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Tracking the Rise of Robotic Surgery for Prostate Cancer …

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Drs. Peter Pinto and Gennady Bratslavsky of NCI’s Urologic Oncology Branch prep a prostatectomy patient for surgery with the da Vinci Surgical System. (Photo by Bill Branson, NIH)

In the years since the Food and Drug Administration (FDA) approved the first robotic surgical system for conducting abdominal and pelvic surgeries, its use has skyrocketed. The da Vinci Surgical System is now used to perform as many as 4 out of 5 radical prostatectomies in the United States. The robotic system is also increasingly being used to treat other cancers, including gynecologic and head and neck cancers. According to da Vinci’s manufacturer, Intuitive Surgical, Inc., more than 1,000 of the robotic systems are in hospitals across the country.

Several studies suggest that the ascendance of robotic prostatectomy has had numerous consequences, including a mass migration of prostate cancer patients to hospitals with robotic systems and an overall increase in the number of prostatectomies performed each year. The latter trend has raised some concern because it coincides with a period during which prostate cancer incidence has declined slightly.

How robotic prostatectomy proliferated so quickly, and what it means for patients and the health care system, is still a matter of study and debate. But the shift appears to have altered the surgical treatment of prostate cancer permanently, observed urologic surgeon Dr. Hugh Lavery of the Mount Sinai Medical Center in New York.

“I think that traditional open and laparoscopic prostatectomies have faded,” Dr. Lavery said. The available data indicate that patients and surgeons “are pushing for the robots,” he added, “and they’re getting them.”

Type “robotic surgery prostate cancer” into an Internet search engine, and the results will typically include glowing testimonials from patients who were treated with robotic surgery and videos of da Vinci’s surgical instruments roaming about the peritoneal cavity suturing, cutting through tissue, removing fat. In these videos, the surgeon is on the other side of the room, head buried in a console, and hands at the robot’s controls, maneuvering the instruments with the aid of a camera that offers a crisp, 3-dimensional image of the surgical field.

Dr. Peter Pinto sits at the da Vinci robot console to perform minimally invasive prostate surgery. (Photo by Bill Branson, NIH)

The Internet videos are just one component of the extensive marketing campaign behind da Vinci by individual hospitals and the system’s manufacturer. A study of 400 hospital websites, published online in May 2011, found that 37 percent of the sites featured robotic surgery on the homepage, 61 percent used stock text provided by the robot’s manufacturer, and nearly one in three sites had claims that robotic procedures led to improved cancer control.

“The tendency is to associate better technology with better care,” explained the study’s lead investigator, Dr. Marty Makary of the Johns Hopkins University School of Medicine.

Dr. Makary said he performs most operations, including complex pancreas surgery, laparoscopically because he believes the robot does not offer sufficient tactile feedback and takes more operative time. Traditional laparoscopy, however, is now rarely used for prostatectomies because the procedure is considered technically demanding, according to several researchers. One estimate put the number of laparoscopic prostatectomies each year in the United States at less than 1 percent of the total.

Patients often arrive for an office visit knowing that they want a prostatectomy performed with the robot, said Dr. William Lowrance, a urologic oncologist at the Huntsman Cancer Institute at the University of Utah. “It may be based on something they saw on the Internet or because of a friend or relative who had a good experience” with robotic surgery, he explained. Approximately 70 percent of the prostatectomies he performs are done with da Vinci.

Patient-to-patient referrals and the fact that the robotic procedure is minimally invasive have been two key drivers of the robot’s popularity, said Dr. Ash Tewari, director of the Prostate Cancer Institute at New York-Presbyterian Hospital/Weill Cornell Medical Center, who performs nearly 600 robotic prostatectomies a year.

Several studies have documented that there can be a fairly steep learning curve before surgeons achieve proficiency with the robot. But according to Dr. Warner K. Huh, a gynecologic oncologist and surgeon at the University of Alabama Birmingham Comprehensive Cancer Center, the robot makes it easier to perform many minimally invasive procedures.

“For many surgeons, they feel they can do a minimally invasive procedure more effectively and safely robotically, and I think that’s a big reason that it’s taken off,” Dr. Huh said.

The growth of robotic surgery is more than just a marketing phenomenon, agreed Dr. Tewari. “It has been supported with a lot of good science,” he continued. “We want to make this field better and beyond the hype of robotics.”

Based on studies to date, there seems to be agreement that robotic surgery is comparable to traditional laparoscopic surgery in terms of blood loss and is superior to open surgery in terms of blood loss and length of hospital stay. Recovery time may also beshorter following robotic surgery than open surgery.

But for the big three outcomescancer control, urinary control, and sexual functionthere is still no clear answer as to whether one approach is superior to another, Dr. Lowrance noted.

A large, randomized clinical trial comparing any of the approaches seems out of the realm of possibility at this point. At Weill Cornell, Dr. Tewari has approval to conduct a trial comparing robotic prostatectomy with open surgery. But the trial never got off the ground because there are not enough patients willing to be randomly assigned to surgery without the robot, he said.

A randomized trial may not even be that informative. “Many open surgeons have excellent outcomes, which may be hard to improve upon,” said Dr. Lavery. “I think that if you have an expert surgeon doing either procedure, you’re likely to have an excellent outcome.”

The remarkably swift proliferation of the da Vinci system in surgery suites across the United States appears to have had population-wide effects. In a study Dr. Lavery presented at the American Urological Association annual meeting in March, he showed that, from 1997 to 2004, the number of prostatectomies performed in the United States was fairly stable, around 60,000 per year.

From 2005 to 2008, howeverwhat Dr. Lavery and his colleagues called the first true years of the “robotic era”the number of prostatectomies and robotic procedures spiked. The number of prostatectomies rose to roughly 88,000 in 2008, and the number of robotic procedures jumped from approximately 9,000 in 2004 to 58,000 in 2008.

The number of prostatectomies rose to roughly 88,000 in 2008, and the number of robotic procedures jumped from approximately 9,000 in 2004 to 58,000 in 2008.

Two other analyses that looked at smaller geographic regionsNew York, New Jersey, and Pennsylvania in one study and Wisconsin in the otheryielded similar results. But they also showed something else: Hospitals that acquired robots saw a significant increase in the number of radical prostatectomies they performed. At the same time, the number of procedures at hospitals that did not acquire a robot fell.

“The overall result has been a sudden, population-wide, technology-driven centralization of procedures that is without precedent,” wrote Dr. Karyn Stitzenberg of the University of North Carolina Division of Surgical Oncology and her colleagues, who conducted the study in New York, New Jersey, and Pennsylvania.

Whether the rise in the number of procedures has meant that patients who might have been strong candidates for a different treatment, including active surveillance, instead opted for surgery is “speculative,” Dr. Lowrance said.

“My own feeling is that radical prostatectomy rates in general have probably peaked and are on their way down,” he said, in part because of the increased emphasis on active surveillance in men with localized, low-risk prostate cancer.

Another uncertain aspect centers on whether there has been any economic fallout from the increased use of this fairly expensive technology. Hospitals are not paid more for procedures using the robot, despite the fact that its use carries significant extra costs.

The robot itself runs anywhere from $1.2 million to $1.7 million (and many hospitals have several), a required annual maintenance contract is approximately $150,000, and about $2,000 in disposable equipment is required each time the robot is used. Studies have suggested that using the robot may add as much as $4,800 to the cost of each surgery.

Shorter hospital stays and less need for blood transfusions may offset some of these costs, however. In fact, data from a study that Dr. Lowrance and his colleagues have in press indicate that, after adjusting for various factors and excluding the fixed cost of the robot, the cost of robotic prostatectomy and the medical care needed for the ensuing year is comparable to the cost of open surgery and the ensuing year of care in a group of Medicare patients.

