Mesh removal using the DaVinci robot and hernia repair with mesh using the DaVinci

[Davinciproblems]

It appears, based on your reply, Intuitive Surgical is again promoting surgeries the robot is not cleared by evidence of surgeons receiving payments for these procedures.

From the fda’s Warning Letter to Intuitive Surgical

In October 2011, Intuitive Surgical, Inc. initiated a separate field correction by sending letters to da Vinci Surgical System clients to notify them that the da Vinci Surgical Systems promoted for thyroidectomy indications is not cleared for that use. You are aware of complaints and MDRs related to thyroidectomies performed with the da Vinci Surgical System. Though the field action was undertaken to reduce a risk to health posed by the device, you failed to report the field action to the FDA as required. Your report of this recall on April 19, 2013 has been classified by FDA as a Class II recall, Z-1426-2013.

[Davinciproblems]

Thank you for the clarification. Since you are using the same instruments cleared for handling tissue only, there must be some type of torque adjustments based on handling a more rigid material.

[drtowfigh]

Intuitive Surgical is a medical device company. They do not offer training courses on mesh removal. Surgeons are using the device for the clinical purposes.

type of instruments depends on type of mesh, area of mesh, etc.

[Davinciproblems]

Thank you for your reply. A couple of added questions:
1) which DaVinci instruments do you use to handle and manipulate the mesh?
2) does Intuitive Surgical have any training courses available on mesh removal?

[drtowfigh]

The robot is an excellent method to remove mesh that can also be removed laparoscopically. Onlay a open mesh placement usually requires open mesh removal techniques

[Davinciproblems]

Thank you for the reply. I see there are special training requirements for mesh removal based on past posts from you, Dr Towfigh, offering this training. I am curious about the specifics of mesh removal (using the DaVinci robot to remove mesh or handle it in general.). Could you please comment on this? Much appreciated!!

[drtowfigh]

No one can operate using the da Vinci robot unless they pass a series of online and hands-on training sessions, pass a test, and then perform a series of proctored operative sessions.

I do teach our residents and fellows on the da Vinci robot and have helped teach courses that use the da Vinci robot.