minimally invasive surgery
Minimally Invasive Surgery (also known as MIS, minimal access,
laparoscopic, or endoscopic surgery) is a major advance
in bringing to patients the excellent results of traditional
surgical procedures, while eliminating the most physically
and emotionally traumatic elements: the pain and lengthy
recovery from "open" surgery. Minimally invasive surgery
means having a minimum of interference with the patient's
normal physiological function. Advances in laparoscopic
surgery allow surgeons access to complex patient anatomy
through very small incisions instead of the large incisions
associated with conventional "open" surgery. Patients experience
less pain and shorter recovery times.
open surgery
Cutting the skin and tissues during surgery to expose a
full view of the structures and organs involved in the procedure.
Surgeons work under direct visualization with full incision.
urologic oncologist
A doctor who specializes in treating cancers of the urinary
system.
urology
The branch of medicine that deals with the diagnosis and
treatment of disorders of the urinary tract or urogenital
system.
benign prostatic hyperplasia (BPH)
A benign (noncancerous) condition in which an overgrowth
of prostate tissue pushes against the urethra and the bladder,
blocking the flow of urine. Also called benign prostatic
hypertrophy.
benign prostatic hypertrophy (BPH)
A benign (noncancerous) condition in which an overgrowth
of prostate tissue pushes against the urethra and the bladder,
blocking the flow of urine. Also called benign prostatic
hyperplasia.
gleason score
A system of grading prostate cancer. The Gleason grading
system assigns a grade to each of the two largest areas
of cancer in the tissue samples. Grades range from 1 to
5), with 1 being the least aggressive and 5 the most aggressive.
Grade 3 tumors, for example, seldom have metastases, but
metastases are common with grade 4 or grade 5. The two grades
are then added together to produce a Gleason score. A score
of 2 to 4 is considered low grade; 5 through 7, intermediate
grade; and 8 through 10, high grade. A tumor with a low
Gleason score typically grows slowly enough that it may
not pose a significant threat to the patient in his lifetime.
prostate
A gland in the male reproductive system just below the bladder.
The prostate surrounds part of the urethra, the canal that
empties the bladder, and produces a fluid that forms part
of semen.
prostate-specific antigen (PSA)
A substance produced by the prostate that may be found in
an increased amount in the blood of men who have prostate
cancer, benign prostatic hyperplasia, or infection or inflammation
of the prostate.
prostate-specific antigen test
A blood test that measures the level of prostate-specific
antigen (PSA), a substance produced by the prostate and
some other tissues in the body. Increased levels of PSA
may be a sign of prostate cancer.
prostatic acid phosphatase (PAP)
An enzyme produced by the prostate. It may be found in increased
amounts in men who have prostate cancer.
prostatic intraepithelial neoplasia
(PIN)
PIN. Noncancerous growth of the cells lining the internal
and external surfaces of the prostate gland. It is an important
sign that prostate cancer may develop.
prostatitis
Inflammation of the prostate gland.
TRUS (Transrectal Ultrasound)
A procedure in which a probe that sends out high-energy
sound waves is inserted into the rectum. The sound waves
are bounced off internal tissues or organs and make echoes.
The echoes form a picture of body tissue called a sonogram.
TRUS is used to look for abnormalities in the rectum and
nearby structures, including the prostate. Also called endorectal
ultrasound.
biopsy
The removal of cells or tissues for examination under a
microscope. When only a sample of tissue is removed, the
procedure is called an incisional biopsy or core biopsy.
When an entire lump or suspicious area is removed, the procedure
is called an excisional biopsy. When a sample of tissue
or fluid is removed with a needle, the procedure is called
a needle biopsy or fine-needle aspiration.
brachytherapy
A procedure in which radioactive material sealed in needles,
seeds, wires, or catheters is placed directly into or near
a tumor. Also called internal radiation, implant radiation,
or interstitial radiation therapy.
chemoprevention
The use of drugs, vitamins, or other agents to try
to reduce the risk of, or delay the development or recurrence
of, cancer.
conformal radiation therapy
A radiation therapy that uses computers to create a 3-dimensional
picture of the tumor so that multiple radiation beams can
be shaped exactly (conform) to the contour of the treatment
area.