Although no other surgical robots have been approved by the FDA, at least two companies are developing similar robotic systems that could, eventually, compete with da Vinci, Dr. Lavery noted, which could reduce costs further.

The dramatic centralization of robotic prostatectomy procedures could be a double-edged sword, Dr. Stitzenberg and her colleagues concluded. A multitude of studies have demonstrated that higher volume is linked to better outcomes, suggesting that having fewer centers performing prostatectomies could improve the overall quality of care. But centralization also raises the specter that access to care could be impaired, particularly in rural areas where market forces could limit the availability of surgeons who can perform the procedure.

The rapid growth of robotic prostatectomy is a proxy for the larger debate about the role of technology in medicine, Dr. Lowrance believes. For example, intensity-modulated radiation therapy and proton-beam therapywhich cost tens of thousands of dollars more than robotic surgeryare also gaining popularity as treatments for localized prostate cancer, even though neither has been shown to produce better outcomes than standard radiation therapy.

“The big question is: How do we balance the uptake of new technology and its cost with the additional [clinical] value it may provide?” he continued. “It’s hard to do those types of studies, but we have to continue to ask whether [a new technology] is always worthwhile.”

The meteoric growth of robotic surgery to treat prostate cancer over the past decade has been mirrored by a similar growth in the treatment of gynecologic cancers, such as cervical and endometrial cancer. (Robotic surgery for gynecologic cancers typically involve a hysterectomy, which may be accompanied by lymph node dissection.)

Minimally invasive surgery with traditional laparoscopy has been a common treatment for gynecologic cancers for two decades, said Dr. Warner Huh of the University of Alabama Birmingham Comprehensive Cancer Center. But many surgeons have switched to the robotic procedure. In particular, the robotic procedure has given surgeons an important new option for treating obese women, Dr. Huh said. Traditional laparoscopy often cannot be performed on obese women, so before robotic surgery these patients typically had to have open surgery.

“An open surgery in these patients is extremely difficult to do,” he said. “Some of these women had horrific complications related to their incision.”

Obesity rates in Alabama are among the highest in the nation, so robotic surgery has provided an important new clinical option for many women in the state. The average hospital stay following open surgery in obese patients was 4 to 5 days, he said. Now, with the robotic procedure, the average stay is often 24 hours or less. Complication rates have dropped from anywhere between 5 to 10 percent with open surgery to 1 to 2 percent with robotic surgery.

“It’s completely changed how we manage these diseases in morbidly obese women,” Dr. Huh said.

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Robotic Surgery: The da Vinci Surgical System

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Robotic Surgery Institute

The da VinciTM Surgical System

The da VinciTM Surgical System consists of a surgeon’s console, a patient-side cart, a high performance vision system and proprietary instruments from Intuitive Surgical, Inc.

Using the da VinciTM Surgical System, the surgeon operates while seated comfortably at a console viewing a 3-D image of the surgical field. The surgeon’s fingers grasp the instrument controls below the display with wrists naturally positioned relative to his or her eyes. The da VinciTM Surgical System’s technology seamlessly translates the surgeon’s movements into precise, real-time movements of surgical instruments inside the patient.

The da VinciTM Surgical System is the only commercially available technology that can provide the surgeon with the intuitive control, range of motion, fine tissue manipulation capability and 3-D visualization characteristic of open surgery, while simultaneously allowing the surgeon to work through small ports of minimally invasive surgery.

The da VinciTM Surgical System has the potential to change surgical procedures in three basic ways:

More information can be found at Intuitive Surgical’s web site.

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Robotic Surgery – Ohio State University Wexner Medical Center

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Robotic surgery allows for incredible precision, while reducing blood loss, pain and recovery time.

Ohio State has always been at the forefront of pioneering new ways to perform traditional surgeries in less invasive ways using robotic technology. With surgeries offered at both The Ohio State University Wexner Medical Center and the OSUCCC – James, the Center for Advanced Robotic Surgery is a unique program that combines:

Robotic surgery is an advanced method of surgery using leading-edge technology called theda Vincisystem to perform minimally invasive procedures. The robot is a sophisticated medical device that allows surgeons to operate through tiny incisions using enhanced imagery and precise movements.

Robotic surgery allows for incredible precision and has the potential to provide benefits to the patient:

Schedule an appointment

1-800-293-5123

Search for active research studies for robotic surgery.

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Equipped with unparalleled robotic expertise and advanced technology, our Center is the most comprehensive robotics program in the country.

Advancing the future of robotic surgery by researching ways to improve current techniques and developing new robotic procedures

Among the goals of our multispecialty robotics program is training the next generation of surgeons.

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Robotic surgery | North Shore-LIJ Health System

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Robot-Assisted Surgery: da Vinci – Brown University

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Introduction:

With already over 210 devices in use throughout the United States, Europe, and Japan, Intuitive Surgical is the leading company in the field of digital surgery with its da Vinci? Surgical System. Approved in July 2000 to perform advanced surgical techniques such as cutting and suturing, this system is the first operative surgical robotic system to be cleared by the FDA, giving it a first-mover advantage over its competitors. Though Intuitive Surgical has had to overcome many obstacles in order to dominate the digital surgery field, it is now a multimillion-dollar business that continues to grow1.

System Overview

*

Making a one-centimeter keyhole incision to perform the operation, the surgeon is able to engage in minimally invasive surgery through this system. According to Ben Gong, Intuitive Surgical’s vice president of finance, da Vinci reduces the average 2-3% infection probability to nearly zero2. There are four main components to da Vinci: the surgeon console, patient-side cart, EndoWrist Instruments, and Insite Vision System with high resolution 3D Endoscope and Image Processing Equipment.

1. Surgeon Console

The surgeon is situated at this console several feet away from the patient operating table. The surgeon has his head tilted forward and his hands inside the systems master interface. The surgeon sits viewing a magnified three- dimensional image of the surgical field with a real-time progression of the instruments as he operates. The instrument controls enable the surgeon to move within a one cubic foot area of workspace.

2. Patient-side Cart

This component of the system contains the robotic arms that directly contact the patient. It consists of two or three instrument arms and one endoscope arm. The feedback as of today is limited to sensing tool-on-tool collision, so the surgeon needs to rely almost solely on the visual field when suturing or contacting soft tissue. As of 2003, Intuitive launched a fourth arm, costing $175,000, as a part of a new system installation or as an upgrade to an existing unit2. It provides the advantages of being able to manipulate another instrument for complex procedures and removes the need for one operating room nurse3.

3. Detachable Instruments (Endowrist Instruments and Intuitive Masters)

The Endowrist detachable instruments allow the robotic arms to maneuver in ways that simulate fine human movements. Each instrument has its own function from suturing to clamping, and is switched from one to the other using quick-release levers on each robotic arm. The device memorizes the position of the robotic arm before the instrument is replaced so that the second one can be reset to the exact same position as the first. The instruments abilities to rotate in full circles provide an advantage over non-robotic arms. The seven degrees of freedom (meaning the number of independent movements the robot can perform) offers considerable choice in rotation and pivoting4. Moreover, the surgeon is also able to control the amount of force applied, which varies from a fraction of an ounce to several pounds. The Intuitive Masters technology also has the ability to filter out hand tremors and scale movements. As a result, the surgeons large hand movements can be translated into smaller ones by the robotic device5. Carbon dioxide is usually pumped into the body cavity to make more room for the robotic arms to maneuver.

