The gallbladder concentrates and stores bile as a pear-shaped sac which it can release to help digestion after a fatty meal.
One of the major breakthroughs in the world of surgery is the use of robotics, especially in the field of minimally invasive surgeries. Robotic surgery, computer-assisted surgery and robotically assisted surgery have allowed for increased precision, easier access to the surgical area, and a timelier surgery and recovery period.
The most commonly used surgical robots are operated by telemanipulation, which uses a computer to give the robotic system instructions. Originally, the telesurgery robots were conceived with the help of DARPA and NASA to allow remote surgeries in remote environments, but have since been found more effective for minimally invasive surgeries. Further development of the robotic surgery field is expected to come out of artificial intelligence and miniature robotics research, currently conducted by the leaders in the medical, computer science and defense industries.
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The control center for the daVinci Si console is shown. The surgeon inserts his or her thumb and middle fingers into the pincher-like controls. This allows the surgeon to have wristed movement while performing a minimally invasive operation.
Ports are devices that serve as interfaces between the body and the operating room. Robotic ports are very similar to other minimally invasive ports that are used for either laparoscopic or thoracoscopic surgery. This close-up demonstrates the surgeon placing the ports for a robotic esophageal…
This is picture demonstrates a first-generation robotic control station. The control console of the da Vinci system is ergonomically designed not only allowing increased visualization but also alleviating some of the orthopedic injuries that occur during laparoscopic retraction.
There are situations when patients who suffer from cancer may require a robotic lobectomy but not have the lung function allowing them to tolerate a formal resection. In these cases a wedge resection and brachytherapy seeds placed robotically may provide a treatment option.
One of the hypothetical uses of the robot is to perform minimally invasive heart surgery. This photo demonstrates a surgeon practicing the process of a surgical anastomosis. The lack of haptic feedback makes identifying coronary targets very difficult which has been recently improved by…
Depending on an evaluation of preoperative swallowing mechanics, a Nissen-fundoplication is typically added to a paraesophageal hernia repair. The fundoplication anchors the stomach and also fixes the problems of reflux that occur with the repositioning of the GE junction.
A robotic thymectomy can be performed from either the left or right chest. The first part of the operation begins with dissecting the thymus off of the sac covering the heart. The surgeon is holding a piece of thymus with the right hand while using the left hand to develop a tissue plane between…
The articulating graspers of the robot allow a total thymectomy to be performed- specifically the difficult task of dissecting the horns from deep inside the neck. This portion of the operation requires careful identification of the surrounding blood vessels and nerves.
The robotic thymectomy is almost completed as the thymus is free from attachments and the final step of dissecting the contralateral horn is seen in the top right of the photo. The thymus is sometimes flipped into the contralateral pleural cavity to allow for retraction.
The robotic surgeon is looking up from the esophageal junction during a robotic heller myotomy. The robot is being used to divide the hypertrophic muscle tissue that causes swallowing problems in achalasia. The left hand is being use to spread the muscle while the energy device is used in the right…
Robotic myotomy continues with separating the muscular fibers of the esophagus gently using the robotic graspers. The use of energy is limited as to not cause an injury to the esophageal mucosa.
Achalasia is caused when the muscular layers of the esophagus near the gastroesophageal junction do not relax properly during swallowing. The robot allows a careful dissection to ensure that all muscular fibers have been separated.