Frequently Asked Questions
Q. Why is the company called Intuitive Surgical?
A. The company is called Intuitive Surgical because its technologies allow surgeons to operate intuitively, with the same direct approach as open surgery and with a similar or better range of motion but through the small ports used in minimally invasive surgery. This is in contrast to traditional laparoscopic surgery, where the surgeon moves the instrument handles in the opposite direction as the instrument tips – moving left means right and moving right means left. Many surgeons describe this approach as counter-intuitive. When a da Vinci surgeon moves the console controls clockwise, the tiny wristed instruments inside the patient turn clockwise as well. So with da Vinci Surgery, left means left and right means right. Surgeons say they benefit from this user interface design, which is very similar to performing open surgery.
A. MIS is surgery performed through small incisions – also known as operating ports or keyhole incisions - rather than large incisions required for direct, manual access to the target anatomy. MIS has become standard-of-care for many surgical procedures. Intuitive Surgical's technology enables the use of MIS even for very complex procedures like cancer operations and heart surgery. To learn more about minimally invasive surgery and the potential benefits of da Vinci Surgery to patients, go to: www.daVinciSurgery.com
A. The product is called "da Vinci" in part because Leonardo da Vinci is credited with inventing the first robot. da Vinci used unparalleled anatomical accuracy and three-dimensional details to bring his masterpieces to life. The da Vinci Surgical System similarly provides surgeons with such enhanced detail and precision that the System can mimic open surgery while allowing doctors to perform complex procedures through a few tiny incisions.
Q. What are the benefits of using the da Vinci Surgical System compared to traditional methods of surgery?
A. Complex conditions like cancers of the prostate, cervix, uterus, lung, colon/rectum, as well as heart disease and fibroid tumors can now be treated minimally invasively with da Vinci Surgery. There are many potential benefits for patient when comparing da Vinci Surgery to traditional open surgery, including:*
- Shorter hospital stay1,2,3,4
- Less blood loss2,3,4,5
- Less pain1,6,7,8
- Faster recovery1,2,9,10
- Smaller incisions for minimal scarring11
Keep in mind, potential benefits can be not guaranteed since every surgical procedure is unique to each patient and procedure.
For surgeons, some of the major benefits of the da Vinci Surgical System include: enhanced vision, precision, dexterity and control due to itsunique instrumentation and 3D-HD vision system. Theda Vinci System alsoprovides surgeons with superior ergonomics for added comfort during surgery.
A. The U.S. Food and Drug Administration (FDA) has cleared the da Vinci Surgical System for use in a wide range of procedures. Please see the FDA Clearance page for specific clearances and representative uses.
A: The da Vinci System is a robotic surgical platform designed to enable complex procedures to be performed through a few 1-2 cm incisions, also called operating ports or keyhole surgery. Single-Site da Vinci technology enables surgeons to remove the gallbladder through one small incision in the belly-button. To date, hundreds of thousands of da Vinci procedures have been performed including: general, urologic, gynecologic, transoral, cardiac, thoracic, and pediatric procedures.
A. No, however da Vinci surgicalprocedures are routinely performed for a wide range of conditions in specialties including: general, urologic, gynecologic, transoral, cardiac, thoracic, and pediatric. The da Vinci instrumentation currently available is not designed for or indicated for use in surgical specialties outside these areas.
A. Since 1998, over 4,000 peer-reviewed publications have appeared in various clinical journals onda Vinci Surgery. Many have concluded thatda Vinci Surgery, across several specialties, is superior to traditional open surgery in several key areas, as noted above. Intuitive Surgical tracks the creation and publication of peer-reviewed studies on the clinical uses of theda Vinci Surgical System. Theda Vinci clinical library is increasing at a rate of approximately 100 publications per month. For additional information, go to: www.intuitivesurgical.com/company/clinical-evidence/
A. Today, with da Vinci technology, most complex operations can be performed minimally invasively through a few small incisions instead of a large open incision. In putting the interests of the patient first, Intuitive Surgical believes that more patients should be offered minimally invasive surgery – even for complex cases. An abundance of studies have shown minimally invasiveda Vinci Surgery allows for better patient outcomes when compared to traditional open surgery (with a scalpel), see: www.intuitivesurgical.com/company/clinical-evidence/. However, regardless of the technology used, nothing can replace a surgeon’s experience. When faced with surgery, patients should explore all treatment options and seek a second opinion before deciding which treatment and surgeon is best for them.
A. No. In fact, several studies concluded that da Vinci Surgery can reduce overall costs compared to traditional surgical approaches.12
Q. Is it true that doctors are overprescribing prostate cancer treatment, including surgery? Can’t prostate cancer patients just wait and see?
