Glossary

Adrenalectomy

An adrenalectomy is the surgical removal of one or both adrenal glands. The procedure can be performed using an open incision or laparoscopic technique. The adrenal glands are endocrine glands located above each kidney. Malignant or benign tumors in the adrenal gland are the most common conditions requiring adrenalectomy. Some adrenal gland tumors excrete hormones. If left untreated, these tumors can cause severe hormonal imbalances.

Anastomosis

A connection between two tubular anatomic structures (e.g., coronary vessels and intestinal structures).

Atrial Septal Defect

The septum is a wall that separates the heart's left and right sides. Septal defects are sometimes called a "hole" in the heart. A defect between the heart's two upper chambers (the atria) is called an atrial septal defect (ASD).

Bariatrics

Pertaining to weight (from the same root as in barometer -- measuring the "weight" of air), the aim of bariatric surgery is to reduce weight, including "morbid" or "clinically severe" obesity, in patients.

Cholecystectomy

Surgical removal of the gall bladder. Traditionally, the surgery is carried out through an incision in the right side of the upper abdomen. More recently the surgery has been carried out laparoscopically or robotically, employing 3 or 4 small incisions.

Colectomy

Surgical removal of part or all of the colon, performed to treat various conditions, including cancer, diverticulitis (inflammation of a herniation in the intestinal tract), inflammatory bowel disease, volvulus (abnormal twisting of the intestine causing obstruction) and fistulae (an abnormal duct or passage in the intestinal tract).

Coronary Bypass

Also known as revascularization or coronary artery bypass grafting (CABG), coronary bypass is a surgical procedure that restores blood flow to the heart beyond a blockage in a coronary artery. Coronary bypass reroutes the blood around the blockage, creating an alternative pathway for blood to reach the heart muscle.

Degrees of freedom

Refers to axes of movement or the flexibility to achieve given positions and orientations of an instrument tip. Six degrees of freedom are required to reach, position and orient an instrument at any point in space. The seventh degree of freedom is the function of the operation itself (e.g., grasping or cutting).

Robots are typically capable of movement along a number of axes; these movements can be rotational or translational (the motion of a body in which every point of the body moves parallel to and the same distance as every other point of the body).

The number of axes of movement (degrees of freedom), their arrangement and their sequence of operation permits movement of the robot to any point within its envelope. Robots have three arm movements (up-down, in-out, side-to-side). In addition, they can have as many as three wrist movements on the end of the robot's arm, similar to a human wrist: yaw (side to side, left and right), pitch (up and down), and roll or rotational (circular rotation/twisting).

Endoscope

A small tubular lens device, usually attached to a video monitor, and video camera, and used to visualize the inside of the body.

Endoscopy

The use of a telescopic viewing device inserted into a body cavity via a small incision together with specialized surgical tools, enabling the surgeon to see the inside of the body cavity on a television screen and identify and repair the defect. Endoscopy is often done to diagnose gastric ulcers, locate the source of upper gastrointestinal bleeding, and examine the lower esophagus, stomach and lower colon.

EndoWrist® Technology

Tiny, computer-enhanced mechanical wrists near the end of the instrument tip that provide all the flexibility of the human wrist and forearm at the operative site, through 1 cm ports.

Gastric Bypass

A weight-loss procedure performed by bariatric or general surgeons that utilizes stapling, suturing and other surgical techniques to create a very small stomach pouch, severely restricting the amount of food that can be consumed at one time. The rest of the stomach is bypassed and therefore no longer receives food.

Haptics

Haptics (pronounced HAP-tiks) is the science of applying touch (tactile) sensation and control to interaction with computer applications. (The word derives from the Greek haptein, meaning "to fasten.") By using special input/output devices (such as joysticks or data gloves), users can receive feedback from computer applications in the form of felt sensations in the hand or other parts of the body. In combination with a visual display, haptics technology can be used to train people for tasks requiring hand-eye coordination, including surgery.

Heller Myotomy

Surgical treatment of esophageal achalasia (failure of the esophagus to relax) by longitudinal division of the lowest part of the esophageal muscle down to the submucosal layer; some muscle fibers of the cardia may also be divided.

Laparoscope

A type of endoscope consisting of an illuminated tube with an optical system.

Laparoscopy

A type of surgery using a laparoscope, which is inserted into one or more small incisions, to examine the abdominal cavity. This technique uses small cylindrical tubes called trocars.

Medical robotics

Remote activated or user-manipulated motion control, imaging and communication devices, operated via computer hardware and software to enable physicians to conduct an increasing array of surgical procedures in a minimally invasive manner.

