Robotic Surgery in Upstate New York | Ronald Marsh | TEDxFMCC

if your parachute doesn’t deploy you are

if your parachute doesn’t deploy you are a victim of uncontrolled trauma a

a victim of uncontrolled trauma a

a victim of uncontrolled trauma a surgical patient is exposed to trauma

surgical patient is exposed to trauma

surgical patient is exposed to trauma but the trauma is controlled abdominal

but the trauma is controlled abdominal

but the trauma is controlled abdominal operations have traditionally required

operations have traditionally required

operations have traditionally required large incisions larger the incision the

large incisions larger the incision the

large incisions larger the incision the bigger the trauma surgery with smaller

bigger the trauma surgery with smaller

bigger the trauma surgery with smaller incisions has significant benefits less

incisions has significant benefits less

incisions has significant benefits less pain quicker recovery more cosmetically

pain quicker recovery more cosmetically

pain quicker recovery more cosmetically appealing and they probably have less of

appealing and they probably have less of

appealing and they probably have less of an insult to the immune system

an insult to the immune system

an insult to the immune system laparoscopic surgery is a way to do a

laparoscopic surgery is a way to do a

laparoscopic surgery is a way to do a number of abdominal operations with tiny

number of abdominal operations with tiny

number of abdominal operations with tiny incisions this is accomplished by

incisions this is accomplished by

incisions this is accomplished by inserting cannulas or trocars through

inserting cannulas or trocars through

inserting cannulas or trocars through the abdominal wall a camera and

the abdominal wall a camera and

the abdominal wall a camera and instruments are inserted through the

instruments are inserted through the

instruments are inserted through the trocar the images are projected onto a

trocar the images are projected onto a

trocar the images are projected onto a monitor the surgeon stands at the

monitor the surgeon stands at the

monitor the surgeon stands at the bedside stares at the monitor and

bedside stares at the monitor and

bedside stares at the monitor and manipulates the target Anatomy with

manipulates the target Anatomy with

manipulates the target Anatomy with instruments that basically opened or

instruments that basically opened or

instruments that basically opened or closed

similarly places trocars and instruments

similarly places trocars and instruments into the abdominal cavity but these

into the abdominal cavity but these

into the abdominal cavity but these instruments are connected to robotic

instruments are connected to robotic

instruments are connected to robotic arms this has a major difference because

arms this has a major difference because

arms this has a major difference because the vision is much much better

the vision is much much better

the vision is much much better the camera with a robotic platform

the camera with a robotic platform

the camera with a robotic platform preserves depth perception there’s a

preserves depth perception there’s a

preserves depth perception there’s a lens for the left eye and a lens for the

lens for the left eye and a lens for the

lens for the left eye and a lens for the right eye so you see the target Anatomy

right eye so you see the target Anatomy

right eye so you see the target Anatomy in three dimensions as it truly is as

in three dimensions as it truly is as

in three dimensions as it truly is as opposed to looking at a monitor it’s

opposed to looking at a monitor it’s

opposed to looking at a monitor it’s only two dimensions the first video this

only two dimensions the first video this

only two dimensions the first video this is an incarcerated left inguinal hernia

is an incarcerated left inguinal hernia

is an incarcerated left inguinal hernia I’m operating with three active arms a

I’m operating with three active arms a

I’m operating with three active arms a camera and two instruments the robotic

camera and two instruments the robotic

camera and two instruments the robotic instruments are not rigid but wristed so

instruments are not rigid but wristed so

instruments are not rigid but wristed so the tip is flexible and fully controlled

the tip is flexible and fully controlled

the tip is flexible and fully controlled from the console not at the patient’s

from the console not at the patient’s

from the console not at the patient’s bedside this allows for a more precise

bedside this allows for a more precise

bedside this allows for a more precise anatomic dissection this is the hernia

anatomic dissection this is the hernia

anatomic dissection this is the hernia here which may appear to be winning this

here which may appear to be winning this

here which may appear to be winning this tug-of-war what will ultimately succumb

tug-of-war what will ultimately succumb

tug-of-war what will ultimately succumb the hernias nose is no match for a

the hernias nose is no match for a

the hernias nose is no match for a surgeon in a robot there’s some

surgeon in a robot there’s some

surgeon in a robot there’s some dissection just producing this

dissection just producing this

dissection just producing this incarcerate appropriate nail fad and

incarcerate appropriate nail fad and

incarcerate appropriate nail fad and peritoneum but soon you’ll see a hole

peritoneum but soon you’ll see a hole

peritoneum but soon you’ll see a hole which is very obvious and the remaining

which is very obvious and the remaining

which is very obvious and the remaining part of that operation is to place

part of that operation is to place

part of that operation is to place basically a large patch at over that

basically a large patch at over that

basically a large patch at over that hole the in more complex operations you

hole the in more complex operations you

hole the in more complex operations you can introduce there we go

can introduce there we go

can introduce there we go and more complex operations you can

and more complex operations you can

and more complex operations you can introduce a third arm so you have a

introduce a third arm so you have a

introduce a third arm so you have a camera and three arms and that can be

camera and three arms and that can be

camera and three arms and that can be useful in a number of different ways the

useful in a number of different ways the

useful in a number of different ways the second video is a cholecystectomy which

second video is a cholecystectomy which

second video is a cholecystectomy which is to remove a patient’s gallbladder if

is to remove a patient’s gallbladder if

is to remove a patient’s gallbladder if you were a guest in the operating room

you were a guest in the operating room

you were a guest in the operating room the OU our staff would tell you that

the OU our staff would tell you that

the OU our staff would tell you that robotic cases are quite different than

robotic cases are quite different than

robotic cases are quite different than any other procedures we do in the

any other procedures we do in the

any other procedures we do in the operating room the surgeon is not at the

operating room the surgeon is not at the

operating room the surgeon is not at the patient’s bedside except for placing the

