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Robotic Assisted Procedures

Robotic-assisted surgery, a type of minimally invasive surgery, uses surgical robotic equipment which imitates surgical movements. Minimally invasive procedures allow surgeons to operate through small ports rather than large incisions, resulting in shorter recovery times, fewer complications and reduced hospital stays. Surgical robotics combines minimally invasive surgery with highly advanced clinical technology.

Cardiothoracic Procedures Performed through da Vinci Surgical System®

Cardiothoracic surgery refers to surgery on the heart, lungs or esophagus. When medication and catheter-based treatments cannot relieve symptoms, surgery is the recommended treatment for many cardiothoracic conditions, including but not limited to mitral valve prolapse, atrial septal defect and coronary artery disease. Mitral valve prolapse is when one or both of the flaps that are supposed to open and close to control blood flow to the heart do not work properly and allows small amounts of blood to flow backwards into the heart valve. Atrial septal defect is a defect between the left and right chambers of the heart that is congenital - you are born the condition. And, coronary artery disease occurs when arteries that supply blood to the heart become hard and narrow because cholesterol and plaque buildup in the inner walls of the artery(ies).  

Facing traditional cardiac surgery or open surgery to treat disorders in the chest cavity can be a frightening experience. It may be difficult to focus on next steps but you may have several choices to make, such as which hospital and surgeon to go to, and which procedure to choose. Learning as much as possible about your options, including minimally invasive alternatives to open surgery may ease some of your concerns.

Surgery is generally the most effective way to treat disorders of the heart, lungs and esophagus. But traditional open surgery has a number of drawbacks caused primarily by the large incision required, splitting the breastbone and spreading the ribs to access the chest cavity. In addition to an 8 to 10" scar down the center of your chest, splitting of the breastbone leads to a long recovery time of eight to twelve weeks as well as a long delay before you will return to normal daily activities.

Fortunately, less invasive options are available for patients facing cardiothoracic surgery. Many cardiothoracic surgeons now recognize the benefits of small incisions made between the ribs to perform coronary bypass or make repairs to the heart or esophagus by using thoracoscopy - the insertion of a miniaturized video camera between the ribs. But this approach has limitations and is not often appropriate for more complex cardiac procedures.

Robotic-Assisted Procedures 

  • Bilateral IMA mobilization
  • Coronary artery bypass surgery (CABG)
  • Lobe resection
  • Heller myotomy
  • Lymph node biopsy
  • Mediasteinal mass removal
  • Mitral valve replacement
  • Paraesophageal hernia repair
  • Wedge resection

Robotic Surgery Risks

As with all types of surgeries, there are risks associated with robotic surgeries and results vary from person to person. Be sure to talk about your specific situation with your physician and surgeon before deciding if robotic-assisted surgery is right for you. 

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Colorectal Cancer Surgery Performed through da Vinci

Robotic Surgery for Colorectal Cancer

(Rectal Cancer Surgery/Resection)

Low Anterior Resection (LAR) is a robotic-assisted surgery that removes the malignant portion of the colon. It offers the following potential benefits:

  • Improved cancer margins
  • Less chance of surgeon switching to open surgery

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Gallbladder Surgery Performed through da Vinci Surgical System®

Minimally Invasive Gallbladder Removal

Gallbladder removal, known as a cholecystectomy, is the most common method for treating gallstones.  With only a single small incision the patient's gallbladder is removed through one tiny incision in the belly button, making the procedure virtually scarless. The surgery can be performed in about one hour with a typical hospital stay of less than 24 hours.

Benefits of the robotic surgery procedure for gall bladder removal include:

  • Minimal or no scarring
  • Minimal pain
  • Low blood loss
  • Faster recovery
  • A shorter hospital stay

Unlike traditional robotic surgeries requiring three to five small incisions, this new technology allows for a single incision where instruments are placed and the gallbladder is removed.

During the procedure, the surgeon uses robotic controls to manipulate the instruments and camera as the system translates the surgeon's hand, wrist and finger movements into more precise movements of the surgical instruments.