4. 3-D Vision System (Insite Vision and Navigator Camera Control)

The camera unit or endoscope arm provides enhanced three-dimensional images. This high-resolution real-time magnification showing the inside the patient allows the surgeon to have a considerable advantage over regular surgery. The system provides over a thousand frames of the instrument position per second and filters each image through a video processor that eliminates background noise. The endoscope is programmed to regulate the temperature of the endoscope tip automatically to prevent fogging during the operation3. Unlike The Navigator Control, it also enables the surgeon to quickly switch views through the use of a simple foot pedal.

Competitors:

Just a few years ago, Intuitive Surgical was in the midst of a fierce legal battle with its competitor, Computer Motion. The series of events was offset by a lawsuit filed by Computer Motion for nine patent infringements. Intuitive Surgical then filed three lawsuits of its own and made a final blow by teaming with IBM to sue its competitor for infringing on its voice-recognition technology. Computer Motion lost the case for this integral component of all its devices including Zeus, its version of da Vinci. It faced a major problem since it would have to stop selling in the event that it could not receive a proper license from its competitor. On March 7, 2003, Intuitive Surgical merged with its main competitor6, ending a four-year legal power struggle that detracted from product advancement and funds7. Intuitive Surgical paid $150 million for Computer Motions and laid off around 90% of its employees following the merger2. Intuitive now owns and will market Computer Motion’s products (Zeus Surgical System, Hermes Control Center, Aesop Robotic Endoscope Positioner, and Socrates Telecollaboration System)8.

Market Information of the Robot Surgical Systems

Advantages and Disadvantages:

The da Vinci Surgical System reduces hospital stays by about half, reducing hospital cost by about 33%9. These fewer days in the intensive care unit are a result of less pain and quicker recovery. Though the size of the device is still not small enough for heart procedures in children, the minimally invasive nature of da Vinci does not leave a large surgical scar and still has some limited applications in children for the time being. Moreover, according to Intuitive Surgical, only 80,000 out of 230,000 new cases of prostate cancer undergo surgery because of the high risk invasive surgery carries, implying that more people may undergo surgery with this evolving technology2. The main drawbacks to this technology are the steep learning curve and high cost of the device. Though Intuitive Surgical does provide a training program, it took surgeons about 12-18 patients before they felt comfortable performing the procedure10. One of the greatest challenges facing surgeons who were training on this device was that they felt hindered by the loss of tactile, or haptic, sensation (ability to feel the tissue). The large floor-mounted patient-side cart limits the assistant surgeons access to the patient. However, there are also many who are unable to access the da Vinci based on the steep price. In a paper published by The American Journal of Surgery, 75% of surgeons claimed that they felt financially limited by any system that cost more than $500,00011. As of now, surgery with the da Vinci Surgical System takes 40-50 minutes longer, but the FDA considered this a learning curve variable and expects time to improve with more use of the system12.

Estimate of Initial Investment and Cost Savings per Heart-Valve Surgery for da Vinci Market Price

Costs

Though Intuitive Surgical has faced some setbacks during its legal battles with Computer Motion, it has recovered quickly and has been growing at an unprecedented rate since the merger. The total sale for the first year of 2004 was $138.8 million (a 51% increase from the previous year) with a total of $60 million in revenue. This includes recurring revenue from instruments, disposable accessories, and services, which have also increased accordingly in response to the larger number of systems installed and greater usage in hospitals. In 2004 alone, 76 da Vinci Systems, each costing about $1.5 million, were sold13.

Reimbursement:

Medical reimbursement by insurance companies is specific to each respective company. However, Medicare reimbursement is available for laparoscopic and thoracoscopic procedures since the da Vinci Surgical System has been FDA approved for commercial distribution in the United States14.

FDA Approval:

Fail Safe Mechanisms

Safety concerns remain the center of focus for Intuitive Surgical. To start the procedure, the surgeons head must be placed in the viewer. Otherwise, the system will lock and remain motionless until it detects the presence of the surgeons head once again. During the procedure, a zero-point movement system prevents the robotic arms from pivoting above or at the one-inch entry incision, which could otherwise be unintentionally torn. Included in the power source is a backup battery that allows the system to run for twenty minutes, giving the hospital enough time to reestablish power. Each instrument contains a chip that prevents the use of any instrument other than those made by Intuitive Surgical. These chips also store information about each instrument for more precise control and keep track of instrument usage to determine when it must be replaced.

Future Outlook

Besides the cost, the da Vinci Surgical System still has many obstacles that it must overcome before it can be fully integrated into the existing healthcare system. From the lack of tactile feedback to the large size, the current da Vinci Surgical System is merely a rough preview of what is to come. Spending around $16.2 million in 2003 alone, Intuitive Surgical has a first-mover advantage over its competitors and continues to lead on as it receives more and more FDA approvals. More improvements in size, tactile sensation, cost, and telesurgery are expected for the future15.

* = All pictures taken from http://www.intuitivesurgical.com

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How Robotic Surgery Will Work – HowStuffWorks

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Just as computers revolutionized the latter half of the 20th century, the field of robotics has the potential to equally alter how we live in the 21st century. We’ve already seen how robots have changed the manufacturing of cars and other consumer goods by streamlining and speeding up the assembly line. We even have robotic lawn mowers and robotic pets. And robots have enabled us to see places that humans are not yet able to visit, such as other planets and the depths of the ocean.

In the coming decades, we may see robots that have artificial intelligence. Some, like Honda’s ASIMO robot, will resemble the human form. They may eventually become self-aware and conscious, and be able to do anything that a human can. When we talk about robots doing the tasks of humans, we often talk about the future, but robotic surgery is already a reality. Doctors around the world are using sophisticated robots to perform surgical procedures on patients.

Not all surgical robots are equal. There are three different kinds of robotic surgery systems: supervisory-controlled systems, telesurgical systems and shared-control systems. The main difference between each system is how involved a human surgeon must be when performing a surgical procedure. On one end of the spectrum, robots perform surgical techniques without the direct intervention of a surgeon. On the other end, doctors perform surgery with the assistance of a robot, but the doctor is doing most of the work [source: Brown University].

While robotic surgery systems are still relatively uncommon, several hospitals around the world have bought robotic surgical systems. These systems have the potential to improve the safety and effectiveness of surgeries. But the systems also have some drawbacks. It’s still a relatively young science and it’s very expensive. Some hospitals may be holding back on adopting the technology.

Why would a hospital consider a robotic surgery system in the first place? Find out in the next section.

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da Vinci Prostatectomy

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Prostate cancer is a disease in which cancerous cells form in the tissues of the prostate. The prostate is a gland in the male reproductive system located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (tube that empties urine from the bladder). The prostate gland produces fluid that is one of the components of semen.

When prostate cancer is found early, there are typically many treatment and surgical options available to patients. That’s why it is important for men to get regular exams and talk to their doctors about any unusual symptoms.

When facing a diagnosis of prostate cancer, it is important to learn about all treatments and surgical options.

Serious complications may occur in any surgery, including da Vinci Surgery, up to and including death. Examples of serious or life-threatening complications, which may require prolonged and/or unexpected hospitalization and/or reoperation, include but are not limited to, one or more of the following: injury to tissues/organs, bleeding, infection and internal scarring that can cause long-lasting dysfunction/pain. Risks of surgery also include the potential for equipment failure and/or human error. Individual surgical results may vary.

Risks specific to minimally invasive surgery, including da Vinci Surgery, include but are not limited to, one or more of the following: temporary pain/nerve injury associated with positioning; temporary pain/discomfort from the use of air or gas in the procedure; a longer operation and time under anesthesia and conversion to another surgical technique. If your doctor needs to convert the surgery to another surgical technique, this could result in a longer operative time, additional time under anesthesia, additional or larger incisions and/or increased complications.

