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Black Pean - Darwin information #2
Spoilers for episode 5. Check the original article for photos!
Of course, the smaller incisions mean less bleeding and much faster recovery.
Many people who receive surgery are still in the prime of life, with family lives and hobbies and many things that they want to enjoy, so it's very important for them to return to their former lives as quickly as possible. If they remain in hospital for a long time, it can cause both physical and financial burdens.
Techniques that had been overwhelmingly difficult to do, hard to see or very precise can now be done while looking at an enlarged 3D image on a screen, treating the patient with precise movements. It felt groundbreaking.
Every month, hundreds of millions are spent on developing the Da Vinci at incredibly high speed, and this robot is still continuing to change. I immediately wondered how it could be used for medical treatment.
You may know that recently, it has been used a lot in urologydepartments for prostate surgery, but its use in heart surgery may not be so well-known yet. However, the heart is a complex organ that cannot be allowed to fail, so this accuracy and precision are very important factors.
However, it's not like anyone can use a Da Vinci machine right away.
In the drama, Dr Matsuoka was in charge of using the Da Vinci machine. What did you think of him?
In this Da Vinci operation, the incisions were made in the right armpit, the stomach and between the ribs and the tools were inserted through them. The distance between ribs is narrower in smaller bodies, so caution is needed with women and children. If the holes are too close together, of course the arms attached to those tools could hit each other. It's a clear case of human error.
That's why, if I imagine that my team had been doing it, I don't think that we would have made that mistake in the first place. Also, if a skilled person like Dr Tokai or Dr Takashina came in and quickly saw what had happened to the machine, they should be able to recover using the robot.
Since this is a drama, of course unrealistic things happen to some extent, but as a person who operates with the Da Vinci system in the real world, I have no choice but to see how robot-assisted surgery is portrayed from now on.
Vol. 2: The robot appears! Dr Watanabe, pioneer of robot-assisted surgery, explains episode 5 in detail.
The robot finally appeared, but is robot-assisted surgery something that only happens in the world of dramas?
Honestly, I think a lot of people will be surprised by watching the drama. But actually, the real version is more advanced.
In the drama, a machine called the Darwin appears, but in the real world, a surgical assistant robot called Da Vinci is now already being used for medical treatment in various settings and has even started to be used in heart surgery. However, I expect a lot of people still don't know about it.
Actually, there are patients who come to our hospital for examination too, but they don't all know about robot surgery either. We get a lot of patients who choose robot-assisted surgery when they first find out in the operating room that it will cause less burden on their body and they'll be able to recover and return to society faster.
When you think of heart surgery, you probably think of a midline incision where they make a long cut in the muscles in the centre of the chest, cut through the bones and stop the bleeding, temporarily stop the heart from beating and then perform a major surgery under those conditions, but with that method it takes months for a complete recovery and the remaining scar could keep hurting afterwards.
The robot finally appeared, but is robot-assisted surgery something that only happens in the world of dramas?
Honestly, I think a lot of people will be surprised by watching the drama. But actually, the real version is more advanced.
In the drama, a machine called the Darwin appears, but in the real world, a surgical assistant robot called Da Vinci is now already being used for medical treatment in various settings and has even started to be used in heart surgery. However, I expect a lot of people still don't know about it.
Actually, there are patients who come to our hospital for examination too, but they don't all know about robot surgery either. We get a lot of patients who choose robot-assisted surgery when they first find out in the operating room that it will cause less burden on their body and they'll be able to recover and return to society faster.
When you think of heart surgery, you probably think of a midline incision where they make a long cut in the muscles in the centre of the chest, cut through the bones and stop the bleeding, temporarily stop the heart from beating and then perform a major surgery under those conditions, but with that method it takes months for a complete recovery and the remaining scar could keep hurting afterwards.
Recently, a method called minimally-invasive cardiac surgery (MICS) where a smaller incision is used to operate has become popular, but robot-assisted heart surgery uses even smaller incisions and causes even less burden.
With robots, just by making four small holes the size of your index finger or your little finger, you can insert the endoscope device and perform surgery like that, using the robotic system to make precise movements and perform detailed techniques more accurately and safely. Even with just a small hole, you can perform the same types of surgery as you would by opening up the chest. The robot can do the cutting and suturing, too.Of course, the smaller incisions mean less bleeding and much faster recovery.
Many people who receive surgery are still in the prime of life, with family lives and hobbies and many things that they want to enjoy, so it's very important for them to return to their former lives as quickly as possible. If they remain in hospital for a long time, it can cause both physical and financial burdens.
