TOTTORI UNIVERSITY HOSPITAL

Surgery without strain on the body.

During surgery the bigger the portion cut the more likely that pain and scars will remain, making it take longer to get back to the patient's normal pre-surgery life. In addition, important functionality can sometimes be lost during the cutting depending upon the affected area. For example, incision surgery for prostate cancer may involve such complications as urinary incontinence and ED (erectile dysfunction).
If only we could speed post surgery recovery by minimizing the burdens on the body and redue the risk of complications as much as possible without harming the body...
Now we can provide a surgical alternative that can be done with respect for the patient's Quality Of Life. This is what we refer to as "minimally invasive surgery".
The robot-assisted surgical system (DaVinci S) was first introduced in the Sanin region at this hospital in August 2010. This was followed by the establishment of the Minimally Invasive Surgery Center in Fubruary 2011 which works beyond the boundaries of established departments to make minimally invasive surgery a reality.

Initiatives of the Center for Minimally Invasive Surgery.

Crossing the boundaries of departments, this Center was established to provide a surgical approach to patients that is easy on the body while ensuring the safest advanced medical care. Our aim to provide the most advanced care in both the Sanin region and the nation.

da Vinci Surgery (Robot-assisted Surgery)

This is a surgery that uses a medical robot called “da Vinci S”. Endoscopic surgery makes it possible to greatly reduce the burdens on patients. In addition to the reduced burden of endoscopic surgery on the body, it has been developed to allow more advanced and complex surgeries.

Advantages of da Vinci Surgery

Compared to the monitor screen of standard endoscopic surgeries, the picture is shown with a three-dimensional perspective. In addition, the High Definition image can be enlarged up to 10 times.
Compared to the forceps used in endoscopic surgery, the movement of the robot arm is more flexible and can perform accurate detailed work equal to or better than that performed by hand.
Shaking is corrected by computer controls in order to make the surgery quicker and more accurate. This reduces operative time and the burden on the body and blood vessels.

da Vinci surgery combines…

How a da Vinci Surgery is performed

First open the smallest incision possible and insert surgical instruments

The surgeon performs the operation while looking at the 3D screen.

The movement of the surgeon's hands are linked to the robotic arm which performs the surgery. Surgical Assistant Robot “da Vinci S”

For Prostate Cancer Surgery

For those in need of surgery for prostate cancer, generally a radical prostatectomy is performed.

Other surgical options include Open Surgery, Endoscopic Surgery (Laparoscopic Surgery), and da Vinci Surgery (Robot-assisted Surgery).
Prostate is surrounded by the pubic bone and pelvis, and blood vessels and nerves are stuck throughout, however da Vinci surgery allows the surgery to be performed quickly and accurately with less burden on the patient.
In America, the leading country in the performance of robot-assisted surgery, approximately 90% of radical prostatectomies are performed via robot-assisted surgery. The number of patients selecting da Vinci surgery is increasing with13 surgeries performed in 2010 (after the introduction of the system in August), and 29 in 2011.

The Major Radical Prostatectomy Surgeries

Classification	Name	Burden on the body	Hospitalization Time	Major Complications	Insurance
General Surgery	Open Surgery	15cm lower abdominal incision	About 2 weeks	Urinary incontinence, ED (erectile dysfunction)	Covered
Minimally Invasive Surgery (body-friendly)	Endoscopic surgery (laparoscopic surgery)	Five 5-20mm holes are opened in the abdomen	About 1-2 weeks	Urinary incontinence, ED (erectile dysfunction)	Covered
	da Vinci Surgery (robot-assisted surgery)	6 5-30mm holes are opened in the abdomen	About 1-2 weeks	Less risk of complications, early recovery	Not Covered Prostatectomy (prostate cancer) covered since April 2012.

da Vinci Surgery at this hospital

Listed below, a total of 90 surgeries have been successfully performed using da Vinci surgery.

• Gastroenterological Surgery ... Pyloric-side Resection (Gastric Surgery)
• Urology ... Radical Prostatectomy (Prostate Cancer Surgery) / Partial Nephrectomy (Kidney Cancer Surgery)
• Women’s Medicine ... Hysterectomy (Uterine Myoma, Uterine Adenomyosis)
• Thoracic Surgery ... Thymectomy (Myasthenia Gravis Surgery) / Lobectomy (Lung Carcinoma Surgery)

(October 2010 – December 2011)

Our hospital has been on the vanguard of robot-assisted surgery in Japan, and were the first in the country to successfully conduct a thymectomy in patients with a myasthenia gravis complication of thymoma using the da Vinci S. The increase in surgical choices will be very beneficial to our patients. Our mission is to pave the way for the future of health care from here in Tottori.

Head of Urology Atsushi Takenaka Our hospital has been the vanguard of domestic robot-assisted surgery, and were the first domestic institution to use the da Vinci S to successfully conduct a thymectomy for patients with myathenia gravis with complicated by thymoma. While both the effects of treatment and the patient’s quality of life are essential, da Vinci surgery is intended to make both possible. We offer the latest technology using exchanges with overseas institutions. In addition, robot-assisted radical prostatectomy became a insured medically across the board from April 2012. For more information (see the Urology page)

“Robotic Surgery Manual” Published

The Tottori University Hospital Center for Minimally Invasive Surgery conducted the writing, editing and supervision for the "Robotic Surgery Manual" as published by Medical View Co., Ltd. on April 10th, 2012.
This book is now widely considered the must-have manual for introduction to robotic surgery from the basic operation of robotic surgery equipment to the actual robotic surgery with the help of the staff involved including surgeons, anesthesiologists, nurses, ME technicians and staff within the Minimally Invasive Surgery Center.