title: Training in robotic surgery using the da Vinci® surgical system for left pneumonectomy and lymph node dissection in an animal model.
abstract: OBJECTIVE
  In Japan, as of March 2010, only 13 hospitals were using the da Vinci® system and only for selected cases. Few clinical robotic lung surgery has been done in Japan, and there are no standardized training programs, although some exist in the U.S. and are under consideration by the Japanese society for thoracic surgery. We have used the da Vinci S® Surgical System for pneumonectomy and lymph node dissection in pigs. We report and review future possibilities and problems of robotic surgery, especially concerning education, training, safety management and ethical considerations for pneumonectomy and lymph node dissection in clinical practice.
  
  
  METHODS
  The da Vinci® system consists of a surgeon's console connected to a patient-side cart, a manipulator unit with three instrument arms and a central arm to guide the endoscope. The surgeon, sitting at the console, triggers highly sensitive motion sensors that transmit the surgeon's movements to the instrument arm.
  
  
  RESULTS
  We experienced exactly the same sensation as when performing standard open thoracotomy. Visual recognition is 3-D, and the high manipulation potential allows free movement of the various accessory instruments, exceeding the capacity of a surgeon's hands in video-assisted thoracic surgery (VATS) or even standard thoracotomy.
  
  
  CONCLUSIONS
  Robotic surgery achieves at least the same level of operation technique for pneumonectomy and lymph node dissection under standard open thoracotomy, and it seemed as safe and easily performed as conventional VATS. The training program using pigs was effective and holds promise as a system to train thoracic surgeons in robotic lung surgery.
authors: Department of Thoracic Surgery, Tokyo Medical University, Tokyo, Japan.
authors: Naohiro
authors: N
authors: Kajiwara
authors: Masatoshi
authors: M
authors: Kakihana
authors: Jitsuo
authors: J
authors: Usuda
authors: Osamu
authors: O
authors: Uchida
authors: Tatsuo
authors: T
authors: Ohira
authors: Norihiko
authors: N
authors: Kawate
authors: Norihiko
authors: N
authors: Ikeda
mesh_terms: D000818:Animals; D002568:Certification; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D019723:Endoscopes; D004867:Equipment Design; D005240:Feasibility Studies; D006801:Humans; D008197:Lymph Node Excision / Q000193:education* / Q000295:instrumentation; D023421:Models, Animal; D009048:Motor Skills; D011013:Pneumonectomy / Q000193:education* / Q000295:instrumentation; D012371:Robotics / Q000193:education* / Q000295:instrumentation; D025321:Surgery, Computer-Assisted / Q000193:education* / Q000295:instrumentation; D013552:Swine; D020775:Thoracic Surgery, Video-Assisted / Q000193:education* / Q000295:instrumentation