The future of robotic surgery — Insights from Intuitive's Chief Digital Officer about the new da Vinci 5

At Becker's 14th Annual Meeting in April, Intuitive launched the da Vinci 5, the company's most advanced and integrated robotic surgery system. 

To learn more about the da Vinci 5's key features and advantages, Becker's Hospital Review spoke with Brian E. Miller, PhD, Intuitive's executive vice president and chief digital officer. Dr. Miller has worked at Intuitive in robotic surgery for 24 years.

Note: Responses have been edited for length and clarity.

Question: What is Intuitive’s approach to developing new systems and tools? 

Brian Miller: We spend time in the hospital environment, understanding the challenges and opportunities to enhance what doctors and hospitals are trying to accomplish. We spent a lot of time in operating rooms. 

We are constantly looking at what our systems can improve in the OR. We bring in surgeons and care teams early on. We say, "Here are some thoughts and ideas and concepts. How do you think about it?" Then, we iterate quickly. Finally, at some point you've got to go through a cycle of prototyping. Prototyping involves focused engineering, development and various evaluations. There's a regulatory process, a final set of testing, risk analysis, and more. 

Q: What is most exciting about the new da Vinci 5?

BM: Intuitive has had a series of platforms, but this is our first multiport system since the Xi system launched in 2014. Da Vinci 5 has technologies we've invested in and worked on for more than a decade.

One of the most exciting aspects of the da Vinci 5 design is the emphasis on delivering better outcomes by enhancing a surgeon’s senses. What I mean by that is our focus is on a enhancing a surgeon’s vision, precision, and comfort while operating. This platform has first-of-its-kind technology that allows surgeons to feel the push and pull forces exerted on a patient’s tissue in real time. We call that Force Feedback, and our early testing found that surgeons of varying experience levels operated more gently when Force Feedback was used (up to 43% less force on tissue). Da Vinci 5 is the most precise system we've ever built for tracking surgeon motions and for dampening vibrations and tremors. It sets a new bar for da Vinci vision systems, providing the most realistic 3D image with better color and resolution. 

Looking beyond the surgeon experience, da Vinci 5 was also designed to improve operational efficiency and provide actionable insights to hospitals, surgeons, and care teams. da Vinci 5 has a universal user interface that may streamline workflows, provide greater autonomy to surgeons while operating, and reduce procedure time.  This system has 10,000 times the computing power that the da Vinci Xi. The data generated provides more actionable insights to understand surgical performance and power AI and machine learning.

Q: My understanding is the da Vinci 5 includes an ecosystem of tools. Can you describe some of these tools?

BM: With da Vinci 5, our goal is to provide all components needed for surgery, interconnected for a streamlined workflow. For example, this system includes an insufflation, smoke evacuation, a handheld camera, and a 4k monitor. By integrating these components, the da Vinci 5 knows what each system component and the surgeon are doing throughout a procedure, which makes it possible for the system to deliver objective insights that surgeons and educators can use to evaluate cases and focus training efforts.

Our systems and the things required during surgery comprise just one aspect of the Intuitive ecosystem. Other aspects are around our analytics and data products. For many years, we've helped hospitals understand how they're performing clinically, operationally and financially. We have data products and services that can be used to help improve performance. These data tools, for example, enable hospitals to analyze what happened during a procedure and use that information to customize a learning pathway for a surgeon. We are looking to bring these types of insights into the operating room. If you can compute in real time, you can present the surgeon with advice or information to enhance clinical decision-making. That's where things are headed. 

Q: The da Vinci 5 is new, but are there some early reactions you can share?

BM: Fourteen sites had early access to the da Vinci 5. Feedback among these early users has been very positive. Administrators and executives have been enthusiastic about the streamlined infrastructure and the potential to reduce redundant capital equipment in the OR. Care teams have praised the system’s ease of use. Feedback from surgeons has emphasized the value of the increased autonomy, improved vision, and integration of automatic smoke evacuation. We’ve seen reduced procedure times in many of the initial cases performed compared to Xi, and we are excited to quantify the clinical, economic, and operational benefits as more procedures are completed. 

Learn more about the da Vinci 5 

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