A subsidiary of the University Medical Center Hamburg-Eppendorf

Eine Operation in der Martini Klinik

Hand in hand with state-of-the-art surgical systems

The da Vinci® and Hugo RAS systems are robotic-assisted surgery systems used to perform minimally invasive operations. These systems support doctors during laparoscopic surgery (also known as keyhole surgery). Instead of making large incisions in the abdomen, small incisions of 5 to 12 mm are sufficient to insert the necessary instruments as well as a camera into the patient’s body. A term often given to this type of procedure is “robotic surgery”. However, this is misleading. The doctor performing surgery operates the instrument arms, which exactly replicate the doctor’s hand movements.

When removing the entire prostate, robotic-assisted surgery is an alternative to conventional open surgery. Since its introduction in 2007, the robotic-assisted method has been used more than 12,000 times at the Martini-Klinik and the University Medical Centre Hamburg-Eppendorf (UKE). Both surgical procedures are suitable for sparing the nerves and the urethral sphincter during a prostatectomy.

Martini-Klinik

Accompanies you through this topic

Prof. Dr. Alexander Haese
Faculty member

Martini-Klinik

Surgical precision

What does robotic-assisted surgery involve? Prof. Alexander Haese and his colleagues provide fascinating insights.

8:04 minutes

Special features of the da Vinci® system for robotic-assisted prostate removal

You can choose elective services (i.e. services that are not medically necessary), such as the use of a robotic-assisted surgical system, regardless of your insurance status. We charge for such services separately; this co-payment will not be reimbursed by your health insurance provider.

Elements in a robotic-assisted surgical system

A robotic-assisted surgical system is composed of three main components: the control console, the video system and one or more instrument carts.

The control console

The surgeon sits at the control console in the operating room and looks into the stereoscopic viewing window integrated into the console. The surgeon’s left and right hands each grip a freely movable controller handle. These handles turn the movement of the surgeon’s fingers and hand joints into electronic control signals. These signals are transmitted to the instrument cart beside the patient and translate the movements of the surgeon’s hands into identical movements by the instruments in the surgical area.

The da Vinci® system relies on state-of-the-art telemanipulator technology. This refines the doctor’s hand movements and adapts them to the delicate structures inside the body. The surgeon works with a completely steady hand – to an extent that would not be possible in conventional surgery or even using conventional laparoscopic techniques.

The full HD video system

The da Vinci® system gives the surgeon an exceptionally good view throughout the procedure thanks to its full 3D HD view. The best comparison for the viewing window is that it is like using binoculars. The camera combines two scopes in a single shaft. A separate camera is available for each scope. The left and right images are transmitted and synchronised on two monitors and transmitted into the viewing window. Consolidating the left and right images creates a three-dimensional image with extraordinary depth. The cameras also offer 10x magnification, clearly visualising even very delicate structures. This gives the surgeon an excellent view of the procedure – a crucial requirement for precise microsurgery. 

The patient cart

The cart is positioned directly beside the patient. It features three instrument arms and, in the centre, the camera arm. These arms use adapters to connect to the instruments and the camera. Trocars specific to the da Vinci® system are used to insert the instruments and camera into the patient. During the operation, this cart converts the movements made by the surgeon at the control console into movements by the instruments. The instruments have multiple articulations and seven degrees of freedom, precisely matching the mobility and agility of the surgeon’s hands and wrists. This presents a particular advantage when dissecting and reconstructing extremely delicate anatomical structures. The instruments move exactly as the surgeon intends. 

Roboterassistiert Konsole für Operation
Ras System Bedienung

The da Vinci® system relies on state-of-the-art telemanipulator technology. This effectively steps down the surgeon’s hand movements like a gear, enabling them to work on delicate structures in the body with smaller amplitudes of movements The surgeon works with a steadier hand – to an extent that would not be possible in conventional surgery or even using conventional laparoscopic techniques.


More information

Special surgical techniques used at the Martini-Klinik to preserve potency and continence

Open or robotic-assisted? An outline and comparison
Conventional open surgery
 

What is the da Vinci surgical method for prostate cancer?

When removing the entire prostate, robotic-assisted surgery is an alternative to conventional open surgery. The skill and expertise of the surgeon are decisive for the quality of the operation, sparing the nerves (and therefore preserving potency) and sparing the urethral sphincter (and therefore completely preserving continence).