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jlesnick t1_iz08v05 wrote

I’m glad if this helps with esophageal cancers. It’s my understanding that they have to really tear up your throat and associated anatomies to treat those cancers. It would be so amazing for patient quality of life if these cancers could be treated with out as much collateral damage

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Blacklight_sunflare t1_iz0fm15 wrote

Robotic esophageal surgery is already pretty common using the Da Vinci platform. Not sure if this is a new surgical approach or just using a new robot to do the same procedure

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WilliamMurderfacex3 t1_iz0lcod wrote

It looks like a new robot doing the same thing. The article doesn't have a ton of detail.

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kobylaz t1_iz0w83j wrote

Versius is getting peddled pretty hard but it is doing the same surgery just with a different ‘robot’. Its probably the closest competitor to Intuitives machines but they also probably have an unassailable market share till peoples machines come to the end of their working life.

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lofixlover t1_iz126yo wrote

from the images, I wonder if versius is meant to be a single-arm robot versus the multi-arm-options of davinci? like, smaller and more affordable?

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awardwinningbanana t1_iz17nt5 wrote

I've had a play with Versius- the arms are separate units which means you can use as many or as few as you want, and you can share them between operating theatres if e.g. your hospital has two 'brain' units. It also means you can get rid of one arm without having to move the whole robot. I haven't played with the DaVinci, but found the Versius very intuitive.

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Jai_Cee t1_iz21r41 wrote

It is a modular unit. You have the endoscope (camera) plus as many arms as you need which is typically two or three. It is smaller and portable so you can move it easily between theatres or even different hospitals.

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Jai_Cee t1_iz21g61 wrote

New robot. Presumably a Da Vinci could do the same procedure the article isn't clear. There are a lot of hospitals Da Vinci wouldn't be suitable for though as you essentially need to build an operating theatre around one.

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borkborkington t1_iz2c8ss wrote

You don’t actually have to build the OR around the Davinci however. The consoles and robot itself are all able to be worked out of the room and stored elsewhere if needed. And it fits through normal OR doors that would also fit a regular bed.

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slimboc t1_iz2tdos wrote

I designed a new DaVinci OR in an existing hospital this year. FGI has minimum guidelines for the room, the issue becomes robot positioning and use for staff. Trip hazards for the circulating and patient nurse are a major concern from the wires from the patient cart, vision cart, and surgeon console. You’re able to better contain them with overhead boom coordination that gets them off the floor. There’s also concerns about the robot approach to the patient because the operating table’s head isn’t going to do a 180 if you have a floor fed anesthesia machine / medgas. You have to plan for the robot to have good positioning at both sides. Other concerns were MEP related to make sure the robot would perform correctly in the room / not hit the overhead boom system when fully deployed.

What I’d personally be interested in is how easy it is to clean the new robot’s arms. Current DaVinci’s take a long time to be sterilized compared to conventional instruments. If the new robot can be sterilized quicker it would allow for more either more cases to be preformed or allow your sterile processing department to have some breathing room in their workflow.

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Jai_Cee t1_iz3m7mb wrote

Versius arms are draped. Obviously the instruments need to be sterilised but you have multiple sets of them since they are consumables.

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slimboc t1_iz3nkfs wrote

That’s a great move and exciting to hear. DaVinci arms take so much more to process in SPD since you can’t cram multiple arms into a sink basin or ultrasonics due to their size.

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nyqs81 t1_iz2m5dw wrote

As an OR nurse you can absolutely move a DaVinci from room to room.

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Jazzy_bear04 t1_iz0mh0j wrote

yeah my grandma was diagnosed a year ago and the treatment is genuinely awful. I can’t remember exactly why but due to her treatment she can no longer produce saliva, meaning she will most likely never be able to eat dry foods again, as well as having a bunch of other issues now. It’s always so uplifting seeing advancements to really help patients :)

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AndIHaveMilesToGo t1_iz0wc9y wrote

My understanding is (and I could be totally wrong so anyone else feel free to correct me) is that radiation treatment targeted at the throat often times kills the salivary glands

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[deleted] t1_iz1ctoy wrote

[deleted]

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47q8AmLjRGfn t1_iz1zfzo wrote

I am facing this surgery plus fu stomach renoval. Having spoken to others who have gone through it many are doing well, some return to an active lifestyle including Jujitsu...of course I am only speaking to the ones who survived.

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gloomdweller t1_iz21ysg wrote

Make sure your surgeon is doing a lot of pre-surgery teaching. Ours are bad about it and patients often come out of surgery saying “what do you mean I can’t eat or drink” or “I didn’t realize this was such a big surgery.”

Make sure you’re working hard every day even when it feels hard. Too many patients that I see do poorly want to lay in bed and do nothing, get pneumonia and that’s what sends them to the ICU. Make sure you’re getting out of bed to a chair, walking in the hall as soon as you can, make sure you do your incentive spirometer and coughing hard even when it hurts. The patients I see do well are the ones who do all of that and have strong family support. Sadly, nursing and therapists are kept too busy in modern healthcare to push patients and support them as much as they need so if you can have a family member to help you during your recovery that would be a huge asset. I’m not saying anything in the previous comment to be negative, I see a disproportionate amount of cases that go poorly and don’t remember the cases that go well because they’re gone quick and don’t come back.

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47q8AmLjRGfn t1_izfogzx wrote

Great advice. Comments from the medical side tend to be casual during a conversation and it's not stressed enough how important it is to keep moving.

Thankfully, there are some great support websites like smartpatients where others do stress the importance in their experience. I do know they get you out of bed as soon as possible to get moving, whilst plugged into all the machines in ICU.

The info coming from the hospital is not complete. I'm on the third FLOT session tomorrow and I've only just found out that regardless of how much the tumour shrinks they still remove the tissue which was affected and shown in pre chemo pet scans / laprascopy etc. I've spent a long time trying to find extra treatment which will further shrink the tumour with the attitude to minimise surgery. A patient I'm talking to online has finished her FLOT , CT shows no tumour and she was excited to think that means minimal surgery.

Appreciate the advice, thank you.

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RuhrowSpaghettio t1_iz25htv wrote

We still do the Ivor Lewis when we use the Da Vinci…similar complications with it.

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UggWantFire t1_iz27ud7 wrote

My dad died from this in January this year. The side effects of the treatment left him largely unable to eat, he lost a lot of weight and then didn’t survive follow on surgeries.

I wouldn’t wish what he went through in anyone.

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Fresh-Ad4987 t1_iz21o49 wrote

Definitely. My cardiothoracic surgeon was worried my cancer had spread to my esophagus, in which case her thought was that she wouldn’t be able to treat it surgically but using radiation only.

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