The robot in the drama was made by a foreign company, but what about real life?
At the moment, the most widely-used robotic surgical assistant throughout the world is the American-made "Da Vinci".
It's well ahead of the competition, and in late March this year there were 4500 Da Vinci machines in the world, mostly in America, with Japan in scond place. There are over 300 machines in Japan. I first encountered the Da Vanci system in 2000, so that was already over 15 years ago. When I saw my first one, I was moved, thinking "this will really change surgery".Techniques that had been overwhelmingly difficult to do, hard to see or very precise can now be done while looking at an enlarged 3D image on a screen, treating the patient with precise movements. It felt groundbreaking.
Every month, hundreds of millions are spent on developing the Da Vinci at incredibly high speed, and this robot is still continuing to change. I immediately wondered how it could be used for medical treatment.
You may know that recently, it has been used a lot in urologydepartments for prostate surgery, but its use in heart surgery may not be so well-known yet. However, the heart is a complex organ that cannot be allowed to fail, so this accuracy and precision are very important factors.
However, it's not like anyone can use a Da Vinci machine right away.
Firstly, you have to be an excellent heart surgeon. If you don't have experience with heart surgery and knowledge of endoscopy as well as training for the Da Vinci, you can't use it.
The word "robot" might suggest that anyone can use it just by pressing a button, but that's not the case. It really relies on the skill of the operator or the person using it.
Unlike other organs, the heart is an organ that moves, can bleed easily and is hard to replace. In our case, not only the doctors but the whole team has been to America many times for training.The word "robot" might suggest that anyone can use it just by pressing a button, but that's not the case. It really relies on the skill of the operator or the person using it.
In the drama, Dr Matsuoka was in charge of using the Da Vinci machine. What did you think of him?
The first thing I should mention is Dr Matsuoka's line "do you know how many times I've done this so far", where he boasts about his skill. Every patient is different, plus this is a small child, right? He really wasn't prepared. Like that, he can't show the abilities of the robot, but quite the opposite. This really depends on the skill of the robot operator and the abilities of the team. Can we really say he has skill?
When my team had done over 100 robot surgeries, I finally realised that much. We'll soon reach 500 cases, and that level of experience has lead to our current natural preparation. Even so, if we had to operate on a child like this, our whole team would seriously discuss it and prepare for it.In this Da Vinci operation, the incisions were made in the right armpit, the stomach and between the ribs and the tools were inserted through them. The distance between ribs is narrower in smaller bodies, so caution is needed with women and children. If the holes are too close together, of course the arms attached to those tools could hit each other. It's a clear case of human error.
That's why, if I imagine that my team had been doing it, I don't think that we would have made that mistake in the first place. Also, if a skilled person like Dr Tokai or Dr Takashina came in and quickly saw what had happened to the machine, they should be able to recover using the robot.
Since this is a drama, of course unrealistic things happen to some extent, but as a person who operates with the Da Vinci system in the real world, I have no choice but to see how robot-assisted surgery is portrayed from now on.
Dr Watanabe's hospital also cooperated as a shooting location
Actually, the Darwin that appears in the drama is the Da Vinci machine that I always use. It was filmed on location at the hospital, so I even instructed that Dr Matsuoka (Otoo Takuma), and he picked it up surprisingly quickly. His role in the drama is quite pitiful though, isn't it? (lol)
Every time the actors said "wow", I thought they must be feeling like I did the first time I excitedly saw and touched the Da Vinci for the first time.
Actually, the Darwin that appears in the drama is the Da Vinci machine that I always use. It was filmed on location at the hospital, so I even instructed that Dr Matsuoka (Otoo Takuma), and he picked it up surprisingly quickly. His role in the drama is quite pitiful though, isn't it? (lol)
Every time the actors said "wow", I thought they must be feeling like I did the first time I excitedly saw and touched the Da Vinci for the first time.
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Robot surgery really change surgery world, nee...
I heard it is really reallt expenssive to have surgery with surgery robot. Is that true?
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You're welcome :)
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http://www.businessinsider.com/robotic-surgery-da-vinci-system-stitches-peeled-grape-fruit-intricate-2017-4/?IR=T
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I agree with him with the surgeon needs the good skill as a surgeon to operate the robot surgery too not like the way the Interns said on the conference hihi. Maybe because the novel was created in 1988 so at that time the surgeons thought the advanced medical tools was like a threat for them?
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