A. According to the American Urological Association, surgery offers the best chance for a cure for localized prostate cancer.13 Active surveillance (“wait and see”) may be appropriate for slow growing cancers and certain patients. However, for patients who want the cancer out, surgery may be the best option. Patients should always seek a second opinion when faced with a serious disease.
A: The da Vinci Surgical System is used in major centers in the United States, France, Italy, Germany and Spain, as well as in many other countries around the world. To locate a hospital or surgeon, go to: http://www.davincisurgeonlocator.com/
A. On the contrary, the da Vinci System is designed to allow surgeons to operate with greater precision, vision, dexterity and control. It is designed to advance their techniques and enhance their ability to perform complex surgery while using a minimally invasive approach. The System translates the surgeon's hand movements in real time to its miniaturized instruments, while using motion scaling and tremor reduction to improve precision. The system can never be programmed to make decisions on its own or to perform any surgical maneuvers without the surgeon's direct input via the console hand controls.
Q. While using the da Vinci Surgical System, can the surgeon feel anything inside the patient's chest or abdomen?
A. Motors on the system move the robotic arms and instruments in response to the surgeon’s hand movements on the controls. As a result, the surgeon receives or feels subtle physical “feedback” while holding the controls. This feedback provides a substitute for the actual sense of touch and is augmented by the enhanced vision provided by the high definition 3D view. While surgeons are not able to touch or feel the anatomy as in open surgery, they indicate that the improved visualization, precision, dexterity and control that da Vinci offers them during surgery more than compensates for the loss of touch.
A. No. Although seated at a console a few feet from the patient, the surgeon views an actual image inside the patient’s body while operating in real-time. At no time does the surgeon see a virtual image, or program the system to perform any independent maneuvers outside of the surgeon's direct, real-time control.
A. Robotic surgical devices are designed to perform entirely independent movements after being programmed by a surgeon. The da Vinci Surgical System is a computer-enhanced system that introduces a computer interface and 3DHD vision system between the surgeon's eyes, hands and the tips of micro-instruments. The system mimics the surgeon's hand movements in real time. It cannot be programmed, nor can it make decisions on its own to move or perform any type of surgical maneuver. So, while the general term "robotic surgery" is often used to refer to our technology, it is not robotic surgery in the strictest sense of the term.
A. No. The da Vinci Surgical System could theoretically be used to operate over long distances. This capability, however, is not the primary focus of the company and is not available with the current da Vinci Surgical System.
A. Intuitive Surgical's goal is to extend the benefits of minimally invasive surgery to as many patients as possible. Our strategy to achieve this includes the development of products that allow doctors to rapidly expand their surgical techniques and capabilities. Our robotic surgical platforms currently allow surgeons to perform complex procedures using a minimally invasive approach.
In the interest of improving the surgeon training experience and expanding training programs, we are exploring telesurgery as a way to provide more convenient or expedient surgeon-to-surgeon proctoring and coaching. We see telesurgery as a means to allow surgeons to learn and optimize their robotic-assisted surgery skills under the guidance of leading specialists – with less disruption to clinical schedules due to travel — and therefore less impact on patients.
A. Intuitive has an extensive patent portfolio of internally developed technology, as well as a variety of patents acquired or exclusively licensed from leaders in surgical robotics.
Q: Why isn't Intuitive Surgical getting involved in the Defense Advanced Research Projects Agency (DARPA) Defense Sciences project to develop robotic technology for use on the battlefield?
A: The DARPA project was, in fact, the project that inspired the creation of the first da Vinci System, and Intuitive Surgical's da Vinci Surgical System could theoretically be used to operate over long distances. However, optimizing the da Vinci System for remote or telesurgery applications is not the primary focus of the company's product design and development efforts, and this capability is not available with the current da Vinci Surgical System. Intuitive Surgical is optimizing its products for applications in minimally invasive surgery today. We are committed to the development of products that can extend the benefits of minimally invasive surgery to the broadest possible number of patients worldwide.
A: Intuitive's principal corporate offices are located in Sunnyvale, California, United States, which is in the Silicon Valley region near San Jose.
A: We currently market our system in the United States through a direct sales organization to hospitals. We have European operations headquartered in Aubonne, Switzerland and Asia-Pacific operations headquartered in Shanghai, China. We sell directly in some European countries and use distributors and agents in the rest of the world.
A: The average selling price of the da Vinci System varies according to model, features, service contract, etc. Please see our investor presentation for more details.