laparoscopic radical prostatectomy
(LRP)
Minimally invasive removal of the prostate, using the laparoscope
or small surgical camera. Advantages of the laparoscopic
approach include improved visualization of the anatomy,
reduced blood loss, better preserved anatomical structures,
and shorter convalescence.
palliative
Relieving or soothing the symptoms of a disease or disorder
without effecting a cure.
prostatectomy
An operation to remove part or all of the prostate. Radical
(or total) prostatectomy is the removal of the entire prostate
and some of the tissue around it.
radiation
Energy released in the form of particles or electromagnetic
waves. Common sources of radiation include radon gas, cosmic
rays from outer space, and medical x-rays.
radiation therapy
The use of high-energy radiation from x-rays, gamma rays,
neutrons, and other sources to kill cancer cells and shrink
tumors. Radiation may come from a machine outside the body
(external-beam radiation therapy), or it may come from radioactive
material placed in the body near cancer cells (internal
radiation therapy, implant radiation, or brachytherapy).
Systemic radiation therapy uses a radioactive substance,
such as a radiolabeled monoclonal antibody, that circulates
throughout the body. Also called radiotherapy.
medical robotics
Remote activated or user manipulated motion-control, imaging
and communication devices, operated via computer hardware
and software to enable physicians to conduct an increasing
array of surgical procedures in a minimally invasive manner.
degrees of freedom
Robots are typically capable of movement along a number
of axes; these movements can be rotational or translational.
The number of axes of movement (degrees of freedom), their
arrangement and their sequence of operation, permits movement
of the robot to any point within its envelope. Robots have
three arm movements (up-down, in-out, side-to-side). In
addition, they can have as many as three additional wrist
movements on the end of the robot's arm: yaw (side to side),
pitch (up and down), and rotational (clockwise).
EndoWristª technology
Tiny computer-enhanced mechanical wrists near the end of
the instrument tip that provide all the flexibility of the
human wrist and forearm at the operative site, through 1
cm ports.
haptics
Haptics (pronounced HAP-tiks) is the science of applying
touch (tactile) sensation and control to interaction with
computer applications. (The word derives from the Greek
haptein meaning "to fasten.") By using special input/output
devices (such as joysticks or data gloves), users can receive
feedback from computer applications in the form of felt
sensations in the hand or other parts of the body. In combination
with a visual display, haptics technology can be used to
train people for tasks requiring hand-eye coordination,
including surgery.
robot
An automatic device that performs functions normally ascribed
to humans. More technically, a reprogrammable, multifunctional
manipulator designed to move material, parts, tools, or
specialized devices through various programmed motions for
the performance of a variety of tasks. The word 'robot'
was coined by the Czech playwright Karel Capek, from the
Czech word for forced labor or serf.
robotics
A branch of engineering that involves the conception, design,
manufacture, and operation of robots. This field overlaps
with electronics, computer science, artificial intelligence,
mechatronics, nanotechnology, and bioengineering.
robot components
For a machine to qualify as a robot, it usually needs these
5 parts:
> Controller
> Arm
> Drive
> End
Effector
> Sensor
port
A tiny (1 cm) incision, into which a cannula (hollow, rigid
tube) is inserted to act as a conduit for an endoscope or
minimally invasive surgical instruments.
Transformsª technology
Natural operative orientation of the instruments in the
visual image is maintained regardless of camera rotation,
or position within the body, relative to the instruments.
In traditional MIS, as the camera is rotated, surgeons become
disoriented since, for example, what was "right" on the
screen can be "left" with a 180 degree camera rotation.
video-assisted surgery
Any surgical procedure utilizing a visualization device,
such as an endoscope.
visual immersion
The surgeon seated at the console is able to look down into
the video display and see a precise 3-D image of the surgical
field, with hands and instruments in a natural line of sight
ø just as it would appear in open surgery. 3-D visualization
that allows eye-hand instrument alignment and coordination
promotes maximum immersion at the surgical site, eliminating
the spatial disorientation and disconnected hand/eye coordination
inherent in current MIS techniques.
Reprinted with permission, courtesy Intuitive Surgical. Posted: March 22, 2006. Copyright © 2006. All rights reserved. More Info