Patients who are not candidates for non-robotic minimally invasive surgery are also not candidates for da Vinci Surgery. Patients should talk to their doctor to decide if da Vinci Surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options in order to make an informed decision. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer to http://www.davincisurgery.com/safety and http://www.intuitivesurgical.com/safety. Unless otherwise noted, all people depicted are models.

2015 Intuitive Surgical. All rights reserved. All product names are trademarks or registered trademarks of their respective holders.

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Robotic Surgery Program | UC Health

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The UC Health Robotic Surgery Program offers a wide-range of procedures that combines more than 25 robotically-skilled surgeons working across eight different specialties, supported by multidisciplinary teams with specialists in each area. Our teams have expertise in 52 robotic procedures, including 15 cancer-related surgeries and several of the most complex types of cases within gynecology, urology and cardiology. Using the da Vinci Surgical System, or robot, enables surgeons to perform delicate and complex operations through a few tiny incisions with increased vision, precision, dexterity and control. The robot consists of several key components, including an ergonomically designed console where the surgeon sits while operating, a side cart where the patient lies during surgery, four interactive robotic arms, a high-definition 3D vision system, and proprietary EndoWrist instruments. da Vinci is powered by state-of-the-art robotic technology that allows the surgeons hand movements to be scaled, filtered and translated into precise movements of the EndoWrist instruments working inside the patients body.

Robotic surgery is the most advanced form of minimally invasive surgery available today and UC Health has one of the most advanced and comprehensive programs in the nation. Our expertise in cardiac, urologic and gynecologic robotic procedures is unsurpassed and we were the first in Ohio to perform gastric banding surgery using this technology. We are also one of the few programs in the area offering single site cholecystectomy. Robotic surgery is particularly effective over traditional surgery when performing more challenging procedures like radical hysterectomy or prostatectomy, but is currently FDA-approved for over 50 procedures in:

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Robotic Surgery | TriHealth

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Your 1 option in town for robotic mitral valve surgery.

Choose the doctor with the most expertise and the best outcomes.

Robotic surgery is an effective, minimally invasive alternative to both open surgery and laparoscopy. For patients, this means less scarring and a faster recovery time with fewer complications.

In Greater Cincinnati, no one performs more robotic surgeries than TriHealth, which has been a pioneer in the field since Good Samaritan Hospital introduced the da Vinci Surgical System to the area in 2003. In 2007, we expanded this expertise further into the region by adding robotic surgery at Bethesda North Hospital. And in 2011, Bethesda North introduced SpineAssist, which allows surgeons to perform minimally invasive spinal surgery.

In 2014, Good Samaritan became the first in the city to offer the Magellan Robotic System, which is used in the minimally-invasive treatment of a wide variety of vascular conditions.

Robotic surgery enables surgeons to be more precise, advancing their technique and enhancing their capability in performing complex minimally invasive surgery. The TriHealth roboticda Vinci Surgical System replicates the surgeons movements in real time and cannot function without the surgeons input.

2015 TriHealth | 619 Oak St., Cincinnati OH 45206 | Find a Doctor: 513 569 5400 | Information: 513 569 1900

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robotic prostate surgery – American Cancer Society

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Surgery is a common choice to try to cure prostate cancer if it is not thought to have spread outside the gland ( stage T1 or T2 cancers).

The main type of surgery for prostate cancer is known as a radical prostatectomy. In this operation, the surgeon removes the entire prostate gland plus some of the tissue around it, including the seminal vesicles. A radical prostatectomy can be done in different ways.

In the more traditional approach to doing a prostatectomy, the surgeon operates through a single long incision to remove the prostate and nearby tissues. This type of surgery, sometimes referred to as an open approach, is now being done less often than in the past.

For this operation, the surgeon makes a skin incision in your lower abdomen, from the belly button down to the pubic bone. You will either be under general anesthesia (asleep) or be given spinal or epidural anesthesia (numbing the lower half of the body) along with sedation during the surgery.

If there is a reasonable chance the cancer has spread to the lymph nodes (based on your PSA level, DRE, and biopsy results), the surgeon may remove lymph nodes from around the prostate at this time (known as a lymph node biopsy). The nodes are usually sent to the lab to see if they have cancer cells (which can take a few days to get results), but in some cases the nodes may be looked at right away. If this is done during the surgery and cancer cells are found in any of the nodes, the surgeon might not continue with the surgery. This is because it is unlikely that the cancer can be cured with surgery, and removing the prostate could still lead to serious side effects.

After the surgery, while you are still under anesthesia, a catheter (thin, flexible tube) will be put in your penis to help drain your bladder. The catheter usually stays in place for 1 to 2 weeks while you heal. You will be able to urinate on your own after the catheter is removed.

You will probably stay in the hospital for a few days after the surgery, and your activities will be limited for about 3 to 5 weeks. The possible side effects of prostatectomy are described below.

In this operation, the surgeon makes the incision in the skin between the anus and scrotum (the perineum), as shown in the picture above. This approach is used less often because its more likely to lead to erection problems and because the nearby lymph nodes cant be removed. But it is often a shorter operation and might be an option if you arent concerned about erections and you dont need lymph nodes removed. It also might be used if you have other medical conditions that make retropubic surgery difficult for you. It can be just as curative as the retropubic approach if done correctly. The perineal operation usually takes less time than the retropubic operation, and may result in less pain and an easier recovery afterward.

After the surgery, while you are still under anesthesia, a catheter will be put in your penis to help drain your bladder. The catheter usually stays in place for 1 to 2 weeks while you are healing. You will be able to urinate on your own after the catheter is removed.

You will probably stay in the hospital for a few days after the surgery, and your activities will be limited for about 3 to 5 weeks. The possible side effects of prostatectomy are described below.

Laparoscopic approaches use several smaller incisions and special surgical tools to remove the prostate. This can be done with the surgeon either holding the tools directly, or using a control panel to precisely move robotic arms that hold the tools.

For a laparoscopic radical prostatectomy (LRP), the surgeon makes several small incisions, through which special long instruments are inserted to remove the prostate. One of the instruments has a small video camera on the end, which lets the surgeon see inside the abdomen.

Laparoscopic prostatectomy has some advantages over the usual open radical prostatectomy, including less blood loss and pain, shorter hospital stays (usually no more than a day), and faster recovery times (although the catheter will need to remain in the bladder for about the same amount of time).

LRP has been used in the United States since 1999 and is done both in community and major medical centers. In experienced hands, LRP appears to be as good as open radical prostatectomy, although we do not yet have long-term results from procedures done in the United States.

The rates of major side effects from LRP, such as erection problems and trouble holding urine (incontinence) seem to be about the same as for open prostatectomy. (These side effects are described below.) Recovery of bladder control may be delayed slightly with this approach.

A newer approach is to do the laparoscopic surgery using a robotic interface (called the da Vinci system), which is known as robotic-assisted laparoscopic radical prostatectomy (RALRP). The surgeon sits at a panel near the operating table and controls robotic arms to do the operation through several small incisions in the patients abdomen.

Like direct LRP, RALRP has advantages over the open approach in terms of pain, blood loss, and recovery time. So far though, there seems to be little difference between robotic and direct LRP for the patient.

In terms of the side effects men are most concerned about, such as urinary or erection problems (described below), there does not seem to be a difference between robotic-assisted LRP and other approaches to prostatectomy.

For the surgeon, the robotic system may provide more maneuverability and more precision when moving the instruments than standard LRP. Still, the most important factor in the success of either type of LRP is the surgeons experience and skill.

