Basic Training Course for Robotic Console Surgeon
Standard Da Vinci Surgical System Setup Tutorial
Materials:
Power point slide presentation
Torso trainer
Laparoscopes (0o, 30o)
3 Sterile adapters Instrument
arm drape
Camera arm drape
3 trocars
Port Layout, Terminology and Insertion Guidelines:
da Vinci Instrument
da Vinci Camera Port should
Ports: Placed minimally
be placed approximately 20
10 cm away from
cm from target anatomy.
Camera Port or other
Cone of 60 degrees:
ports, accessory ports
can be 5 cm from any
No instruments should be
placed within a 60 degree cone other port.
from camera port (dashed
Protected blade Trocar
triangle).
5 Instruments
(2 needle drivers,
1 scissors,
1 Prograsp,
1 Maryland)
Remote Center:
Decreases tension on
patient skin and should
be placed in the muscle
layer of the abdomen.
Remote Center
(Thick black line)
DOCKING
DOCKING
Bladeless Trocar
Positioning Bedside Surgical Cart:
Align Camera port,
Position arms high enough to
target anatomy and
clear patient.
surgical cart center
Identify obstacles in the path,
column.
lower OR table.
Direct center column of cart
toward target organ.
Camera Arm Placement and Coupling Guidelines:
10 cm (about 1 fist
Place setup joint of camera
width) between the
arm opposite to the 4th arm.
black bumper on
center column of
bedside cart and the
camera arm- this is
called the “Sweet
Spot”.
Setup Tutorial Position patient and OR table
with tilting the bed as
needed.
Lock wheels once cart is in position.
Align Camera Arm Setup
joint release grip with the 3rd
set up joint and center
column.
Dock Camera arm by
1) Lower camera arm down to
camera cannula by
continually holding the setup
release button.
2) Change angle of cannula to
point toward target anatomy
by pressing the clutch button
3) Stabilize cannula at port site
with one hand while
repositioning closing camera
arm clasp around cannula
with other hand
setuptutorial.v2 1.10.11gd DOCKING
Instrrument Arm Positioning and
a Coupling Guideliness:
o
Check that arms arre at 90
Dock arm using
Stabilize cannnula at port site
s
anglee to maximizee range of
Instrumentt arm
with one hannd when dockking.
motioon, separate innstrument
Setup jointt Release
Rock cannula in to cannulla
mount, whenn flush screw in
arms to minimize
buttons ON
NLY.
cannula keepping the remoote
interfferences.
center withinn the muscle layer.
l
4th arrm should be horizontal
(paraallel with the floor)
f
and stilll be
90o from
fr
the cameera arm.
minology Preeparation and
d Bedside Caart Function:
Equipment Term
Placee sterile adaptter on
Placee Laparoscopees 0o or 30o in
nto
12mm
m port.
bottoom silver bars (like a bird
Placee Sterile Drapes on instrum
ment
on a perch),
p
press top of
arm and
a place sterrile adaptors.
adaptter against arm
m with both
Know
w the parts off the Bedside cart
c
thum
mbs at top.
0o Laparosccope
and Vision
V
cart:
Endooscope Cannuula mount
Camera Steerile Adapter
(Da Vinci
V
S/Si sysstem)
(da Vinci Standard systeem)
Camera cannula
(disposabble trocar)
30o Lapparoscope
Light Guide
G
Cables
Instrument Sterile Adaptter
Setupp joint buttons
minology and Insertion:
Instrrument Term
5) Preess instrumennt
1) Strraighten instruument wrist
2) Close instrumennt tips
clutchh button
3) Inssert instrumennt tip into
6) Inssert instrumennt
cannuula.
underr direct visionn
4) Sliide instrumennt into sterile
7) Whhen instrumennt
adaptter.
has reeached desired
locatiion press
instruument clutch
buttonn
8) Too remove
instruument surgeonn
shoulld straighten
instruument slightlyy
and open
o
instrumeent
jaws.
Know the Instrumennts:
A. Neeedle driver
B. Curvved Scissors
C. Marryland forceps
D. Proggrasp forcepss
B.
C.
A.
Setup
p Tutorial D.
setuptutorial.v2 1.10.11gd Terminology and Console function:
Know the parts of the
Console:
Clutch Peddle
Camera Peddle
Focus bar
Cautery Peddle
Setup Tutorial Left Side:
Scope angle button
Console height adjust buttons
Fault Reset button
Right Side:
On/Off button
Ready button
Emergency Stop button
setuptutorial.v2 1.10.11gd Verification of Proficiency-Tutorial Components
Port Placement
Bedside cart
Placement
Equipment
Preparation
Arms
Positioning
Verbalizes distance of
camera port from target
anatomy
□Needs more practice □Meets expectations □Exceeds expectations
Verbalizes distance of
instrument arms from
camera port
□Needs more practice □Meets expectations □Exceeds expectations Verbalizes understanding of
optimal triangulation (cone
of 60 degrees)
□Needs more practice □Meets expectations □Exceeds expectations Demonstrates proper
Bedside cart positioning
without running into
obstacles, OR table or
patient
Demonstrates proper
placement of sterile adapter
and instrument insertion
Demonstrates proper
guided tool exchange
□Needs more practice □Meets expectations □Exceeds expectations □Needs more practice □Meets expectations □Exceeds expectations Demonstrates proper
camera arm placement
relative to 4th arm
□Needs more practice □Meets expectations □Exceeds expectations Demonstrates positioning
of camera arm in “Sweet
Spot” (distance from black
bumper)
□Needs more practice □Meets expectations □Exceeds expectations Demonstrates proper
docking of camera arm
maintaining alignment of
Camera cannula, target
anatomy and surgical cart
center column
Demonstrates proper
docking of instrument arm
Demonstrates proper
placement of the 4th arm in
relation to floor
Setup Tutorial □Needs more practice □Meets expectations □Exceeds expectations □Needs more practice □Meets expectations □Exceeds expectations □Needs more practice □Meets expectations □Exceeds expectations □Needs more practice □Meets expectations □Exceeds expectations setuptutorial.v2 1.10.11gd Prepares console for
different angled scope by
pressing which button?
Activates system by
pressing ready button
Console
(Incorporated
in tasks)
Demonstrates use of clutch
□Needs more practice □Meets expectations □Exceeds expectations □Needs more practice □Meets expectations □Exceeds expectations □Needs more practice □Meets expectations □Exceeds expectations Demonstrates correct use of
camera
□Needs more practice □Meets expectations □Exceeds expectations Setup Tutorial setuptutorial.v2 1.10.11gd