More than 1 million people in the U.S. have their gallbladder removed each year, typically because of gallbladder pain from gallstones and/or non-functioning gall-bladders. Most people who require gallbladder removal are candidates for the robotic, single-incision surgery.

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Gynecologic Procedures Performed through da Vinci Surgical System®

Endometriosis

Endometriosis is a painful, chronic disease that occurs most often in women between the ages of 25 and 40. It occurs when tissue, like that which lines the uterus, is found outside the uterus – usually in the abdomen on the ovaries, fallopian tubes, and ligaments that support the uterus.

What are the symptoms of endometriosis?

  • Pain before and during periods
  • Pain with sex
  • Infertility
  • Fatigue
  • Painful urination during periods
  • Painful bowel movements during periods
  • Other gastrointestinal upsets such as diarrhea, constipation, nausea

A leading treatment for endometriosis is robotic-assisted endometrial ablations. Advantages of robotic-assisted surgery include less bleeding, lower risk of infection, less pain and minimal scarring. Patients usually experience a faster recovery. In most cases, the patient goes home the same day and is able to get back to normal daily activity much sooner than with traditional surgery.

Hysterectomy

The surgical removal of the uterus, is the second most common surgery among women in the United States. Typically, with traditional surgery, this operation means a hospital stay of three days and up to six weeks of recovery time.

At McLaren, surgeons are getting women back to their normal routines faster using a superior robotic surgical system. With the hospital's advanced daVinci® robotics, surgeons are able to make only small incisions in the patient's abdomen.

That's because the robotics platform has tiny instruments that replicate the movements of the human wrist, allowing the surgeon to make more precise, fine movements. These special instruments -- in miniature scale -- allow for an even greater range of motion than the human hand.

The system also projects a 3-D, high-definition image of what's going on inside the body during the procedure. Surgeons say the image of the patient's anatomy is actually clearer than with the naked eye.

Robotic tools help with even the most complicated surgeries for severe endometriosis or extensive pelvic scarring from a previous surgery.

With a robotically performed hysterectomy, patients can typically return to work in about two weeks.

Myomectomy

A procedure that allows a woman to have fibroids or tumors removed from the uterus without losing her ability to become pregnant. The advanced robotic instruments are especially suited to this type of procedure, allowing the surgeon to make only a small incision in the abdomen.

Sacrocolpopexy

A complex procedure to correct uterine prolapse. The procedure supports the uterus by suspending the walls of the vagina from the back of the pelvis. In the past, hysterectomy was the recommended for prolapse treatment, but today, most doctors recommend that the uterus be re-suspended. The minimally invasive procedure using the da Vinci system is the gold standard for this type of surgery. To learn more about the procedure and our physicians that perform it, click here.

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Gynecologic Procedures Performed through Single-Site Surgery

Traditionally, many conditions affecting the uterus are treated with hysterectomy - the surgical removal of the uterus. Hysterectomy may offer a life-saving treatment for serious conditions such as cancer or uncontrollable bleeding. In most cases, however, hysterectomy is an elective procedure performed to relieve chronic pain, bleeding or other disabling conditions.

The single-port laparoscopic technique allows for the removal of the uterus through a small incision, about ¾ an inch long, in the belly button. To perform this procedure, A SILS™ port is inserted through the incision. The port is a soft and flexible instrument equipped with three distinct openings allowing for the use of three surgical devices at the same time. The single-site hysterectomy can be a same-day procedure, but usually requires a one night stay in the hospital. Because there is only one small incision, pain during recovery is mild or minimal, and patients are often able to return to work just weeks after surgery compared to the longer recovery time often associated with an open hysterectomy.

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Hernia Repair Performed through da Vinci Surgery

A hernia occurs when tissue pushes through an opening in your abdomen (ventral hernia) or groin area (inguinal hernia). A hernia can only be repaired with surgery.

If you and your doctor decide that a surgical repair is right for you, talk to your doctor about all of your options, including minimally invasive surgery. One option your surgeon may present is robotic-assisted surgery. Early studies* suggest that robotic-assisted hernia repair with the da Vinci surgical system may get you back to what matters most … sooner.

