OR-Live.com Presents: Surgical Tutorial on Complex da Vinci(R) Hysterectomy — Strategies for Managing Endometriosis, Prior Pelvic Surgery and Large Uteri

Webcast With Live Moderation: Thursday, September 18, 2008 From 4:00-5:30 PM ET

ANN ARBOR, MI–(EMWNews – August 20, 2008) – OR-Live.com, the University of Michigan

Health System and Intuitive Surgical, Inc. will present the second in a

series of surgical tutorials on Complex da Vinci (robotic) Hysterectomy on

September 18, 2008 from 4:00-5:30 PM (ET). Dr. Arnold P. Advincula,

Associate Professor of Obstetrics and Gynecology and Director of the Minimally

Invasive Gynecologic Surgery Program and Fellowship at the University

of Michigan Health System, will moderate the event to explain critical

portions of the surgery and to answer e-mail questions from viewers.

One complex case will be highlighted, including advanced endometriosis

with associated adnexal mass, prior pelvic surgery and an enlarged uterus.

Dr. Advincula will elaborate on strategies for surgically managing complex

pathology while leveraging the advantages of the da Vinci® (robotic)

Surgical System. He will perform a total laparoscopic hysterectomy

(TLH) using all four operative arms of the da Vinci® S™ HD System.

The da Vinci® Surgical System is a breakthrough robotic platform designed

to transcend the limitations of both traditional open surgery and

conventional laparoscopy — expanding the surgeon’s ability to perform more

complex gynecologic procedures using a

minimally invasive approach. The da Vinci’s high-definition 3D vision

system, fully wristed EndoWrist® instrumentation, Intuitive® motion and

ergonomic design provide unsurpassed visualization, surgical dexterity and

control. These enhanced capabilities allow gynecologists to perform more complex

hysterectomies with greater reproducibility across their patient

population compared to conventional laparoscopy, while preserving

techniques used in traditional open surgery.

Despite the broad acceptance of laparoscopy, open surgery remains the most

common approach to hysterectomy. This is due in part to the learning curve

associated with conventional laparoscopy and its associated

complications(1) as well as the difficulty in treating advanced pathology

— such as an enlarged uterus, pelvic adhesions or endometriosis — via

laparoscopy.(2)

According to Dr. Advincula, “da Vinci provides a means to overcome both the

challenges presented by advanced pathology and the surgical limitations of

conventional laparoscopy. It does this by providing surgeons with improved

precision and dexterity, coupled with advanced imaging, which allows for

the completion of complex, minimally invasive procedures in a fashion

analogous to open surgery.”

The da Vinci

System enables the GYN surgeon to tackle more complex pathology using a

minimally invasive approach, thereby minimizing the need to perform

hysterectomy via laparotomy (open incision). “I can operate with greater

precision and control, which is especially valuable with more complex

pathology, such as enlarged uterine pathology, pelvic

adhesions or endometriosis,” Advincula said. “With da Vinci, I can

discern the tissue planes more easily and perform more difficult

dissections — which enables me to offer minimally invasive surgery to more

of my patients,” he added.

According to Dr. Advincula, “Robotic

surgery is more intuitive to learn and perform compared to traditional

laparoscopy, which will allow more GYN surgeons to perform minimally

invasive surgery for their patients.” Moreover, he added, “after you’ve

become comfortable with the system, operative times for the da Vinci cases

are comparable to that of open procedures, and based upon recent data(3)

can even be faster than conventional laparoscopy.”

“While more complex cases take longer, I routinely perform a simple, benign

hysterectomy in 60 minutes,” said Advincula. “And with new robotic

instruments being introduced specific to GYN applications, da Vinci

Hysterectomy and Myomectomy [removal of uterine fibroids] procedures are

becoming even easier and quicker to perform.”

For many patients, da Vinci Surgery means significantly less pain and

scarring, less blood loss, reduced risk of infection, shorter hospital

stays, a much quicker recovery and faster return to normal daily activities

compared to conventional open surgery. According to Dr. Advincula, his

patients who received a da Vinci Hysterectomy typically go home the same

day or the following day, and return to their lifestyles within a matter of

weeks.

The University of Michigan Health System is one of the nation’s leading

centers in minimally invasive gynecologic surgery. It offers one of the

only training programs available in robotic-assisted gynecologic surgery.

With ongoing investment in technology and procedure development in

minimally invasive gynecologic surgery, the University of Michigan Health

System is achieving its mission to raise surgical standards-of-care for

women.

About the University of Michigan Health System

The University of Michigan Health System improves the health of patients

and communities through excellence in education, patient care, community

service, research and technology development — and through leadership

activities in Michigan, nationally and internationally. Our mission of

patient care, education and research together enhance our contribution to

society.

About Intuitive Surgical, Inc.

Intuitive Surgical, Inc. (NASDAQ: ISRG), headquartered in Sunnyvale,

California, is the global technology leader in the emerging field of

robotic-assisted, minimally invasive surgery (MIS). Intuitive Surgical

develops, manufactures and markets robotic technologies designed to improve

clinical outcomes and help patients return more quickly to active and

productive lives. The company’s mission is to extend the benefits of

minimally invasive surgery to the broadest possible base of patients. More

information is available at www.IntuitiveSurgical.com and

www.daVinciSurgery.com. Intuitive Surgical – Taking surgical precision

beyond the limits of the human hand™

About the da Vinci® Surgical System

The da Vinci Surgical System is a sophisticated robotic platform designed

to enable complex surgery using a minimally invasive approach. The da Vinci

System consists of an ergonomic surgeon’s console, a patient-side cart with

four interactive robotic arms, a high-performance vision system and

proprietary EndoWrist® instruments. Powered by state-of-the-art robotic

technology, the da Vinci System is designed to scale, filter and seamlessly

translate the surgeon’s hand movements into more precise movements of the

EndoWrist instruments. The net result is an intuitive interface with

breakthrough surgical capabilities. By providing surgeons with superior

visualization, enhanced dexterity, greater precision and ergonomic comfort,

the da Vinci Surgical System makes it possible for more surgeons to perform

minimally invasive procedures involving complex dissection or

reconstruction. This ultimately raises the standard of care for complex

surgeries, translating into numerous potential patient benefits, including

less pain, a shorter recovery and quicker return to normal daily

activities.

The content presented above is for general information only and is not

intended to substitute for formal medical training or certification. An

independent surgeon, who is not an Intuitive Surgical employee, provides

procedure descriptions. Intuitive Surgical trains only on the use of its

products and is not responsible for surgical credentialing or for training

in surgical procedure or technique. As a result, Intuitive is not

responsible for procedural content. While clinical studies support the use

of the da Vinci Surgical System as an effective tool for minimally invasive

surgery, individual results may vary. Intuitive®, da Vinci®, InSite®

and EndoWrist® are registered trademarks of Intuitive Surgical, Inc.

(1) Garry, R. Laparoscopic Surgery. Best Pract Res Clin Obstet Gynaecol.

2006 Feb;20(1):89-104. Epub 2005 Dec 20.

(2) Sokol AI, Chuang K, Milad MP. Risk factors for conversion to laparotomy

during gynecologic laparoscopy. J Am

Assoc Gynecol Laparosc. 2003 Nov;10(4):469-73.

(3) Payne, T., Dauterive, F. Robotically Assisted Hysterectomy: Surgical

Outcomes in a Community Practice, Journal of Minimally Invasive Gynecology,

May 2008. (Ref. No.: JMIG-D-07-00152R3).

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