“The Operating Table is Not Paired with da Vinci”

Leonardo da Vinci is renowned as an artist, scientist, and inventor–a true Renaissance man. Famously known for painting works such as The Mona Lisa and The Last Supper, inventing the flying machine and the helicopter, and inking the iconic Vitruvian Man, da Vinci’s influence over an ever-evolving society has made a lasting impact. His work not only drove progress within art, architecture, engineering, and science, but inspired novels like Dan Brown’s best selling 2003 thriller The Da Vinci Code, and the cartoon of the sword-wielding teenage mutant ninja turtle, Leonardo. 

Da Vinci’s extensive study of human anatomy (evidenced by Vitruvian Man) resulted in him building what is thought to be the first robot recorded in history.1 It is thus quite fitting (and intentionally poetic) that Intuitive named their revolutionary robotic technology the da Vinci Surgical System. 

Da Vinci was first introduced to the world in 1999, a system that combined the concepts of minimally invasive laparoscopic surgery with robotics, overall improving a surgeon’s precision, dexterity, and visualization of the surgical field while still maintaining a minimally invasive approach. Since its debut, the da Vinci system has advanced through four generations (Classic, S, Si, and Xi).2 Each generation has brought with it upgrades to the technology, including 3D high-definition imaging, improved ergonomics for surgeons, expanding options for instrumentation, use of fluorescent FireFly® technology, and greater mobility and flexibility of the robotic arms to maneuver around the patient while minimizing collisions.2 

Intuitive, already the market leader in robotic-assisted surgical systems, is about to widen the gap even further. Their “most integrated advanced surgery system–ever,” the highly anticipated da Vinci 5, is scheduled to be released in 2025.3 The da Vinci 5 will feature a moveable headset that can be adjusted per the surgeon’s preference for more comfortable positioning while operating, more settings and controls incorporated directly into the surgeon’s console, 10,000x more computing power than previous models, and an updated tower with everything built in to use multiple tools from one manufacturer.3,4 Perhaps the most exciting update of all though is the brand new force feedback technology. Previously, surgeons had to rely on visual cues to estimate how much force they were using on tissues while operating. With the new force feedback tech, the operating system is able to measure subtle forces exerted by the surgeons and simulate push/pull forces back, essentially generating the resistance normally felt during open and laparoscopic cases. Already, pre-clinical trials have shown a 43% reduction in force used on tissues during operations, meaning gentler surgeries and easier recoveries for patients.3,4 The da Vinci 5 certainly seems promising in its aim to provide surgeons with heightened surgical senses, greater autonomy, enhanced ergonomics, increased efficiency, shortened procedure times, and above all, improved patient outcomes.3 

What’s the price of such advanced technology? Analysts are estimating $2-$2.5 million, an increase from the current $1.8 million for the most current da Vinci Xi.5 Despite the high price point though, there does not seem to be any concern on Intuitive’s end for selling the product. Already it is anticipated that there will be a da Vinci 5 shortage from such a high-demand, with it looking more and more like hospitals will lease rather than own the tech. With upgrades to the tower portion of the da Vinci system enabling use of its own tools, reliance on third-party suppliers (i.e. Stryker) will likely drop drastically.5 There’s been no word yet on whether the da Vinci 5 will be compatible with the TS 7000dV Surgical Table designed by Hillrom in exclusive partnership with Intuitive, which was produced to only pair with da Vinci Xi.6 Though, in my albeit brief experience in the field of surgery as a third year medical student, none of the ORs I’ve been in have had such a table anyway. This elicits my favorite da Vinci phrase to mimic: “the operating table is not paired with da Vinci.”

Much like the Leonardo da Vinci of the 1400s, da Vinci Surgical Systems’ impact on the medical field is exponential and will continue to drive forward and revolutionize the possibilities of surgery. Already, as of 2022, Intuitive reported more than 12 million surgical procedures were done on the da Vinci system, with more than 7,500 units used in operating rooms around the world.7 With the rollout of da Vinci 5, those numbers are sure to exponentially increase in the coming years. 

References:

1. “Leonardo Da Vinci.” Wikipedia, 3 June 2024. Wikipedia, https://en.wikipedia.org/w/index.php?title=Leonardo_da_Vinci&oldid=1226990214.

2. Morrell ALG, Morrell-Junior AC, Morrell AG, et al. The history of robotic surgery and its evolution: when illusion becomes reality. Rev Col Bras Cir. 2021;48:e20202798. Published 2021 Jan 13. doi:10.1590/0100-6991e-20202798

3. https://www.intuitive.com/en-us/products-and-services/da-vinci/5. Accessed 18 June 2024.

4. “Dr. Shakuri-Rad Discusses the Da Vinci 5 Robotic System.” Urology Times, 15 Apr. 2024,https://www.urologytimes.com/view/dr-shakuri-rad-discusses-the-da-vinci-5-robotic-system.

5.https://www.medtechdive.com/news/intuitive-da-vinci-5-robot-sages-conference/713937/

6.Robotic Operating Table – Surgical Innovation. https://www.hillrom.com/en/solutions/robotic-operating-table-surgical-innovation/. Accessed 21 June 2024.

7. https://www.intuitive.com/en-us/about-us/company. Accessed 18 June 2024.

*Image has a Creative Commons/Public License

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Kathleen LeFiles is a medical student from the Class of 2026 at The University of Arizona College of Medicine - Phoenix. She graduated in 2020 from The University of Arizona in Tucson with a degree in Physiology and a minor in Care, Health, and Society. When she's not studying or writing, Kathleen enjoys practicing Pilates and yoga, frequenting local coffee shops, and listening to pop music. Feel free to contact her @kathleenlefiles on Instagram or email at klefiles@arizona.edu.