ROBOTİK CERRAHİ
CERRAHİ TEKNOLOJİDE ULAŞILAN
EN İLERİ SEVİYE…
 Mükemmel görüntü
 Cerrahi el hareketlerinde kusursuzluk
Robotik cerrahi nasıl doğdu?
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NASA Araştırma Merkezi’nde çalışan araştırmacılar,
sanal gerçeklik sistemini inceleyen mekanik mühendisleri
ve ABD Kaliforniya’daki Stanford Üniversitesi Araştırma
Merkezi’nde çalışan robot teknolojisi uzmanları
tarafından gerçekleştirildi.
Prototipi 1997 yılında ortaya çıkarılan da Vinci
Sistemi, ilk olarak robotik kolesisektomi (safra kesesi
ameliyatı) ile denendi.
2000 yılında Amerika Gıda ve İlaç Dairesi – FDA
onayını alarak ilk olarak kardiyovasküler cerrahide,
sonra da yaygın olarak üroloji, genel cerrahi ve
jinekolojide kullanılmaya başlandı.
Tekniğin limitasyonları …
 Ameliyatı yapan robot değildir. Cerrahınızın uygulama alanında
birçok cerrahi teknik gibi (açık teknikler, laparoskopi, endoskopi, vs.)
robotik cerrahi de yer almakta ve bazı teknik avantajlar
sağlamaktadır.
 Karın içi yapışıklıklar, hastalığın durumu, anatomik farklılıklar, vs.
gibi nedenlerle robotik cerrahi sizin için uygun olmayabilir. Bazen
ameliyat esnasında bunlar saptanabilir ve cerrahinin klasik
yöntemlerle yapılmasına ya da değiştirilmesine karar verilebilir.
 Safety unguarenteed … Robotik cerrahinin uygulanması, sonuç ve
komplikasyonlar açısından herhangi bir garanti vermez/sağlamaz.
ROBOTİK CERRAHİ
Colon Cancer
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The wall of the colon is made up of layers of tissue.
Colon cancer occurs when abnormal cells form in the
inner layer of this tissue (adenocarcinomas). The
cancer can grow through some or all of the other
layers. The stage (extent) of the cancer depends to
a great degree on how deep the cancer goes into
these layers.
Rectal Cancer
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Rectal cancer is the development of cancerous cells
in the lining of the rectum (the last several inches of
the large intestine closest to the anus). The stage
(extent) of the cancer depends to a great degree
on how deep the cancer goes into and beyond the
wall of the rectum. Most rectal cancers are called
adenocarcinomas
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Because the majority of colon cancers begin as
precancerous polyps, colon cancer is a potentially
preventable disease. Screening and early detection can
catch colon cancer at an early stage or before polyps
turn into cancer.1
Cancer of the colon is rare in developing countries, but
is the second most frequent cancer in affluent societies.
Worldwide, there are more than 940,000 cases
(colorectal) and nearly 500,000 deaths each year.2
Colonoscopy is the most reliable means for early
detection. Improved diagnosis and treatment have
resulted in a five-year survival rate of 50 percent.2
ROBOTİK CERRAHİ
da Vinci® Surgery for Rectal Cancer
 If your doctor recommends surgery to treat rectal
cancer, you may be a candidate for minimally
invasive da Vinci Surgery. Using the most advanced
technology available, the da Vinci Surgical System
enables your doctor to perform this delicate
operation through a few tiny incisions with
breakthrough vision, precision, dexterity and
control.
ROBOTİK CERRAHİ
da Vinci offers patients facing rectal cancer surgery (low anterior
resection and APR) such potential benefits as:
 Excellent clinical outcomes for cancer control5
 Quick return of bowel function5
5
 Fast return to diet
 Less blood loss6
 Shorter hospital stay6
 Fast recovery time5
 The da Vinci System is a state-of-the-art surgical platform with 3D,
high-definition vision and patented surgical instruments that takes
surgery beyond the limits of the human hand. By overcoming the
challenges of traditional open and laparoscopic surgery, da Vinci is
changing the experience of surgery for people around the world.
ROBOTİK CERRAHİ
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If your doctor recommends surgery to treat a colorectal
condition, you may be a candidate for minimally
invasive da Vinci Surgery. Using state-of-the-art
technology, the da Vinci System enables doctors to
perform delicate and complex operations through a
few tiny incisions with breakthrough vision, precision,
dexterity and control.
da Vinci Surgery is used to treat such colorectal
conditions as: colon cancer, rectal cancer, diverticulitis,
and inflammatory bowel disease (ulcerative colitis and
Crohn’s disease). Surgery to remove all or part of the
colon is known as a colectomy. Rectal cancer surgery is
known as a low anterior resection.
da Vinci offers patients facing colon surgery (right, left or sigmoid colectomy)
such potential benefits as:
 Low blood loss1
 Quicker return to bowel function1
 Quicker return to diet1
 Short hospital stay1
 da Vinci offers patients facing rectal cancer surgery (low anterior resection
and APR) such potential benefits as:
 Excellent clinical outcomes for cancer control3
 Quick return of bowel function3
 Fast return to diet3
 Less blood loss4
 Shorter hospital stay4
 Fast recovery time3
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Luca F, Cenciarelli S, Valvo M, Pozzi S, Faso FL, Ravizza D, Zampino G, Sonzogni A, Biffi R. Full
robotic left colon and rectal cancer resection: technique and early outcome. Ann Surg Oncol
2009;16;274-8.
Choi DJ, Kim SH, Lee PJ, Kim J, Woo SU. Single-stage totally robotic dissection for rectal cancer
surgery: technique and short-term outcome in 50 consecutive patients. Dis Colon Rectum
2009;52:1824-30.
D'Annibale A, Morpurgo E, Fiscon V, Trevisan P, Sovernigo G, Orsini C, Guidolin D. Robotic and
laparoscopic surgery for treatment of colorectal diseases. Dis Colon Rectum 2004;47:2162-8.
Baik SH, Kwon HY, Kim JS, Hur H, Sohn SK, Cho CH, Kim H. Robotic versus laparoscopic low
anterior resection of rectal cancer: short-term outcome of a prospective comparative study. Ann
Surg Oncol. 2009 Jun;16(6):1480-7.
Hellan M, Anderson C, Ellenhorn JD, Paz B, Pigazzi A; Short-Term Outcomes After RoboticAssisted Total Mesorectal Excision for Rectal Cancer; Annals of Surgical Oncology (_ 2007)
DOI: 10.1245/s10434-007-9544-z.
Park JS, Choi GS, Lim KH, Jang YS, Jun SH. S052: a comparison of robot-assisted,
laparoscopic, and open surgery in the treatment of rectal cancer. Surg Endosc 2010 Jun 15.
[Epub ahead of print].
Zimmern A, Prasad L, deSouza A, Marecik S, Park J, Abcarian H. Robotic Colon and Rectal
Surgery: A Series of 131 Cases; World J Surg DOI 10.1007/s00268-010-0591-4.
http://www.youtube.com/watch?feature=player_deta
ilpage&v=6J1TBGgyuxA#t=10s
http://www.youtube.com/watch?feature=player_deta
ilpage&v=6J1TBGgyuxA