- When I was growing up, I used to really like this cartoon called "Inspector Gadget."
And I think what spoke to me about that character was I wanted to be this half-machine, half-man.
Cyborg, if you will.
And nowadays, as a surgeon,
I get to kinda be that person.
There's lives at stake.
Any miscalculated movement, things can happen,
bad things can happen.
Anytime I operate robotically,
I feel like I'm so much more calm
and I have full control over the operation.
- Once you've taken these big, imprecise hands of ours,
and scaled them down and put them inside the patient,
we could suddenly achieve this level of precision
that simply isn't possible for the human body alone to do.
The thing is, that's taken tens of thousands of hours
of engineering and development,
and working through problems
to be able to get to this point.
- So, when I do open surgery,
a lot of the instruments that I use is something like this,
like a scalpel.
But when I do robotics,
the difference is I'm able to have the robotic arms
become an extension of me.
- So in order to translate the surgeon’s movements
of their hands into the patient,
first we start with the grips.
There's sensors in those grips,
which sense, obviously, how open and closed things are,
how much my wrist has moved,
how much have I moved in and out or left and right in space.
Once those sensors have captured
those vectors in 3D space,
that information is sent to the Vision Cart.
The Vision Cart then applies algorithms on top of that
to then translate those big, gross motions
of the surgeon's hands,
into microscopic motions inside the patient.
On the other side of the room,
those series of algorithms
control a series of motors and cables,
which in turn control the instrument tips
inside the patient.
The time in-between what's going on
here in the surgeon's hands,
and what's going on inside the patient is called ‘latency.’
And that latency needs to be measured in milliseconds
for things to be safe.
- So when I'm operating, I may see some tissue bleeding.
And if I don't react to that tissue bleeding
by stopping it somehow by grasping it and cauterizing it,
that could be a serious problem.
- Removing latency from the system
at the millisecond level is a constant battle.
So much work goes into making the software code
as efficient as possible.
We make sure that the translation of that signal
using fiber optic cables to be as fast as possible
from one component of the robotic system to another—
the more latency, the less safe this is.
So, just like you have two eyes in your head
and you need both of those to create depth perception,
we have two eyes on the endoscope inside the patient.
The key is to be able to fuse those two images
into something that your brain can process
as three-dimensional.
When your head is in the surgeon console
and you're fully immersed inside those images,
you are fully inside that patient.
- Doing an operation on Da Vinci is completely different
than doing an operation with laparoscopy,
because I was able to regain
that three-dimensional experience
and move around structures and see exactly
how that structure would look in the real world,
as opposed to a two-dimensional screen.
Lots of things can mess up your visualization.
Yes, the organs are roughly placed in the same spot,
but everyone, just like on the outside,
is shaped a little bit differently on the inside.
- Firefly's a specialized imaging system,
which enables that surgeon to be able to see things
that they can't see with the naked eye.
Firefly relies on shining a specific wavelength
inside the patient to excite a molecule, called ICG
or Indocyanine green.
It's something that's injected into the patient
either before their surgery or during the surgery.
When Firefly mode is activated,
we shine a near-infrared light inside the patient.
And what happens then is that the ICG,
which has bound to the patient's blood,
it reflects back that light of that near-infrared wavelength.
It actually lights up green inside the patient
and very differentiates
where there's blood and where there isn't.
- It's like night vision for surgeons.
All the lights go dark,
and all I'm seeing is a big, green glow of tissue.
- I'm a patient; I've had a Da Vinci surgery.
My father was a patient; he had a Da Vinci surgery.
In my everyday, I'm charged up about what we're doing,
about building better products.
We're thinking about different types of robots,
different instruments to be able to do more jobs,
more efficiently or safer.
Ways to bring new vision technologies
to the surgeons so that they can see
yet more that the naked eye can't see.
Giving that surgeon more information
to do their job better.