- Glossary -

General Terms

minimally invasive surgery
Minimally Invasive Surgery (also known as MIS, minimal access, laparoscopic, or endoscopic surgery) allow surgeons to perform complex operations through very small incisions, as contrasted with the large, muscle-dividing incisions associated with conventional "open" surgery. These operations are performed by visualizing the anatomy on a video monitor and using long, specialized instruments. MIS has advanced to the point that results are generally as good or better than traditional open surgical procedures, while eliminating much of the trauma. Making surgery less invasive means decreased interference with normal physiological functions, so patients to get back to their lives in a shorter period of time. 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 directly visualize the anatomy.

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 and male reproductive system.

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Prostate-related Terms

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.

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 may grow 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 protein 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. The PSA is measured by a simple blood test.

prostatic intraepithelial neoplasia (PIN)
PIN. Precancerous growth of prostate gland cells. High-grade PIN in a prostate biopsy should followed up closely as it is a sign that prostate cancer may develop.

prostatitis
Inflammation of the prostate gland.

TRUS (Transrectal Ultrasound)
Imaging study using a rectal ultrasound probe (generates sound waves) to produce images of structures in the pelvis. TRUS is used to look for abnormalities in the rectum and nearby structures, including the prostate. Also called endorectal ultrasound. TRUS is utiliized for several procedures that treat prostate disorders under real-time visualization: prostate biopsy, radioactive seed implantation (brachytherapy), cryotherapy, microwave therapy (TUMT).

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Treatment Terms

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 accurately (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
Surgical removal of the prostate. Radical (total) prostatectomy is the removal of the entire prostate and some of the tissue around it, and often includes sampling of the nearby lymph nodes.

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), or it may come from radioactive material placed in the organ containing cancer (radioactive seed implant, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy.

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Robotics Terms

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
Robotic arms are 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. Importantly, the da Vinci surgical system is not an autonomous robot, as it only moves with real-time guidance from the operating surgeon.

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

motion scaling
A software-based feature of the da Vinci¨ Surgical System that increases surgical precision and fine motor control by: 1) scaling hand movements so that large motions by the surgeon are reduced to micro-movements at the operative site, and 2) eliminating natural hand tremors.

port
A small incision, into which a cannula (hollow, rigid tube) is inserted to act as a conduit for an endoscope or minimally invasive surgical instrument.

video-assisted surgery
Any surgical procedure utilizing a visualization device, such as an endoscope or, in the latest da Vinci system, a high-definition binocular laparoscope.

visual immersion
The surgeon seated comfortably at the console looks down into the video display and see a high-resolution 3-D image of the surgical field, with instruments in the natural line of sight. 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 standard 2-D laparoscopic surgery.

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