History and development of robotics, current indications for

gynaecological oncology

Dr Tom Manolitsas

Gynaecological Oncologist

1961

1967

1978

1991

Mid 1980’s to mid 90’s Collaboration of 3 major US Agencies

• NASA virtual reality and telepresence surgery

• Stanford Research Institute (SRI) collaboration with NASA developed telemanipulator

• Defense Advanced Research Project Agency (DARPA) “bring the surgeon to the soldier through telepresence”

• Developed the “SRI System” prototype

AESOP (Automated Endoscopic System for Optimal Positioning) voice commands to manipulate camera

1993

2001

Fred Moll & Robert Younge

Early Years at Intuitive

• 1995 “ Intuitive Surgical Devices “

• 1997 Refined the prototype “Lenny”

• 1999 litigation from “Computer Motion”

• 2000 public listing ($9 per share, now $690)

• 2003 Intuitive and Computer Motion merge

Early Electronics Chassis First Robotic Console

Early da Vinci® Components

Evolution of the da Vinci® System

Traditional

Laparoscopy

da Vinci® Si™ - 2009 • Dual Console option

• Enhanced HD Vision (1080i)

• Superior Ergonomics

• Increased Surgeon Control

• Advanced instruments

• Skills Simulator (2011)

• Fluorescence Imaging (2012)

• Single-Site (2013)

• Vessel Sealer (2014)

• Stapler (2014)

da Vinci® S™ - 2006 • 3D HD Vision (720p)

• Visual Inputs – TilePro

• Multi-quadrant access

• Streamlined set-up

• Procedure-specific

and energy instruments

da Vinci® - (1999)

•Eliminates lap compromises

•Introduction of 4th arm (2003)

•Simple instruments

2015

Robot in Gyn Oncology

• Endometrial Cancer

• Cervix cancer

• Morbid obesity

• Previous surgery / adhesions

• Complex surgery

• Learning curve