SCHOTT solutions no. 2/2014 > Medical Technology

Präzisionslicht für Chirurgen
The telerobotic daVinci® surgical system from Intuitive Surgical features a console for surgeons, a patient-side cart with robotic arms, endoscopic instruments and a 3-D vision system. The latest system uses PURAVIS® glass fibers from SCHOTT to illuminate surgical areas (left). Photo: Intuitive Surgical

A guiding light for surgeons

SCHOTT’s glass optical fibers and lighting systems are helpful in many different contexts – among them such vital fields as minimally invasive surgery.

Stephanie Hügler

In the 1970s robots were thought to replace mankind in the near future. Contemporary movies featured robotic droids that looked and acted like humans. Today, in 2014, we do have robots to help us with our everyday lives. But in most cases they neither look like us nor are they really designed to be a replacement. Instead, many of them are developed as computer-assisted systems that complement professional tasks we must perform ourselves.
Glasfaser PURAVIS®
Photo: SCHOTT/H. Fischer
Medical surgery is one of the fields that strongly benefits from robotic assistance, as it requires absolute precision. Operating on a patient’s body always involves grasping, cutting and manipulation of tissue – leaving scars and subjecting the patient to pain. To minimize such side effects, minimally invasive surgery has become a standard procedure. It is the first method of choice for many
operations such as removing the spleen, the appendix or cancer tissue. In contrast to ”ordinary” surgeries, minimally invasive surgery usually involves only a few incisions for a camera, illumination, scalpels and other instruments on endoscopes. Yet, although so-called ”laparoscopic” techniques boomed for relatively simple operations during the 1980s and 1990s, minimally invasive surgery was long thought to be too risky for more complicated procedures.

This has changed since the American company Intuitive Surgical introduced telerobotic surgery. Their daVinci® surgical system consists of a console that allows the surgeon to be comfortably seated while operating, a patient-side cart with three or four robotic arms, several endoscopic instruments and a 3-D-vision system. All of the surgeon’s hand movements are translated into smaller and more precise movements of tiny instruments such as scalpels, scissors or needle holders that are fixed to the system arms, which are able to rotate far more than the human wrist while under visual view and control of the surgeon.
PURAVIS® fibers guarantee transmission of white light across great distances directly into the patient’s body. Photo: Intuitive Surgical
”This technology can be used across a wide spectrum of minimally invasive surgical procedures, but our latest system has been especially designed for complex multi-quadrant surgeries like prostate operations,” says Mike Hanuschik, Design & Product Management Director at Intuitive Surgical. Enabling efficient access through the abdomen, the chest and different body openings, the system can, however, also be employed in such various medical fields as gynaecology or thoracic, cardiac and general surgery. ”We offer intuitive motion and an ergonomic design while providing surgeons with a highly magnified view and 3D-HD visualization. We are virtually extending their eyes and hands into the patients,” explains Hanuschik.

Founded in 1995, Intuitive Surgical has become the market leader in computer-assisted systems. Their daVinci® system is clearly the most advanced and most installed tele robotic surgery system available. The 3-D-visualization system offers surgeons a continuously updated in-depth view of the operation field, helping them to work with the highest precision possible.
The eco-friendly optical glass fibers PURAVIS® from SCHOTT are strong and can withstand more sterilization processes than conventional fibers. Photo: SCHOTT/C. Costard
It is here that SCHOTT’s contribution comes in: ”SCHOTT provides the surgeon’s light,” explains Ralf Daferner, Division Manager Medical at SCHOTT’s Lighting and Imaging Business Unit. “Intuitive’s newest system now benefits from the eco-friendly PURAVIS® glass optical fibers. These high-performance fibers are produced without using lead, antimony and arsenic. And they guarantee a pure white light transmission over a long length right into the patient’s body.” Besides, SCHOTT’s PURAVIS® fibers are very robust, which saves hospitals a lot of money in the long run. This is achieved through excellent chemical stability, which is particularly important for medical reprocessing or cleaning. This allows medical instruments to be sterilized much more often than those equipped with conventional fibers – a fact which is very important in a hospital where sterile instruments are crucial to prevent infections in the operation theater. ”SCHOTT’s light guides are an indispensable part of Intuitive Surgical’s robotic surgery systems,” says Hanuschik. ”They provide the exact lighting the surgeon needs to safely distinguish between different types of tissue and do this reliably for a very long time.”

With lighting solutions and robotic surgical systems becoming ever more sophisticated, Hanuschik believes that robotic surgery will soon become the standard of care for many more complex operations. ”The future of minimally invasive operations lies in robotic surgery,” Hanuschik says. ”Physicians worldwide have used the daVinci® System successfully in approximately 1.5 million surgical procedures to date. Among them are renowned clinics such as New York University Medical Center, USC University Hospital in Los Angeles, and hundreds more. We will continue to improve it, thus changing the surgical experience for people all around the world.” <
SCHOTT website