How Can You Prepare For Surgery

To help you make an informed decision, consider bringing questions like these to your surgeon or doctor visit:

  • What medical options are available for my hernia?
  • What happens if I don’t get surgery?
  • What kind of experience do you have with my type of hernia?
  • Should I get a second opinion?
  • What is the difference between robotic-assisted surgery and laparoscopic surgery?
  • What type of anesthesia will I receive?
  • How long will surgery take?
  • Where will I have scars?
  • When will I go home? 
  • How soon can I lift light weights after surgery? Heavier weights?

For more information:

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Knee Procedures Performed through Navio

Navio Partial Knee Replacement

The Navio Surgical System provides robotic assistance in partial knee replacement for patients living with knee pain caused by early to mid-stage osteoarthritis. A Navio procedure differs from other robotic-assisted techniques because of its unique CT-free principles and handheld instrumentation.

How can Navio help?

Navio aids the surgeon through accurate and precise robotic assistance. During the procedure, the diseased portion of the bone is replaced with an implant that spares healthy bone and returns functionality to the knee.

Partial knee replacement may offer several benefits over total knee replacement, including:

  • Less pain
  • Quicker rehabilitation
  • Smaller incisions
  • More natural knee kinematics
  • ACL and PCL preservation
  • Less bone loss

What can Navio mean for you?

  • Accurately placed implants
  • No CT radiation exposure
  • Customized surgical plans unique to your anatomy

What is osteoarthritis?

Millions of Americans suffer from the debilitating pain of osteoarthritis (OA) each day. As one of the leading causes of disability, OA is a degenerative joint disease that results in wearing and eventual loss of cartilage. Those suffering from OA often experience quality of life issues, loss of mobility, stiffness and swelling, and joint pain through activity.

How does a Navio surgery work?

The surgeon uses advanced image-free navigation to create a virtual reconstruction of the patient’s knee anatomy, ligament tension, and kinematic motion. This information is used to tailor the position of the implant to the patient’s femur and tibia shape, taking into account the patient’s unique cartilage wear, condylar shape, and soft-tissue balance. The surgeon then uses Navio’s robotic-assisted handpiece to sculpt damaged bone away from remaining healthy bone. The handpiece enforces bone resection within the surgeon defined plan, ensuring final placement of the implant is accurately positioned as intended.

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Partial Knee Resurfacing Through Mako Robotic-Arm Assisted Technology

What is Mako Robotic-Arm Assisted Surgery?

Mako Robotic-Arm Assisted Surgery is a robotic arm assisted partial knee resurfacing procedure designed to relieve the pain caused by joint degeneration due to osteoarthritis (OA). By selectively targeting the part of your knee damaged by OA, your surgeon can resurface your knee while sparing the healthy bone and ligaments surrounding it.

Mako Robotic-Arm Assisted Surgery partial knee application can:

  • Enable surgeons to precisely resurface only the arthritic portion of the knee
  • Preserve healthy tissue and bone
  • Facilitate optimal implant positioning to result in a more natural feeling knee following surgery
  • Result in a more rapid recovery and shorter hospital stay than traditional total knee replacement surgery  

Unlike other more invasive procedures Mako can often be performed through a four to six inch incision over your knee with small incisions in both your femur (thigh bone) and tibia (shin). Additionally the preservation of your own natural bone and tissue along with more ideal patient specific implant positioning may also result in a more natural feeling knee. And since healthy bone is preserved, patients who undergo mako partial knee application may still be a candidate for a total knee replacement procedure later in life if necessary.

The Mako procedure is indicated for patients suffering from unicompartmental or bicompartmental knee disease. A total replacement is sometimes necessary if your surgeon discovers during surgery that your knee has more damage than originally seen in the pre-operative X-rays and CT scan.

Your physician should discuss the specific risks associated with Mako and other treatment options with you. In addition, you should be informed of any pre-operative and post-operative instructions by your surgeon or his or her staff.

Am I a Candidate for Makoplasty Partial Knee Replacement?


 

Mako Technology
may be the right
treatment option
for you.