If you are thinking about treatment with either type of LRP, its important to understand what is known and what is not yet known about this approach. Again, the most important factors are likely to be the skill and experience of your surgeon. If you decide that either type of LRP is the treatment for you, be sure to find a surgeon with a lot of experience.

There are possible risks and side effects with any type of surgery for prostate cancer.

The risks with any type of radical prostatectomy are much like those with any major surgery. Among the most serious, there is a small risk of heart attack, stroke, blood clots in the legs that could travel to your lungs, reactions to anesthesia, and infection at the incision site. Because there are many blood vessels near the prostate gland, another risk is bleeding during and after the surgery. You might need blood transfusions, which carry their own small risk.

Rarely, part of the intestine might be cut during surgery, which could lead to infections in the abdomen and might require more surgery to correct. Injuries to the intestines are more common with laparoscopic and robotic surgeries than with the open approach.

If lymph nodes are removed, a collection of lymph fluid (called a lymphocele) can form and may need to be drained.

In extremely rare cases, people die because of complications of this operation. Your risk depends, in part, on your overall health, your age, and the skill of your surgical team.

The major possible side effects of radical prostatectomy are urinary incontinence (being unable to control urine) and impotence (being unable to have erections). It should be noted that these side effects can also occur with other forms of treatment for prostate cancer, although they are described here in more detail.

Urinary incontinence: You may develop urinary incontinence, which means you cant control your urine or have leakage or dribbling. There are different levels of incontinence. Being incontinent can affect you not only physically but emotionally and socially as well. There are 3 major types of incontinence:

Rarely after surgery, men lose all ability to control their urine. This is called continuous incontinence.

After surgery for prostate cancer, normal bladder control usually returns within several weeks or months. This recovery usually occurs gradually, in stages.

Doctors cant predict for sure how any man will be affected after surgery. In general, older men tend to have more incontinence problems than younger men.

Most large cancer centers, where prostate surgery is done more often and surgeons have more experience, report fewer problems with incontinence.

Incontinence can be treated. Even if your incontinence cant be corrected completely, it can still be helped. You can learn how to manage and live with incontinence. See our document Managing Incontinence for Men With Cancer to learn more about this side effect and what can be done about it.

Impotence (erectile dysfunction): This means you cant get an erection sufficient for sexual penetration.

Erections are controlled by 2 tiny bundles of nerves that run on either side of the prostate. If you are able to have erections before surgery, the surgeon will try not to injure these nerves during the prostatectomy (known as a nerve-sparing approach). But if the cancer is growing into or very close to the nerves, the surgeon will need to remove them. If both nerves are removed, you wont be able to have spontaneous erections, but you might still be able to have erections using some of the aids described below. If the nerves on only one side are removed, you might still have erections, but the chance is lower than if neither were removed. If neither nerve bundle is removed you might have normal erections again at some point.

Other treatments (besides surgery) can also damage these nerves or the blood vessels that supply blood to the penis to cause an erection.

Your ability to have an erection after surgery depends on your age, your ability to get an erection before the operation, and whether the nerves were cut. All men can expect some decrease in the ability to have an erection, but the younger you are, the more likely it is that you will keep this ability.

A wide range of impotency rates have been reported in the medical literature, from as low as about 1 in 4 men under age 60 to as high as about 3 in 4 men over age 70. Surgeons who do many nerve-sparing radical prostatectomies tend to report lower impotence rates than doctors who do the surgery less often.

Each mans situation is different, so the best way to get an idea of your chances for recovering erections is to ask your doctor about his or her success rates and what the outcome is likely to be in your case.

If your ability to have erections does return after surgery, it often occurs slowly. In fact, it can take from a few months up to 2 years. During the first few months, you will probably not be able to have a spontaneous erection, so you may need to use medicines or other treatments.

If potency comes back after surgery, the sensation of orgasm should still be pleasurable, but there is no ejaculation of semen the orgasm is dry. This is because during the prostatectomy, the glands that made most of the fluid for semen (the seminal vesicles and prostate) were removed, and the pathways used by sperm (the vas deferens) were cut.

Most doctors feel that regaining potency is helped along by trying to get an erection as soon as possible once the body has had a chance to heal (usually several weeks after the operation). Some doctors call this penile rehabilitation. Medicines (see below) may be helpful at this time. Be sure to talk to your doctor about your situation.

Several options might help you if you have erectile dysfunction:

For more on coping with erection problems and other sexuality issues, see our document Sexuality for the Man With Cancer.

Changes in orgasm: In some men, orgasm becomes less intense or goes away completely. Less often, men report pain with orgasm.

Loss of fertility: Radical prostatectomy cuts the connection between the testicles (where sperm are made) and the urethra (through which sperm leave the body). Your testicles will still make sperm, but it cant get out as a part of the ejaculate. This means that a man can no longer father a child the natural way. Often, this is not an issue, as men with prostate cancer tend to be older. But if it is a concern for you, you might want to ask your doctor about banking your sperm before the operation. To learn more, see our document Fertility and Men With Cancer.

Lymphedema: A rare but possible complication of removing many of the lymph nodes around the prostate is a condition called lymphedema. Lymph nodes normally provide a way for fluid to return to the heart from all areas of the body. When nodes are removed, fluid can collect in the legs or genital region over time, causing swelling and pain. Lymphedema can usually be treated with physical therapy, although it may not go away completely. To learn more, see our document Understanding Lymphedema: For Cancers Other Than Breast Cancer.

Change in penis length: A possible effect of surgery is a small decrease in penis length. This is probably due to a shortening of the urethra when a portion of it is removed along with the prostate.

Inguinal hernia: A prostatectomy increases a mans chances of developing an inguinal (groin) hernia in the future.

This operation is more often used to treat men with non-cancerous enlargement of the prostate called benign prostatic hyperplasia (BPH). A TURP is not used to try to cure prostate cancer, but it is sometimes used in men with advanced prostate cancer to help relieve symptoms, such as urination problems.

During this operation, the surgeon removes the inner part of the prostate gland that surrounds the urethra (the tube through which urine exits the bladder). The skin is not cut with this surgery. An instrument called a resectoscope is passed through the tip of the penis into the urethra to the level of the prostate. Once it is in place, either electricity is passed through a wire to heat it or a laser is used to cut or vaporize the tissue. Spinal anesthesia (which numbs the lower half of your body) or general anesthesia (where you are asleep) is used.

The operation usually takes about an hour. After surgery, a catheter (thin, flexible tube) is inserted through the penis and into the bladder. It remains in place for about a day to help urine drain while the prostate heals. You can usually leave the hospital after 1 to 2 days and return to normal activities in 1 to 2 weeks.

You will probably have some blood in your urine after surgery. Other possible side effects from TURP include infection and any risks that come with the type of anesthesia that was used.

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Robotic Surgery Center | NYU Langone Medical Center

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Experts at NYU Langones Robotic Surgery Center are international leaders in using robotic technology for a wide range of advanced robotic-assisted procedures.

For more than a decade, our surgeons have been performing minimally invasive robotic surgery in multiple specialty areas, including cardiothoracic surgery, colorectal surgery, general surgery, gynecologic surgery, urologic surgery, and ear, nose, and throat surgery. A team of specialized physician assistants, nurses, surgical technicians, and anesthesiologists supports our surgeons during every procedure.

Our extensive experience and access to the most intelligent robotic technology available allows us to offer procedures for many complex conditions. We have the ability to operate with pinpoint accuracy, ensuring the best possible result for each patient.

The procedures we perform include:

Robotic surgery at NYU Langone is performed in dedicated operating rooms using one of our five state-of-the-art da Vinci surgical systems that include advanced infrared imaging and dual consoles on which surgeons can work collaboratively.

