The advancement of laparoscopic robotic surgery largely depends on the development of innovative laparoscopic instrumentation. The most widely used system, the da Vinci surgical robot (Intuitive Surgical Inc., Sunnyvale, California), was introduced in 1998 and received FDA approval in 2000. Its popularity may largely be attributed to the development of EndoWrist instruments with increased degrees of freedom and improved stereoscopic vision. The electronics integrated into the system allow motion scaling of surgeon hand movement into smaller instrument tip movements in the field, reducing natural tremor of surgeon’s hands. Instruments have a total of six degrees of freedom plus grip, mimicking the up and down and side-to-side flexibility of human wrist. Recently da Vinci S system has introduced (Intuitive Surgical Inc.), which features easier docking, added system feedback and high-definition telemonitoring. Another feature of the new S system is the additional 2 inches of length of the instruments.
The combination of pure laparoscopic and robot-assisted tools constitutes a standard approach to the advanced endourological techniques.
There are many available tools at the disposal of the robotic surgeon. Similar to the surgeon performing open surgery, a robotic surgeon’s familiarity with available equipment and technology is essential. This knowledge of all the available tools is essential to the surgeon in maximizing the outcomes of the surgery and shortening the procedure times.
Marescaux J. and Rubino F. (2003) The ZEUS robotic system: experimental and clinical applications. Surg Clin North Am83, 1305–15PubMedCrossRefGoogle Scholar
Murphy D., Challacombe B., Khan M.S. and Dasgupta P. (2006) Robotic technology in urology. Postgrad Med J82, 743–7PubMedCrossRefGoogle Scholar
Kim V.B., Chapman W.H., Albrecht R.J., Bailey B.M., Young J.A., Nifong L.W. and Chitwood W.R. Jr. (2002) Early experience with telemanipulative robot-assisted laparoscopic cholecystectomy using da Vinci. Surg Laparosc Endosc Percutan Tech12, 33–40PubMedCrossRefGoogle Scholar
EndoWrist instrument and accessory catalog (2007) Intuitive Surgical Inc.Google Scholar
Azurin D.J., Go L.S., Arroyo L.R. and Kirkland M.L. (1995) Trocar-site herniation following laparoscopic cholecystectomy and the significance of an incidental preexisting umbilical hernia. Am Surg61, 718–20PubMedGoogle Scholar
Florio G., Silvestro C. and Polito D.S. (2003) Peri-umbilical Veress needle pneumoperitoneum: technique and results in 2126 cases. Chir Ital55, 51–4PubMedGoogle Scholar
Bonjer H.J., Hazebroek E.J., Kazemier G., Gluffrida M.C., Meijer W.S. and Lance J.F. (1997) Open versus closed establishment of pneumoperitoneum in laparoscopic surgery. Br J Surg84, 599–602PubMedCrossRefGoogle Scholar
Phillips P.A. and Amaral F.A. (2001) Abdominal access complications in laparoscopic surgery. J Am Coll Surg192, 525–36CrossRefGoogle Scholar
The da Vinci endoscopic instrument control system user manual. (2004) Intuitive Surgical Inc.Google Scholar
Vancaillie T.G. (1998) Active electrode monitoring. How to prevent unintentional thermal injury associated with monopolar electrosurgery at laparoscopy. Surg Endosc12, 1009–12PubMedCrossRefGoogle Scholar
Bishoff J.T., Allaf M.T., Kirkels W., Moore R.G., Kavoussi L.R. and Schroder F (1999) Laparoscopic bowel injuries: incidence and clinical presentation. J Urol161, 887–90PubMedCrossRefGoogle Scholar