If you've been diagnosed with osteoarthritis(OA) of the knee, you may be a candidate for Mako -- a robotic arm assisted partial knee resurfacing procedure designed to relieve pain and restore range of motion. Mako is an innovative treatment option for adults living with early to mid-stage osteoarthritis that has not progressed to all three compartments of the knee.

Symptoms of OA of the knee include:

  • Pain while standing or walking short distances, climbing up or downstairs, or getting in and out of chairs
  • Pain with activity
  • Start up pain or stiffness when activities are initiated from a sitting position
  • Joint stiffness after getting out of bed
  • Swelling in one or more areas of the knee
  • A grating sensation or crunching feeling in the knee during use

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Thoracic Procedures Performed through da Vinci Surgical System®

da Vinci Lobectomy (Non-small cell lung cancer)

If you’ve been diagnosed with non-small cell lung cancer, your doctor will discuss all treatment and surgical options with you. He/she may suggest surgery to remove part of your lung (lobe). The operation is called a lobectomy. It can be done using open surgery or minimally invasive surgery.

At McLaren, our surgeons offer minimally invasive robotic-assisted thoracic surgery, providing patients with a superior alternative to open surgery.

While surgery is generally the most effective way to treat disorders of the lungs and esophagus, traditional open surgery has a number of drawbacks caused primarily by the large incision required. Open thoracic surgery also spreads the ribs to access the chest cavity, leading to long recovery times of eight to twelve weeks as well as a long delay before returning to normal daily activities.

Minimally Invasive Surgery

One minimally invasive surgical option is thoracoscopy, also called video-assisted thoracic surgery or VATS. Doctors insert a tiny camera and surgical instruments into your chest through small incisions. The camera sends images to a video screen to guide doctors as they operate. Another minimally invasive option for patients facing lobectomy is da Vinci® Surgery.

McLaren's surgeons operate using advanced da Vinci® robotic-assisted surgical technology and the most advanced thoracic surgical procedures, making a few small incisions without splitting the breastbone or separating the ribs. Using magnified 3D high-definition and special instruments, McLaren physicians operate with enhanced vision, precision and control.

The Minimally Invasive Advantage

McLaren has the expert physicians and state-of-the-art technology to be region's source for robotic-assisted thoracic surgery. This gives our patients access to better outcomes, including minimal scarring, less pain and bleeding, shorter hospital stays, fewer complications, and a faster recovery compared to traditional surgery.

Benefits of da Vinci® assisted lobectomy can include:

  • Shorter hospital stay
  • Shorter chest tube duration
  • Less or similar rate of blood loss and/or transfusions
  • Smaller incisions for less scarring
  • Shorter/similar hospital stay

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Total Hip Procedure Through Mako Robotic-Arm Assisted Technology

Mako Total Hip is a procedure known as total hip replacement that is supported by robotic-arm assisted technology. This innovative solution was designed for patients who suffer from non-inflammatory or inflammatory degenerative joint disease. The robot enables surgeons to achieve a new level of precision using the latest techniques in total hip replacement and is designed to restore patient mobility and active lifestyle.

Robotic-arm assisted technology provides your surgeon a patient-specific 3-D model to pre-plan your hip replacement. During the procedure, tactile, visual, auditory feedback, and real-time data assists your surgeon in preparing the hip joint and placing the implants in the desired orientation with more accuracy.

If your surgeon determines that you are a good candidate for the Mako Robotic-Arm Assisted Surgery, he or she will schedule a computed tomography (CT) scan of your hip one or two weeks prior to your surgery date. This is used to create your unique surgical plan for optimal implant placement.

Am I a Candidate? - Mako Robotic-Arm Assisted Hip Replacement

If your symptoms aren't responding to non-surgical solutions, or your pain can no longer be controlled by medication, you may be a candidate for Mako Total Hip Arthroplasty, a procedure also known as total hip replacement. Only your surgeon can determine if Mako Total Hip Replacement is right for you.

A Mako Total Hip Replacement candidate may experience the following:

  • Pain while putting weight on the affected hip
  • Limping to lessen the weight-bearing pressure on the affected hip
  • Pain that may radiate to the groin, lower back, or down the thigh to the knee
  • Hip pain or stiffness during walking or other impact activities
  • Failure to respond to non-surgical treatments or nomsteroidal anti-inflammatory medication

Mako Total Hip may:

  • Facilitate optimal implant placement
  • Enhance stability and mobility
  • Restore an active lifestyle

Mako Robotic-Arm Assisted Surgery is typically covered by Medicare insurers-check with your private health insurers.