Currently, we perform more than 1,800 robotic-assisted surgeries each year. NYU Langone pioneered the development and refinement of many robotic surgery techniques and procedures, including the first robotic-assisted cardiac bypass surgery, partial kidney removal with enhanced imaging, and ureteral reconstruction using the inner lining of the cheek. We were also the first in New York City to use enhanced fluorescence imaging in cardiac, gynecologic, and general urologic robotic surgeries.

As leaders in robotic surgical techniques, we train surgeons from some of the most prestigious hospitals in the nation and from around the world in how to perform the latest robotic-assisted cardiac, thoracic, gynecologic, colorectal, and urologic robotic procedures. Last year alone, we welcomed more than 250 physicians from countries including England, Italy, Australia, France, Japan, Brazil, and South Korea, and our teaching programs have been recognized by Intuitive Surgical. Learn more about our research and educational programs.

To make an appointment or learn more about our services, call 877-ROBO-NYU (877-762-6698).

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Robotic Heart and Lung Surgery – University of Southern …

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Robotic Surgery

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With the introduction of groundbreaking robotic surgery, USC Surgery continues its tradition of visionary innovation. Our goal is to focus our clinical and research efforts on expanding the treatment alternatives for our patients. We want to give patients direct access to the latest treatment approaches, using innovation as a guide when conventional therapy is not an option.

The USC Robotic Surgery Institute is devoted to conducting clinical and bench research to advance the use of robotic techniques in the field of surgery, encompassing all surgical specialties that could benefit from robotic surgery such as general surgery, urology and orthopedics.

Benefits of Robotic Surgery

Through small punctures and tiny instruments involved in minimally invasive robotic surgery, patients experience shorter incisions. The robot can accomplish what the human surgeon cannot because of its ability to mimic the human hand within a small, contained space. The EndoWrist Instruments transform the surgeons wrists, hand and fingers into tiny instruments.

During the procedure, while the console surgeon operates the sophisticated robot from a distance, the bedside surgeon is responsible for placement of the correct surgical ports and directing the robot into the patient. And like other surgery, nurses and anesthesiologists play key roles during the procedure.

About the da Vinci Surgical System

The da Vinci Surgical System enables doctors to perform surgery in a manner never before experienced. With the surgeon sitting at a console a few feet from the patient, da Vinci translates that surgeons hand movements into corresponding micro-movements of instruments inside the patients body.

The da Vinci System provides better visualization, dexterity, precision and control than open surgery, while enabling the surgeon to perform procedures through tiny, 1-2 cm incisions.

3D HD Vision

The da Vinci System provides unparalleled vision inside the patients body with natural depth perception, and magnification for more accurate tissue identification.

Improved visualization allows surgeons to handle and dissect delicate tissue with added precision even in confined spaces like the chest, abdomen or pelvis. This precision allows the surgeon to minimize trauma to the surrounding anatomy, such as the neurovascular bundle near the prostate during prostate cancer surgery.

EndoWrist Instrumentation and Intuitive Motion

As surgeons operate in confined spaces of the body, da Vinci instruments provide a range-of-motion that enhances dexterity. Added dexterity enables surgeons to more accurately and easily perform complex surgical maneuvers through small “ports” – eliminating the need for large, traumatic incisions.

Superior Ergonomics

da Vinci is the only surgical system that allows doctors to operate while seated. da Vinci is not only more comfortable, but may also be clinicallyadvantageous due to reduced surgeon fatigue.

The design of the da Vinci System allows for natural hand-eye positioning at the surgeon’s console, which provides better ergonomics than traditional open and laparoscopic technology.

The da Vinci System’s robotic arms hold the camera and instruments steady. For the patient, that means less potential for torque and trauma to the body. For the surgeon, it can man less assistance needed and reduced fatigue.

Finally, with the robotic arms providing added mechanical strength, surgeons can now offer a minimally invasive approach to higher-BMI patients who are considered obese.

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Prostate Cancer Treatment – Da Vinci Robotic Surgery

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had few prostate surgery choices. Historically, the only prostate surgery option wasopen prostatectomy, involving large incisions and post-operative side effects. Using this procedure, the entire cancerous prostate was removed with risk of excessive blood loss, post-op infections, long hospital stays, and considerable pain. Following open prostatectomy, patient activity was limited and often resulted in a loss of bladder control and

due to severance of the delicate plexus of nerves around the prostate gland.

Over the last two decades there has been revolutionary improvement in medical surgical technology with great impact on prostate cancer treatment and prostatectomy. The most famous robotic prostatectomy available today involves the

, manufactured by Intuitive Surgical. Robotic prostatectomy is gaining popularity as a

. The da Vinci robotic prostatectomy enables surgeons to overcome many of the shortcomings of both open prostatectomy and laparoscopic prostatectomy.

Unlike laparoscopic surgery, da Vinci Surgical System instruments used in robotic prostatectomy can turn in all directions with 90 degrees of articulation and 7 degrees of freedom. During robotic prostate surgery the da Vinci robot provides the surgeon with improved visualization, dexterity, and precision compared with open or laparoscopic surgery, while enabling operation through 1-2 cm incisions. This allows Dr. Samadi to perform fine computer-controlled movements and a more precise and minimally invasive robotic prostatectomy. During this prostate cancer treatment, his patients’ delicate prostate nerves that controlbladder and sexual function. Robotic prostatectomy achieves the same or better prostate cancer treatment results than a surgeons own hands in open or laparoscopic surgery.

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nanotechnology – Science – HowStuffWorks

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The most immediate challenge in nanotechnology is that we need to learn more about materials and their properties at the nanoscale. Universities and corporations across the world are rigorously studying how atoms fit together to form larger structures. We’re still learning about how quantum mechanics impact substances at the nanoscale.

Because elements at the nanoscale behave differently than they do in their bulk form, there’s a concern that some nanoparticles could be toxic. Some doctors worry that the nanoparticles are so small, that they could easily cross the blood-brain barrier, a membrane that protects the brain from harmful chemicals in the bloodstream. If we plan on using nanoparticles to coat everything from our clothing to our highways, we need to be sure that they won’t poison us.

Closely related to the knowledge barrier is the technical barrier. In order for the incredible predictions regarding nanotechnology to come true, we have to find ways to mass produce nano-size products like transistors and nanowires. While we can use nanoparticles to build things like tennis rackets and make wrinkle-free fabrics, we can’t make really complex microprocessor chips with nanowires yet.

There are some hefty social concerns about nanotechnology too. Nanotechnology may also allow us to create more powerful weapons, both lethal and non-lethal. Some organizations are concerned that we’ll only get around to examining the ethical implications of nanotechnology in weaponry after these devices are built. They urge scientists and politicians to examine carefully all the possibilities of nanotechnology before designing increasingly powerful weapons.

If nanotechnology in medicine makes it possible for us to enhance ourselves physically, is that ethical? In theory, medical nanotechnology could make us smarter, stronger and give us other abilities ranging from rapid healing to night vision. Should we pursue such goals? Could we continue to call ourselves human, or would we become transhuman — the next step on man’s evolutionary path? Since almost every technology starts off as very expensive, would this mean we’d create two races of people — a wealthy race of modified humans and a poorer population of unaltered people? We don’t have answers to these questions, but several organizations are urging nanoscientists to consider these implications now, before it becomes too late.

Not all questions involve altering the human body — some deal with the world of finance and economics. If molecular manufacturing becomes a reality, how will that impact the world’s economy? Assuming we can build anything we need with the click of a button, what happens to all the manufacturing jobs? If you can create anything using a replicator, what happens to currency? Would we move to a completely electronic economy? Would we even need money?