Minimally Invasive Surgery

Minimally Invasive Surgery (also known as MIS, minimal access, keyhole surgery, laparoscopic, or endoscopic surgery) is a major advance in bringing to patients the excellent results of traditional surgical procedures, while eliminating the most physically and emotionally traumatic elements: the pain and lengthy recovery from "open" surgery.

Minimally invasive surgery means having a minimum of interference with the patient's normal physiological function. Advances in laparoscopic surgery allow surgeons access to complex patient anatomy through very small incisions instead of the large incisions associated with conventional "open" surgery. Patients experience less pain and shorter recovery times.

Mitral Valve Repair

A heart procedure to treat stenosis (narrowing) or regurgitation (leakage) of the mitral valve. The mitral valve is the "inflow valve" for the left side of the heart.

Motion scaling

A software-based feature of the da Vinci® Surgical System that increases surgical precision and fine motor control by: 1) scaling hand movements so that large motions by the surgeon are reduced to micro-movements at the operative site, and 2) eliminating natural hand tremors.

Nissen Fundoplication

Laparoscopic procedure developed for management of acid reflux or chronic heartburn, also known as Gastroesophageal Reflux Disease (GERD). The procedure consists of wrapping the stomach around the lower 4-6cm of the esophagus and suturing the stomach in place.

Open Surgery

Cutting the skin and tissues during surgery to expose a full view of the structures and organs involved in the procedure. Surgeons work under direct visualization with full incision.

Port

A tiny (1-2 cm) incision, into which a cannula (hollow, rigid tube) is inserted to act as a conduit for an endoscope or minimally invasive surgical instruments, including EndoWrist® instruments.

Prostatectomy or radical prostatectomy

Removal of the prostate to treat prostate cancer.

Reliability-Controlled™ Reusable Instruments

Intuitive Surgical® instruments that are used multiple times before being discarded, ensuring consistent high performance. They are completely sterilizable via standard methods.

Robot

An automatic device that performs functions normally ascribed to humans. More technically, a reprogrammable, multifunctional manipulator designed to move material, parts, tools, or specialized devices through various programmed motions for the performance of a variety of tasks. The word 'robot' was coined by the Czech playwright Karel Capek, from the Czech word for forced labor or serf.

Robotics

A branch of engineering that involves the conception, design, manufacture, and operation of robots. This field overlaps with electronics, computer science, artificial intelligence, mechatronics (the synergistic combination of precision mechanical engineering, electronic control and systems thinking in the design of products and manufacturing processes); nanotechnology (the science and technology of building electronic circuits and devices from single atoms and molecules); and bioengineering (the application of engineering principles to the fields of biology and medicine, as in the development of aids or replacements for defective or missing body organs).

Robotic components

For a machine to qualify as a robot, it usually needs these 5 parts:

• A controller – the computer
• Arm(s) – the part of the robot that positions the end-effector and sensors
• The drive – the "engine" that moves the links – the sections between the joints into their desired position
• End effector(s) – the "hand" connected to the robot's arm
• Sensor(s) – technology that sends information, in the form of electronic signals back to the controller

Sacrocolpopexy

Sacrocolpopexy is a procedure designed to surgically correct vaginal vault prolapse, where surgical mesh is used to hold the vagina in the correct anatomical position. This procedure can also be performed following a hysterectomy, in order to treat uterine prolapse and to provide long-term support for the vagina.

Splenectomy

 An operation to remove the spleen.

Telesurgery

A term for robotic surgical technologies that are programmed with commands and then move autonomously, without human touch. The da Vinci® Surgical System, by contrast, is based on servo-assisted technology that consistently updates critical performance inputs approximately 1500 times/second, simultaneously transferring the surgeon’s exact hand and finger movements made at the console to precise microsurgical movements of the instruments in the operative field.

Thymectomy

Surgical removal of the thymus gland. The thymus has been demonstrated to play a role in the development of autoimmune myasthenia gravis (MG). It is removed in an effort to improve the weakness caused by MG, and to remove a thymoma (a usually benign tumor of the thymus), if present.

Video-Assisted Surgery

Any surgical procedure utilizing a visualization device, such as an endoscope.

Visual Immersion

Refers to the sense of being inside the body, or present at the operative site, which the surgeon typically experiences while using the da Vinci System. Seated at the console, the surgeon is able to look into the video display and see a high-resolution, 3-D image of the surgical field, with hands and instruments in a natural line of sight – brighter and clearer than it would even appear in open surgery. 3-D visualization that allows eye-hand instrument alignment and coordination promotes maximum immersion at the surgical site, eliminating the spatial disorientation and disconnected hand/eye coordination inherent in traditional laparoscopic technology.