the first institution in New York and New Jersey to begin using the da Vinci Si HD system, which has the following advantages over older models:

• 40% higher definition view of the surgical field
• Additional robotic arm to hold surgical instruments
• Physicians can import and display medical test results from any networked computer or diagnostic medical device
• Two surgeons may participate in the operation concurrently, using networked surgical consoles

• Watch a video overview of the da Vinci surgical system (link will open in a new window)

Nephrectomy incisions in open (left) vs. robotic (right) surgery

Surgery with the da Vinci system

During robotic surgery using the da Vinci surgical system, three small incisions are made in the patient’s abdomen. The four arms of the tower are inserted into the patient's body through the incisions and controlled by the surgeon seated at the console. The operation then proceeds similarly to standard laparoscopic surgery, but with several advantages over the traditional technique.

Advantages of surgery with the da Vinci system

• Three-dimensional stereo view of the surgical field (vs. two-dimensional view in traditional laparoscopic surgery)
• Greater range of motion of the surgical tools
• Scaled-down movement: relatively large movements of the surgeon’s hands at the console are translated into very fine movements of the robotic tools

These factors allow for more precision within a smaller operative field and are particularly useful in procedures that involve extensive suturing and reconstruction.