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Total Knee Replacement Through Mako Robotic-Arm Assisted Technology

We understand that making sure you know what to expect from your joint replacement experience is important to you. As you are reading through this material, if you have additional questions please reach out to us to discuss.

Each patient is unique, and can experience joint pain for different reasons. It’s important to talk to us about the reason for your knee pain so you can understand the treatment options available to you. Pain from arthritis and joint degeneration can be constant or come and go, occur with movement or after a period of rest, or be located in one spot or many parts of the body. It is common for patients to try medication and other conservative treatments to treat their knee pain. If you haven’t experienced adequate relief with those treatment options, you may be a candidate for Mako Total Knee Replacement, which may provide you with relief from your knee pain.

personalized pre-operative plan

How Mako Technology works

Mako Robotic-Arm Assisted Total Knee Replacement is a treatment option for adults living with mid to late-stage osteoarthritis (OA) of the knee. Mako provides you with a personalized surgical plan based on your unique anatomy. First, a CT scan of the diseased knee joint is taken. This CT scan is uploaded into the Mako System software, where a 3D model of your knee is created. This 3D model is used to pre-plan and assist your surgeon in performing your total knee replacement.

In the operating room, your surgeon follows your personalized surgical plan while preparing the bone for the Triathlon Total Knee implant. With over a decade of clinical history, Triathlon knee replacements are different than traditional knee replacements because they are designed to work with the body to promote natural-like circular motion.1-4

The surgeon guides the robotic-arm to remove diseased bone and cartilage within the pre-defined area and the Mako System helps the surgeon stay within the planned boundaries that were defined when the personalized pre-operative plan was created. In a laboratory study, Mako Technology demonstrated accurate placement of implants to a personalized surgical plan.5

It’s important to understand that the surgery is performed by an orthopaedic surgeon, who guides the robotic-arm during the surgery to position the implant in the knee joint. The robotic-arm does not perform surgery, make decisions on its own, or move without the surgeon guiding the robotic-arm. The Mako System also allows your surgeon to make adjustments to your plan during surgery as needed.

personalized pre-operative plan

IMPORTANT INFORMATION

Knee replacements

General indications: Total knee replacement is intended for use in individuals with joint disease resulting from degenerative, rheumatoid and post-traumatic arthritis, and for moderate deformity of the knee.

Contraindications: Knee replacement surgery is not appropriate for patients with certain types of infections, any mental or neuromuscular disorder which would create an unacceptable risk of prosthesis instability, prosthesis fixation failure or complications in postoperative care, compromised bone stock, skeletal immaturity, or severe instability of the knee.

As with any surgery, knee replacement surgery has serious risks which include, but are not limited to, peripheral neuropathies (nerve damage), circulatory compromise (including deep vein thrombosis (blood clots in the legs)), genitourinary disorders (including kidney failure), gastrointestinal disorders (including paralytic ileus (loss of intestinal digestive movement)), vascular disorders (including thrombus (blood clots), blood loss, or changes in blood pressure or heart rhythm), bronchopulmonary disorders (including emboli, stroke or pneumonia), heart attack, and death.

Implant related risks which may lead to a revision include dislocation, loosening, fracture, nerve damage, heterotopic bone formation (abnormal bone growth in tissue), wear of the implant, metal sensitivity, soft tissue imbalance, osteolysis (localized progressive bone loss), and reaction to particle debris. Knee implants may not provide the same feel or performance characteristics experienced with a normal healthy joint.

The information presented is for educational purposes only. Speak to your doctor to decide if joint replacement surgery is right for you. Individual results vary and not all patients will receive the same postoperative activity level. The lifetime of a joint replacement is not infinite and varies with each individual. Your doctor will help counsel you about how to best maintain your activities in order to potentially prolong the lifetime of the device. Such strategies include not engaging in high-impact activities, such as running, as well as maintaining a healthy weight. Ask your doctor if the Triathlon knee is right for you.