Whether we’ll actually need to answer all of these questions is a matter of debate. Many experts think that concerns like grey goo and transhumans are at best premature, and probably unnecessary. Even so, nanotechnology will definitely continue to impact us as we learn more about the enormous potential of the nanoscale.

To learn more about nanotechnology and other subjects, follow the links on the next page.

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CDC – Nanotechnology – NIOSH Workplace Safety and Health Topic

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Nanotechnology is the manipulation of matter on a near-atomic scale to produce new structures, materials and devices. The technology promises scientific advancement in many sectors such as medicine, consumer products, energy, materials and manufacturing. Nanotechnology is generally defined as engineered structures, devices, and systems. Nanomaterials are defined as those things that have a length scale between 1 and 100 nanometers. At this size, materials begin to exhibit unique properties that affect physical, chemical, and biological behavior. Researching, developing, and utilizing these properties is at the heart of new technology.

Workers within nanotechnology-related industries have the potential to be exposed to uniquely engineered materials with novel sizes, shapes, and physical and chemical properties. Occupational health risks associated with manufacturing and using nanomaterials are not yet clearly understood. Minimal information is currently available on dominant exposure routes, potential exposure levels, and material toxicity of nanomaterials.

Studies have indicated that low solubility nanoparticles are more toxic than larger particles on a mass for mass basis. There are strong indications that particle surface area and surface chemistry are responsible for observed responses in cell cultures and animals. Studies suggests that some nanoparticles can move from the respiratory system to other organs. Research is continuing to understand how these unique properties may lead to specific health effects.

NIOSH leads the federal government nanotechnology initiative. Research and activities are coordinated through the NIOSH Nanotechnology Research Center (NTRC) established in 2004.

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Introduction to Nanotechnology – About.com Education

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Definition of Nanotechnology:

Nanotechnology is the understanding and control of matter at the realm of 1 to 100 nanometers. (For reference, a piece of paper is about 100,000 nanometers thick.) At the nanoscale, matter functions differently from both the individual atomic and macroscopic scales, so some unique properties are available for use in the field.

Development of Nanotechnology:

Nanotechnology is a natural end-result of scientific development and our ability to understand and manipulate matter at smaller and smaller levels.

Just as computers have gone from bulky, room-filling monstrosities to handheld computers, such reductions in size will continue until we reach fundamental physical limits.

Feynman & Nanotechnology:

On December 29, 1959, the influential American physicist Richard P. Feynman presented a talk to the American Physical Society entitled “There’s Plenty of Room at the Bottom: An Invitation to Enter a New Field of Physics.” Among physicists, this is respectfully called “the classic talk” (it’s the first hit on a Google search of “classic talk”). He asked “Why cannot we write the entire 24 volumes of the Encyclopedia Brittanica on the head of a pin?” and introduced the concept of nanotechnology.

Spread of Nanotechnology:

Though Feynman’s speech inspired many researchers, it wasn’t until the mid-1980s that nanotechnology began to seep into the cultural mainstream conversation. In 1986, the MIT researcher K. Eric Drexler wrote Engines of Creation which laid out extensive prospects of emerging nanotechnology research.

Nanotechnology & Medicine:

One major application of nanotechnology is in the field of medicine, and in fact the knowledge gained from research of natural nanomachines, such as bacteria, has proven essential to the field. In this respect, it has developed some close connections with biophysics. It is theorized that man-made nanomachines could repair damage to the human body that is currently untreatable.

Graphene:

One material which is frequently discussed in nanotechnological research is graphene, an atom-thick form of graphite which was discovered by a University of Manchester team in 2004.

Preparing for a Career in Nanotechnology:

There are few degrees of study specifically in nanotechnology, so look for a good, well-rounded physics program. Nanotechnology works at tiny levels of matter, so knowledge of atomic, molecular, chemical and quantum physics is essential to this field of study. Working knowledge of biochemistry, chemistry, and biophysics, as well as a proficiency with complex mathematics, would also help qualify you for this field.

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What is nanomedicine? – Definition from WhatIs.com

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Nanomedicine is the application of nanotechnology (the engineering of tiny machines) to the prevention and treatment of disease in the human body. This evolving discipline has the potential to dramatically change medical science.

Established and near-future nanomedicine applications include activity monitors, chemotherapy, pacemakers, biochip s, OTC tests, insulin pumps, nebulizers, needleless injectors, hearing aids, medical flow sensors and blood pressure, glucose monitoring and drug delivery systems.

Here are a few examples of how nanomedicine could transform common medical procedures:

The most advanced nanomedicine involves the use of nanorobot s as miniature surgeons. Such machines might repair damaged cells, or get inside cells and replace or assist damaged intracellular structures. At the extreme, nanomachines might replicate themselves, or correct genetic deficiencies by altering or replacing DNA (deoxyribonucleic acid) molecules.

In a 2006 publication on the worldwide status of nanomedicine, MedMarket Diligence reported that about 150 of the largest companies in the world are conducting nanotechnology research projects or planning nanotechnology products. According to Patrick Driscoll, President of MMD, there is a $1 billion market for nanotechnology applications, mostly in the area of MEMS (microelectromechanical systems), a figure that is likely to increase a hundred-fold by 2015.

This was last updated in May 2007

Contributor(s): Robert Freitas

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Nanotechnology Development – Nonotechnology development

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Nanotechnologies has vast new applications for solving major problems and creating opportunities for the human race. If nanotechnology solutions can be commercialised it can transform entire industries and substantially improve the way we live. Commercialisation of nanotechnologies often requires extensive capital investment over an extended period. This is especially so when it comes to nanotech development, the research and development phase tends to be relatively lengthy and length of this phase is hard to predict. Furthermore, because many projects will never be successful, many projects find it difficult to get finance. It is therefore the ability to obtain finance that determines the success or failure of a nanotechnology development venture, especially during the early phase. Obtaining commercial finance can therefore be the determining factor between success and failure of nanotechnology development projects, especially in the early stages. Successful finance often requires a mix of investors and bank finance secured by commercial property or residential property to ensure that interest rates remain affordable. In this respect a good mortgage broker can be essential in ensuring the success of your project.

Nanotechnology (nanotech) is science, engineering, and technology of the manipulation of matter on an atomic, molecular, and supramolecular scale. Nanoscience and nanotechnology are the study and application of extremely small things and can be used across all the other science fields, such as chemistry, biology, physics, materials science, and engineering.

The earliest, widespread description of nanotechnology referred to the particular technological goal of precisely manipulating atoms and molecules for fabrication of macroscale products, also now referred to as molecular nanotechnology. A more generalized description of nanotechnology was subsequently established by the National Nanotechnology Initiative, which defines nanotechnology as the manipulation of matter with at least one dimension sized from 1 to 100 nanometers.

The ideas and concepts behind nanoscience and nanotechnology started with a talk entitled Theres Plenty of Room at the Bottom by physicist Richard Feynman at an American Physical Society meeting at the California Institute of Technology (CalTech) on December 29, 1959, long before the term nanotechnology was used. In his talk, Feynman described a process in which scientists would be able to manipulate and control individual atoms and molecules. Over a decade later, in his explorations of ultraprecision machining, Professor Norio Taniguchi coined the term nanotechnology. It wasnt until 1981, with the development of the scanning tunneling microscope that could see individual atoms, that modern nanotechnology began.