A: Today, more than 2,585 Systems are installed in over 2,025 hospitals worldwide. Please see our investor presentation for more details.
A: As of December 31, 2012 we had a total of 2,362 employees.
1Park 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. 2011 Jan;25(1):240-8. Epub 2010 Jun 15.
2Poston RS, Tran R, Collins M, Reynolds M, Connerney I, Reicher B, Zimrin D, Griffith BP, Bartlett ST. Comparison of economic and patient outcomes with minimally invasive versus traditional off-pump coronary artery bypass grafting techniques. Ann Surg. 2008 Oct;248(4):638-46.
3Health Information and Quality Authority (HIQA), reporting to the Minister of Health-Ireland. Health technology assessment of robot-assisted surgery in selected surgical procedures, 21 September 2011.
4Landeen LB, , Bell MC, Hubert HB, Bennis LY, Knutsen-Larson SS, Seshadri-Kreaden U. Clinical and cost comparisons for hysterectomy via abdominal, standard laparoscopic, vaginal and robot-assisted approaches. S D Med. 2011 Jun;64(6):197-9, 201, 203 passim
5deSouza AL, Prasad LM, Ricci J, Park JJ, Marecik SJ, Zimmern A, Blumetti J, Abcarian H. A comparison of open and robotic total mesorectal excision for rectal adenocarcinoma. Dis Colon Rectum. 2011 Mar;54(3):275-82
6Cerfolio RJ, Bryant AS, Skylizard L, Minnich DJ. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg. 2011 Oct;142(4):740-6. Epub 2011 Aug 15.
7Lowe MP, Hoekstra AV, Jairam-Thodla A, Singh DK, Buttin BM, Lurain JR and Schink JC. A comparison of robot-assisted and traditional radical hysterectomy for early-stage cervical cancer. Journal of Robotic Surgery 2009:1-5.
8Menon M, Tewari A, Baize B, Guillonneau B, Vallancien G. Prospective comparison of radical retropubic prostatectomy and robot-assisted anatomic prostatectomy: the Vattikuti Urology Institute experience. Urology. 2002 Nov;60(5):864-8.
9Bell MC, Bell MC, Torgerson J, Seshadri-Kreaden U, Suttle AW, and Hunt S. Comparison of outcomes and cost for endometrial cancer staging via traditional laparotomy, standard laparoscopy, and robotic techniques. Gynecologic Oncology III 2008:407-411.
10Miller J, Smith A, Kouba E, Wallen E, Pruthi RS. Prospective evaluation of short-term impact and recovery of health related quality of life in men undergoing robotic assisted laparoscopic radical prostatectomy versus open radical prostatectomy. J Urol. 2007 Sep;178(3 Pt 1):854-8; discussion 859. Epub 2007 Jul 16.
11Data on file with Intuitive Surgical, Inc.
12 Lau S, Vaknin, Z, Ramana-Kumar AV, Halliday D, Franco EL, Gotlieb WH. Outcomes and Cost Comparisons After Introducing a Robotics Program for Endometrial Cancer Surgery. Obstetrics & Gynecology. 2012 April; vol 119(4):717-724.
13American Urological Association. Guideline for the Management of Clinically Localized Prostate Cancer: 2007 Update.
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All surgery presents risk, including da Vinci® Surgery and other minimally invasive procedures. Serious complications may occur in any surgery, up to and including death. Examples of serious or life-threatening complications which may require hospitalization include injury to tissues or organs, bleeding, infection or internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Risks of surgery also include potential for equipment failure and human error. Risks specific to minimally invasive surgery may include: A long operation and time under anesthesia, conversion to another technique or the need for additional or larger incisions. If your surgeon needs to convert the procedure, it could mean a long operative time with additional time under anesthesia and increased complications. Temporary pain or discomfort may result from pneumoperitoneum, the presence of air or gas in the abdominal cavity used by surgeons in minimally invasive surgery. Research suggests that there could be an increased risk of incision-site hernia with single-incision surgery. Results, including cosmetic results, may vary. Patients who bleed easily, who have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci® Surgery. For more complete information on surgical risks, safety, and indications for use, please refer to http://www.davincisurgery.com/safety/. Patients should talk to their doctors about their surgical experience and to decide if da Vinci Surgery is right for them. Other options may be available. Intuitive Surgical reviews clinical literature from the highest level of evidence available to provide benefit and risk information about use of the da Vinci Surgical System in specific representative procedures. We encourage patients and physicians to review all available information on surgical options and treatment in order to make an informed decision. Clinical studies are available through the National Library of Medicine at www.ncbi.nlm.nih.gov/pubmed.
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