Number of the day - 150 design enhamcements in da Vinci 5

 Intuitive Surgical’s da Vinci 5 has more than 150 design enhancements and innovations since the surgical robotics developer’s fourth-generation systems, including the force feedback feature that an Intuitive leader described as “groundbreaking.”

“Da Vinci 5 looks similar to [multiport predecessor da Vinci] Xi,” Intuitive President Dave Rosa said in a discussion of the upgrades and enhancements. “It built on Xi’s highly functional design, which has been used around the world in more than 7 million procedures.”

Rosa discussed da Vinci 5’s design along with Intuitive CEO Gary Guthart and Chief Medical Officer Dr. Myriam Curet.

“Da Vinci 5 takes surgical precision to a new level,” Rosa said. “The system is designed with next-generation surgeon controllers and patient-side manipulators with additional sensors. This combination translates to super-smooth, low-resistance and highly precise motion at both slow and high speeds. Unwanted tremor and vibration filtration is the best we’ve ever brought to market.”

The da Vinci 5’s 3D surgical imaging system is the “highest quality and most natural” ever developed by Intuitive, he said, and has additional capability for future generations of surgical endoscopes and vision software.
A photo of the Intuitive Surgical da Vinci 5 surgical robotics system.

Intuitive Surgical’s da Vinci 5 is the device developer’s fifth-generation surgical robotics system. [Image courtesy of Intuitive Surgical]
From a computing power standpoint, da Vinci 5 has 10,000 times more than the fourth-generation Xi system for integration with the My Intuitive app, Intuitive Hub video platform, SimNow virtual reality simulator and Case Insights, which lets surgeons review their surgeries with objective performance indicators and video of critical steps.

The extra computing power could support future features and integration such as better integration of preoperative images as Intuitive brings those into the surgical field, Rosa said.

“It sets us up for our innovation teams internally to make a lot of progress over the coming years,” he said.
Intuitive’s ‘groundbreaking’ Force Feedback tech

Curet described Intuitive’s new Force Feedback technology on the da Vinci 5 as “groundbreaking for robotic surgery.” The system measures subtle forces exerted on tissue during surgery and relays that feeling back to surgeons, a feature that the device developer says is unique to the da Vinci 5 system.

“In preclinical testing, surgeons who used the Force Feedback feedback instruments on da Vinci 5 exerted significantly less force on tissue, which could translate into less tissue trauma during surgery when compared to da Vinci Xi,” she said. “With our customers, we intend to study how this could translate to real-world clinical and patient-reported outcomes as surgeons of all experience levels use this technology in a broad range of procedures.”

“We believe that the ability to measure force during robotic surgery adds an important new data stream to surgical data science,” Curet continued. “Our insights engine will incorporate real-time surgical force measurement along with the surgical data Intuitive currently collects to build analytical insights for surgeons and care teams.”

Da Vinci 5 can record interaction forces during a case when surgeons are using force-sensing instruments. The surgeon can choose to have that haptic feedback in their hands or to turn it off.

Overall, the FDA cleared da Vinci 5 for the same indications as the da Vinci Xi, except for cardiac and pediatric procedures. The Force Feedback needle driver is contraindicated for hysterectomy and myomectomy. While surgeons can still use instruments without Force Feedback, Intuitive is going to pursue the removal of those contraindications, Curet said.

“It’s very clear that there’s significant value in using the Force Feedback needle driver, so we believe that will be used in suturing steps of procedures, but there’s also significant use in retraction and getting that Force Feedback information on the force being applied to tissue.” Curet said. “… Some of that will depend on the surgeon and how much the surgeon wants to get that information during the procedure.”

Intuitive plans prospective and retrospective studies to generate clinical evidence on Force Feedback, with database studies to follow as more surgeons use the feature. Guthart expects a healthy debate among surgeons about Force Feedback, and predicts the feature will be more useful in some procedures than others.

“There will be some surgeons —particularly very experienced surgeons — who say, ‘I can see forces, I can use visual haptics’ … but even when we observe those highly experienced surgeons in lab, when Force Feedback is on versus off there’s a different amount of force that gets transmitted to the tissue,” Guthart said.

“Some of the study here will be exactly this issue of what is the difference in clinical outcome and patient experience when you turn Force Feedback on and off,” he later continued. “It won’t be a matter of opinion — this is the thing that I love — you’ll get a chance to actually see what do you feel and what do you do. That data is the data we’re going to go out and collect over time, and I think it will be fascinating and transformative.”

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