patient’s bedside except for placing the

patient’s bedside except for placing the instruments through the abdominal wall

instruments through the abdominal wall

instruments through the abdominal wall but is actually sitting at the console

but is actually sitting at the console

but is actually sitting at the console and appears to be playing a video game

and appears to be playing a video game

and appears to be playing a video game but is in fact doing the operation

but is in fact doing the operation

but is in fact doing the operation because I mentioned earlier with with

because I mentioned earlier with with

because I mentioned earlier with with more complicated cases you can introduce

more complicated cases you can introduce

more complicated cases you can introduce instruments that have even more of a

instruments that have even more of a

instruments that have even more of a versatility than these see two of these

versatility than these see two of these

versatility than these see two of these instruments are not wristed but but

instruments are not wristed but but

instruments are not wristed but but rigid

rigid

rigid so the laparoscopic instruments are as I

so the laparoscopic instruments are as I

so the laparoscopic instruments are as I showed before are just straight that

showed before are just straight that

showed before are just straight that open and close and the robotic

open and close and the robotic

open and close and the robotic instruments the tip moves that’s what we

instruments the tip moves that’s what we

instruments the tip moves that’s what we call wristed not rigid and it actually

call wristed not rigid and it actually

call wristed not rigid and it actually has more degrees of freedom than a human

has more degrees of freedom than a human

has more degrees of freedom than a human wrist and as I mentioned a moment ago

wrist and as I mentioned a moment ago

wrist and as I mentioned a moment ago you get to have a third wrist I’ve been

you get to have a third wrist I’ve been

you get to have a third wrist I’ve been in the practice of general surgery for

in the practice of general surgery for

in the practice of general surgery for 26 years have done thousands of

26 years have done thousands of

26 years have done thousands of operations most peering into a surgical

operations most peering into a surgical

operations most peering into a surgical wound or staring at a monitor more

wound or staring at a monitor more

wound or staring at a monitor more recently I’ve had the privilege to do

recently I’ve had the privilege to do

recently I’ve had the privilege to do those same operations robotically the

those same operations robotically the

those same operations robotically the difference is truly amazing and it’s

difference is truly amazing and it’s

difference is truly amazing and it’s predicated on the vision imagine walking

predicated on the vision imagine walking

predicated on the vision imagine walking by a house in your neighborhood a

by a house in your neighborhood a

by a house in your neighborhood a thousand times

thousand times

thousand times every time you look in the house you

every time you look in the house you

every time you look in the house you can’t see anything because the curtains

can’t see anything because the curtains

can’t see anything because the curtains are drawn but then one day you walk by

are drawn but then one day you walk by

are drawn but then one day you walk by the same house and you notice it looks a

the same house and you notice it looks a

the same house and you notice it looks a little bit different the curtains not

little bit different the curtains not

little bit different the curtains not there anymore

there anymore

there anymore you take a look inside things look very

you take a look inside things look very

you take a look inside things look very familiar they’re familiar because you’ve

familiar they’re familiar because you’ve

familiar they’re familiar because you’ve read about them in anatomy textbooks

read about them in anatomy textbooks

read about them in anatomy textbooks seeing illustrations but today you’re

seeing illustrations but today you’re

seeing illustrations but today you’re the operating surgeon and you’re seeing

the operating surgeon and you’re seeing

the operating surgeon and you’re seeing subtle anatomic features for the first

subtle anatomic features for the first

subtle anatomic features for the first time and you’ve been in this

time and you’ve been in this

time and you’ve been in this neighborhood thousands of times it’s an

neighborhood thousands of times it’s an

neighborhood thousands of times it’s an amazing and lightning and inspiring

amazing and lightning and inspiring

amazing and lightning and inspiring experience that never gets old

experience that never gets old

experience that never gets old this is why I believe that surgery is

this is why I believe that surgery is

this is why I believe that surgery is more precise on a robotic platform and

more precise on a robotic platform and

more precise on a robotic platform and that the DaVinci robot changes the

that the DaVinci robot changes the

that the DaVinci robot changes the paradigm and general surgery these are

paradigm and general surgery these are

paradigm and general surgery these are the two critical structures during the

the two critical structures during the

the two critical structures during the procedure one is a cystic duct the other

procedure one is a cystic duct the other

procedure one is a cystic duct the other Cystic artery in a moment you’re gonna

Cystic artery in a moment you’re gonna

Cystic artery in a moment you’re gonna see a change in color it’s a pretty

see a change in color it’s a pretty

see a change in color it’s a pretty remarkable flash fairness so that was

remarkable flash fairness so that was

remarkable flash fairness so that was the highlight so that is not an angry

the highlight so that is not an angry

the highlight so that is not an angry patient turning into the Incredible Hulk

patient turning into the Incredible Hulk

patient turning into the Incredible Hulk it’s actually technology called Firefly

it’s actually technology called Firefly

it’s actually technology called Firefly and it’s a way during an operation in

and it’s a way during an operation in

and it’s a way during an operation in real time to highlight different parts

real time to highlight different parts

real time to highlight different parts of the anatomy and it’s a quite useful

of the anatomy and it’s a quite useful

of the anatomy and it’s a quite useful tool thanks for your attention

tool thanks for your attention

tool thanks for your attention [Applause]