Training in Robotic Surgery Using the da Vinci^【○!R】 Surgical System for Left Pneumonectomy and Lymph Node Dissection in an Animal Model

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概要

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• Objectives: In Japan, as of March 2010, only 13 hospitals were using the da Vinci system and only for selected cases. Few clinical robotic lung surgery has been done in Japan, and there are no standardized training programs, although some exist in the U.S. and are under consideration by the Japanese society for thoracic surgery. We have used the da Vinci S® Surgical System for pneumonectomy and lymph node dissection in pigs. We report and review future possibilities and problems of robotic surgery, especially concerning education, training, safety management and ethical considerations for pneumonectomy and lymph node dissection in clinical practice.Methods: The da Vinci® system consists of a surgeon’s console connected to a patient-side cart, a manipulator unit with three instrument arms and a central arm to guide the endoscope. The surgeon, sitting at the console, triggers highly sensitive motion sensors that transmit the surgeon’s movements to the instrument arm. Results: We experienced exactly the same sensation as when performing standard open thoracotomy. Visual recognition is 3-D, and the high manipulation potential allows free movement of the various accessory instruments, exceeding the capacity of a surgeon’s hands in video-assisted thoracic surgery (VATS) or even standard thoracotomy.Conclusions: Robotic surgery achieves at least the same level of operation technique for pneumonectomy and lymph node dissection under standard open thoracotomy, and it seemed as safe and easily performed as conventional VATS. The training program using pigs was effective and holds promise as a system to train thoracic surgeons in robotic lung surgery.

• 2011-10-01

著者

• Ohira T

  Department Of Thoracic Surgery Tokyo Medical University

• Ohira Tatsuo

  Department Of Surgery Tokyo Medical University

• Uchida Osamu

  The First Department Of Surgery Tokyo Medical University

• Ikeda Norihiko

  Department Of Applied Chemistry Faculty Of Engineering Okayama University

• USUDA Jitsuo

  Department of Thoracic Surgery, Tokyo Medical University

• Uchida Osamu

  Department Of Anesthesiology National Cardiovascular Center

• Ikeda Norihiko

  Department Of Thoracic Surgery International University Of Health And Welfare

• Okunaka Tetsuya

  Department Of Thoracic Surgery Tokyo Medical University

• Kajiwara Naohiro

  The First Department Of Surgery Tokyo Medical University

• Kakihana Masatoshi

  Department Of Surgery Tokyo Medical University

• Usuda Jitsuo

  Department Of Gastroenterology And Hepatology Tokyo Medical University

• Kajiwara Naohiro

  Department Of Thoracic Surgery & Oncology Tokyo Medical University & Hospital

• Kakihana Masatoshi

  Department Of Thoracic Surgery Tokyo Medical University

• KAWATE Norihiko

  Department of Health Science and Social Welfare, Waseda University School of Human Sciences

• KAJIWARA Naohiro

  Department of Surgery, Tokyo Medical University

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