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Robotic Devices inSurgery oftheDigestive System
https://t.me/medicina_free
Fig. 23 Monopolar
cautery hook. (From
Intuitive Surgical, 2023
[2, 3])
Fig. 24 Monopolar curved
scissors. (From Intuitive
Surgical, 2023 [2, 3])
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B. Zilberstein et al.
Vessel Sealer: The bipolar energy clamp that can seal vessels up to 7mm. It has
an endowrist and used for dissection, but is too coarse for ne dissection. Very useful for performing colectomies or bariatric surgery of the “sleeve gastrectomy” type
(Sleeve) (Figs.26, 27, 28, and 29).
Fig. 25 Monopolar
spatula cautery. (From
Intuitive Surgical, 2023
[2, 3])
Fig. 26 Harmonic energy
clamp. (From Intuitive
Surgical, 2023 [2, 3])
Robotic Devices inSurgery oftheDigestive System
https://t.me/medicina_free
Fig. 27 Vessel Sealer.
(From Intuitive Surgical,
2023 [2, 3])
Fig. 28 Vessel Sealer
Extend. (From Intuitive
Surgical, 2023 [2, 3])
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Fig. 29 SynchroSeal.
(From Intuitive Surgical,
2023 [2, 3])
Fig. 30 Big clipper. (From
Intuitive Surgical, 2023
[2, 3])
B. Zilberstein et al.
4.3 Robotic Clippers
Robotic clippers: Instruments for applying clips for ligation of vessels, with three
sizes, small, medium, and large (Figs.30, 31, and 32).
Robotic Devices inSurgery oftheDigestive System
https://t.me/medicina_free
Fig. 31 Medium clipper.
(From Intuitive Surgical,
2023 [2, 3])
Fig. 32 Small clipper.
(From Intuitive Surgical,
2023 [2, 3])
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Fig. 33 Models and characteristics of robotic staplers. (From Intuitive Surgical, 2023 [2, 3])
B. Zilberstein et al.
4.4 Robotic Staplers
Robotic staplers: They correspond to automatic staplers with lateral movements
that allow the cutting and sealing of tissues and large vessels. It has the advantage
that the surgeon himself can apply the staple line using the benet of the endowrist;
however, its cost in our country makes its routine use difcult (Fig.33).
4.5 Needle Holder
All have articulated movements (endowrist).
Large Needle Driver: For smaller diameter wires up to 3-0.
Mega Needle Driver: For larger diameter wires.
Mega Suturecut Needle Driver: There is a needle holder that can also cut the
suture thread. Its use requires a lot of attention so that there is no accidental cutting
of the suture thread during the performance of the same (Figs.34, 35, 36, 37, 38,
and 39).
Robotic Devices inSurgery oftheDigestive System
https://t.me/medicina_free
Fig. 34 Large Needle
Driver. (From Intuitive
Surgical, 2023 [2, 3])
Fig. 35 Mega Needle
Driver. (From Intuitive
Surgical, 2023 [2, 3])
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Fig. 36 Mega SutureCut
Needle Driver. (From
Intuitive Surgical, 2023
[2, 3])
Fig. 37 Si Robotic
clamps. (From the author’s
archive [7])
B. Zilberstein et al.
Robotic Devices inSurgery oftheDigestive System
https://t.me/medicina_free
Fig. 38 Xi and X Robotic
clamps. (From the author’s
archive [7])
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Fig. 39 Xi and X Robotic clamp. (From the author’s archive [7])
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Fig. 40 Disposable robotic surgery kit. (From the author’s archive [6, 7])
B. Zilberstein et al.
5 Robotic Surgery Kit
Robotic surgeries, in addition to the use of tweezers and optics, require disposable
supplies:
– 4 arm drapes (robot arm cover);
– 1 column cover;
– 4 cannulas for trocars 5–8mm;
– 1 scissor tip protector (tip cover);
– 1 shutter (bladeless).
Single use tweezers:
– 1 harmonic ace clamp (single use);
– 1 vessel sealer clamp (single use) (Fig.40).
6 Non-robot Instruments Needed foraRobotic Procedure
In addition to the Robot’s own instruments, it is necessary to add instruments specic to video laparoscopy surgery:
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