UM Medical Center’s Robotic Surgery Program

da Vinci Surgical System Frequently Asked Questions

Q. What is minimally invasive surgery (MIS)?

A. The term MIS can be used interchangeably with laparoscopy or endoscopic surgery. Minimally invasive surgery is performed through dime-sized (1-2 cm) incisions — also called operating ports. This is in contrast to the much larger incisions used in traditional, open surgery, which are often as large as 6-12 inches long. In cardiac surgery, a conventional “open” approach also involves splitting the breastbone and opening the ribs.

The smaller incisions used in MIS typically enable shorter recovery times and result in less pain, less blood loss, fewer transfusions, fewer infections and reduced hospitalization costs. 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's technology, however, enables the use of MIS technique for complex procedures.

Q. What are the benefits of using the da Vinci Surgical System when 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. Benefits experienced by patients may include a shorter hospital stay, less pain, less risk of infection, less blood loss, fewer transfusions, less scarring, faster recovery and a quicker return to normal daily activities. None of these benefits can be guaranteed, as surgery can be both patient- and procedure-specific.

Q. Why can't surgeons currently perform complex procedures such as cardiac surgery through the smaller (minimally invasive) incisions?

A. Complex procedures like cardiac surgery require an excellent view of the operative field and the ability to maneuver instruments within the chest cavity, abdomen or pelvis with precision and control. Surgeons historically have used the "open sternotomy" approach to heart surgery, which means splitting the sternum (breastbone) and pulling back the ribs — which typically requires a foot-long incision. This provides visibility and allows room for the surgeon to get his hands and instruments very close to the operative site.

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. In contrast, the da Vinci System’s unique EndoWrist Instruments and InSite Vision System can provide better control, dexterity and visualization than with an open procedure.

Q: What procedures have been performed using the da Vinci Surgical System? What additional procedures are possible?

A. To date, tens of thousands of procedures, including general, urologic, gynecologic, thoracoscopic and thoracoscopically-assisted cardiotomy procedures have been performed using the da Vinci Surgical System. The University of Maryland Medical Center is the first in the state of Maryland to perform robotic-assisted minimally invasive coronary artery bypass surgery, and is also offering offers robotic prostatectomy for patients with prostate cancer.

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.

Q: Where is the da Vinci Surgical System being used now?

A. There are more than 300 da Vinci Surgical Systems in use worldwide, in major centers in the United States, (such as the University of Maryland Medical Center), Austria, Belgium, Canada, Denmark, France, Germany, Italy, India, Japan, the Netherlands, Romania, Saudi Arabia, Singapore, Sweden, Switzerland, United Kingdom, Australia and Turkey.

Q. Does the robot perform the surgery on its own?

A. The da Vinci Surgical System cannot — in any manner — run on its own. Instead, the System is designed to seamlessly replicate the movement of the surgeon's hands with the tips of micro-instruments. The System cannot make decisions, nor can it perform any type of movement or maneuver, without the surgeon’s direct input.

Q. Will the da Vinci Surgical System make the surgeon unnecessary?

A. Absolutely not. On the contrary, the da Vinci System is designed to help surgeons advance their technique by enhancing their ability to perform 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 the surgical instruments.

This page was last updated on: December 11, 2006.