Stryker Corporation or its other divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: MAKO, Stryker, Triathlon. All other trademarks are trademarks of their respected owners or holders.

References

  1. Mistry J, Elmallah R, Chughtai M, Oktem M, Harwin S, Mont M. Long-Term Survivorship and Clinical Outcomes of a Single Radius Total Knee Arthroplasty. International XXVIII.
  2. Designed to maintain collateral ligament stability throughout the range of motion. Stryker-Initiated Dynamic Computer Simulations of Passive ROM and Oxford Rig Test, Stephen Piazza, 2003.
  3. Wang H, Simpson KJ, Ferrara MS, Chamnongkich S, Kinsey T, Mahoney, OM. Biomechanical differences exhibited during sit-to-stand between total knee arthroplasty designs of varying radii. J Arthroplasty. 2006;21(8):1193-1199.
  4. Gómez-Barrena E, Fernandez-García C, Fernandez- Bravo A, Cutillas-Ruiz R, Bermejo-Fernandez G. Functional performance with a single-radius femoral design total knee arthroplasty. Clin Ortho Relates Res. 2010;468(5):1214-1220.
  5. Hampp E. et al. Robotic-Arm Assisted Total Knee Arthroplasty Demonstrated Greater Accuracy to Plan Compared to Manual Technique. Orthopaedic Research Society 2017 Annual Meeting, San Diego, CA. Poster No. 2412. March 20-22, 2017.

MKOHMT-PE-3_Rev-1_13841
Copyright © 2017 Stryker Corporation

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Urology Procedures Performed through da Vinci Surgical System®

The Disease:  Prostate Cancer

Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate.  The prostate is a gland in the male reproductive system located just below the bladder and in front of the rectum.  It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder).  The prostate gland produces fluid that makes up part of the semen.

davinci prostatectomy

Approximately 16% of American men will be diagnosed with prostate cancer sometime in their life.  Treatment options and prognosis depend on the stage of the cancer, the Gleason score, and the patient's age and general health.  With greater public awareness, early detection is on the rise and mortality rates are declining.

Additionally, new advances in medical technology are enabling cancer victims to go on to live active and productive lives after their treatment.  Consult with your doctor for advice on the options that are available to treat your specific condition.

The Surgical Treatment:  Radical Prostatectomy

One of the most common treatments for prostate cancer involves the surgical removal of the prostate gland, known as radical prostatectomy.  Traditional radical prostatectomy requires a large, 8 - 10 inch incision.  This open surgery commonly results in substantial blood loss, a lengthy and uncomfortable recovery and the risk of impotence and incontinence.

Prostatectomy incisions

da Vinci Prostatectomy:  A Less Invasive Surgical Procedure

If your doctor recommends surgery to treat your prostate cancer, you may be a candidate for a new, less-invasive surgical procedure called da Vinci Prostatectomy.  This procedure incorporates a state-of-the-art surgical system that helps your surgeon see vital anatomical structures more clearly and to perform a more precise surgical procedure.

For most patients, da Vinci Prostatectomy offers numerous potential benefits over open prostatectomy including:

Surgery image
  • Shorter hospital stay
  • Less pain
  • Less risk of infection
  • Less blood loss and transfusions
  • Less scarring
  • Faster recovery
  • Quicker return to normal activities

As with any surgical procedures, these benefits cannot be guaranteed as surgery is both patient and procedure specific.

The Enabling Technology:  da Vinci Surgical System®

The da Vinci Surgical System® is powered by state-of-the-art robotic technology.  The System allows your surgeon's hand movements to be scaled, filtered and translated into precise movement of micro-instruments within the operative site.

The da Vinci System® enhances surgical capabilities by enabling the performance of complex surgeries through tiny surgical openings.  The System cannot be programmed nor can it make decisions on its own.  The da Vinci System requires that every surgical maneuver be performed with direct input from your surgeon.

The da Vinci Surgical System® has been successfully used in thousands of prostate cancer procedures worldwide.

For more information visit www.daVinciSurgery.com

 

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