From fighter pilots to lap procedures
From fighter pilots to lap procedures
3D system is portable, less costly than robotic
Three-dimensional technology that the military created to help fighter pilots in air combat is now being used by outpatient surgeons to perform complex laparoscopic cases, and at about one-tenth the price of the da Vinci Surgical robotic system (Intuitive Surgical, Santa Monica, CA). The 3Di Digital Vision System, available from Viking Systems in San Diego, also has the advantage of being portable and thus can be shared among facilities.
The three-dimensional aspect of the system is what makes a difference to surgeons, says Lonna Williams, senior vice president of commercial operations. "You have the ability to have that [depth] perception while you perform lap surgery," she says. "Your natural vision is restored."
At Hoag Hospital in Newport Beach, CA, "Viking provides the surgeon a greater field of vision in minimally invasive surgery, which is an advantage for both the MD and the patient," says Carole Metcalf, RN, CNOR, CRNFA, director of perioperative services. Hoag is one of about 60 hospitals in the United States and 40 more worldwide using the Viking system.
The Viking system includes the head-mounted display, a 300-watt xenon light source, a 3D digital stereo camera, stereoscopes, a digital video recorder, a central data-processing unit, and a 23-inch flat-panel LCD monitor and cart. The head-mounted display offers surgeons a three-dimensional video image of the inside of the patient's body. The cameras are inserted into patients via the laparoscope. The system can be used with any procedures that use a 10-mm endoscope.
The system costs approximately $150,000. In comparison, the da Vinci system costs about $1.2 to $1.6 million, according to a company spokesperson. Also, the da Vinci has an annual maintenance fee of about $100,000-$140,000 and the total cost of instruments and accessories used per case is about $1,500.
No twisting your head
The Viking system provides an ergonomic benefit, says Don Tucker, CEO of Viking. The image goes directly into the eye of the surgeons as opposed to surgeons having to stare at monitors across the rooms, which may require them to twist their heads.
Also the system has the ability to bring secondary information into the surgeons' field of view, Tucker says. For example, surgeons can see a fluoroscopic scan or diagnostic material in their head-mounted display, similar to a "picture-in-picture" capability of some TVs. That information can be brought in using voice technology.
Hoag is using the system in some of the more complex laparoscopic procedures, including some gynecological and general cases, Metcalf says. "If you're doing fine tissue dissection or if dissections involve a nerve or delicate structure, then the enhanced vision is helpful," Metcalf says.
Surgeons who are trained to perform laparoscopic procedures need only a few minutes to become comfortable with the head-mounted display, Williams says. At Hoag, Viking officials provided in-house training for staff and physicians, Metcalf says. "They provided structured inservices, with hands-on opportunity to learn the equipment, and individual case support" she says. Viking representatives also attended department meetings and offered individual support to physicians in private meetings.
The challenge was having adequate support staff who were comfortable with the system and able to assist physicians, Metcalf says. Staff set up the system, monitor it, and adjust it as needed she says. "[They] must be familiar with the system, Metcalf says. "We have 18 operating rooms and a lot of staff, so we chose to train some key staff members thoroughly, and they are 'super-users,' so to speak."
Three-dimensional technology that the military created to help fighter pilots in air combat is now being used by outpatient surgeons to perform complex laparoscopic cases, and at about one-tenth the price of the da Vinci Surgical robotic system (Intuitive Surgical, Santa Monica, CA).Subscribe Now for Access
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