Much of the work being done today that carries the name nanotechnology is not nanotechnology in the original meaning of the word. Nanotechnology, in its traditional sense, means building things from the bottom up, with atomic precision. This theoretical capability was envisioned as early as 1959 by the renowned physicist Richard Feynman. I want to build a billion tiny factories, models of each other, which are manufacturing simultaneously. . . The principles of physics, as far as I can see, do not speak against the possibility of maneuvering things atom by atom. It is not an attempt to violate any laws; it is something, in principle, that can be done; but in practice, it has not been done because we are too big. Richard Feynman, Nobel Prize winner in physics

Scientists currently debate the future implications of nanotechnology. Nanotechnology may be able to create many new materials and devices with a vast range of applications, such as in medicine, electronics, biomaterials energy production, and consumer products.

If you have news about nanotechnology that you would like to publicise or you are interested in nanotechnology finance please contact us.

Please check out our nanotechnology forum.

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Nanotechnology – Flinders University

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A postgraduate program Fast facts

Course type: Postgraduate (coursework) Availability (full-time or part-time): Full-time (N/A for Grad Cert) l Part-time Location: On campus

Course name: Graduate Certificate in Nanotechnology Duration (full-time equivalent): 6 months SATAC code: 2GC075 CRICOS code: Not available to international students

Course name: Graduate Diploma in Nanotechnology Duration (full-time equivalent): 1 year SATAC code: 2GD045 CRICOS code: 057869J

Course name: Master of Nanotechnology Duration (full-time equivalent): 2 years SATAC code: 2CM060 CRICOS code: 057870E

Students will develop the capacity to understand the basic scientific concepts underpinning nanoscience and the properties of materials and biomaterials at the atomic/molecular level and the scaling laws governing these properties. They will understand current frontier developments in nanotechnology, and recognise and develop novel and innovative ideas using a range of laboratory methods, specifically the fabrication and characterisation tools used in nanotechnology such as various microscopies, surface modifications and molecular level construction methods. Communication, problem-based and critical thinking skills that will promote life long learning in their future careers will also be developed during these courses.

The courses articulate and the sequentially developed topics allow progression through the three awards. Candidates who have completed the Graduate Certificate are awarded credit towards the Graduate Diploma. Candidates who have completed the Graduate Diploma are awarded credit towards the Masters.

The Graduate Certificate and Graduate Diploma are for students who require coverage of the fundamental knowledge and skills in the core areas. The Masters award also covers the fundamental knowledge and skills, subsequently extending them through advanced study of selected areas and development of research and problem solving skills. Masters candidates complete a significant research/industry training project, and prepare a professional thesis or report on the project from project conception, design of methods, collection of results and their analysis, through to final conclusions and recommendations for future work. The project also equips students with skills in advanced experimental nanotechnology tools which will further enhance their employment prospects in the industry.

Refer to the course rule:

Graduates of these nanotechnology postgraduate courses will be in great demand in industry, research institutions and government organisations. The cross-disciplinary nature of their degree opens up many possibilities and the collaborations forged in the Masters project only serve to expand the opportunities.

The skills in communication, research, teamwork and computing, along with the capacity for critical thinking and analysis, make graduates of these programs exceptional candidates for positions in forward thinking institutions. Careers in environment, biomedicine, chemistry, and industries such as building, electronics, materials and renewable energy beckon for these graduates and an exciting career at the forefront of a new science awaits.

A coursework Masters is also a pathway to PhD for those who dont have an honours degree and prefer to develop a research career.

Applicants for the Graduate Certificate, Graduate Diploma and Masters in Nanotechnology must normally hold a degree in any relevant discipline of science or engineering or equivalent qualification from an approved tertiary institution. Examples of relevant disciplines include but are not limited to Chemistry, Physics, Materials Engineering, Chemical Engineering or Biotechnology

Students who have completed the four-year undergraduate Nanotechnology course at Flinders cannot be admitted to the Graduate Certificate or Graduate Diploma but may have 36 units of credit towards completion of the Masters program. Students who have completed the Graduate Certificate or Graduate Diploma (or other qualifications deemed equivalent) receive credit when progressing to the Graduate Diploma or Masters.

International students: Entry and English language requirements

Check SATAC.

Place type: Full fee paying

2016: $11,655

Place type: Full fee paying

2016: $24,519

Place type: Full fee paying

2016: $24,519

Note:

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Nanotechnology – Flinders University

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Nanotechnology and Bioengineering – Research Innovation …

§ September 5th, 2015 § Filed under Nano Medicine Comments Off on Nanotechnology and Bioengineering – Research Innovation …

Nanotechnology and bioengineering transform basic science into novel materials, devices and processes for improved sustainability and health. They play a vital role in current and emerging technologies, and contribute to all areas of engineering through materials expertise including developing new materials and improving existing ones.

UQs researchers in this field are internationally renowned with accolades including: three past Australian Research Council (ARC) Federation Fellows; one State of Queensland Premier’s Fellow; one ARC Professorial Fellow; four ARC Future Fellows; four Fellows of the Australian Academy for Technological Science and Engineering (ATSE); one Fellow of the Australian Academy of Science; an ATSE Clunies Ross Award; a Eureka Prize; and a CSIRO Office of the Chief Executive Science Leader. Australian nanomaterials pioneer, Professor Max Lu, has been named a Queensland Great and also received a China International Science and Technology Award.

Nano-bio applications are as diverse as sustainable energy, regenerative medicine, biomedical imaging, drug and vaccine delivery, and personalised medicine. The impact of these new technologies will be felt across a wide range of endeavours, from therapeutic and tissue regeneration products, to bioderived consumer products and environmental applications. Of particular interest at UQ is nanotechnology research at the biological interface, including nanoparticles developed to detect early cancer markers in the blood; smart surfaces mimicking conditions in the body and encouraging high rates of stem cell production; and the engineering of cells to produce the building blocks for plastics.

Our Nano- and Bio- researchers have extensive global links with universities and industry. Collaborative partner highlights include DOW Chemicals, DSM Biologics, DuPont, GS Caltex, Merck and Co, Stanford University, University of California, Berkeley, MIT, University of Oxford, Harvard, Max Planck Institute, and the ETH.

UQ activity is centred at the Australian Institute for Bioengineering and Nanotechnology (AIBN), and the Schools of Chemical Engineering; Chemistry and Molecular Biosciences; Information Technology and Electrical Engineering; and Mechanical and Mining Engineering.

Infrastructure: UQ has substantial infrastructure supporting intensive research activity in nanotechnology including: The Australian Institute for Bioengineering and Nanotechnology supporting three NCRIS facilities in nanofabrication, biologics and metabolomics. Centre for Microscopy and Microanalysis with advanced facilities for electron microscopy The Centre for Advanced Imaging with extensive capabilities in NMR studies for soft materials and biomolecules.

UQ start-up company TenasiTech Pty Ltd is commercialising a polymer nanocomposites platform as applied to large polyurethane and acrylic polymer markets and applications. This technology has a strong focus on fundamental materials science with global benchmarking, biomaterials and nanomaterials toxicology studies, and scalable advanced manufacturing.

Biomedical engineering (BME) is a rapidly growing transdisciplinary field that bridges the gap between technology, medicine and biology. The core aim of UQ BME is to find practical solutions in medical and biomedical sciences using engineering approaches and analyses, for example, developing life support systems, designing devices to aid the impaired or disabled, or creating systems to allow better diagnosis of medical disorders. The BME group at UQ is led by Professor Stuart Crozier, who co-developed the technology now used in two-thirdsof the worlds high field MRI systems sold since 1996.

UQs Centre for Systems and Synthetic Biology develops approaches for handling complex, transient dynamics in developing tissue as well as rational design of complex pathways. These novel approaches are used in the design of bioprocesses as diverse as the production of blood cells for transfusion and the production of industrial biopolymers.

The Nanotechnology&Bioengineering at UQbrochure is available at:

Nanotechnology and Bioengineering

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Nanotechnology and Bioengineering – Research Innovation …

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