Lawsuits Pile Up Against Da Vinci Robot Surgery

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The wonder robot has been legally performing surgeries for 13 years now. Is it everything we thought it would be?

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Background

In the year 2000 the Da Vinci surgical robot was approved by the FDA to perform surgeries on adults and minors. The 1.7 million dollar machine allows surgeons to perform minimally invasive complex surgery. The surgeon controls the robot by manipulating a series of foot pedals and two hand controllers while peering at a 3D image of the surgical site. It is able to turn shaky movements of the doctor into exact instrumental movements. Since its’ introduction, 2500 surgical robots have been installed in hospitals around the world and have performed 1.5 million surgeries.

The problem, as with anything, is not all of the surgeries have gone as planned. One particular incident happened in 2007 when part of the robot’s arm fell off while performing surgery inside a prostate cancer patient. It was bad enough that the urologists needed to make the incision larger in order to remove the part that broke off. This kind of mistake almost always results in a lawsuit which is why doctor’s insurance coverage is so high. The problem is not necessarily the machine.

Patient Complaining of Injuries

It seems to be one of the most common issue patients have are burn related injuries. The Federal Drug Administration’s database, current lawsuits, and attorney’s dealing with the cases all point to a fairly common issue: Heat Related injuries.

“When performing surgery on sensitive organs like the intestines or the ureter, temperature is a important factor.” Says a spokes person for the Orlando personal injury lawyer group. “Patients who are in pain will come to us and inquire about what is involved with a medical malpractice lawsuit. It is not until we pull the medical records that we find the link between the burn and the Da Vinci robot.”

When these injuries do happen, the doctor does not always know it as the field of vision is limited. If the doctor is performing surgery by hand there is never a concern that his hand will over heat. The machines mechanical arms get warmer, the longer the surgery goes on.

Steep Learning Curve

Technically a surgeon can be certified to use Da Vinci over the weekend. Surgeons learning how to use Da Vinci take a multi step course that starts with an hour of online training. Next they view two entire robot procedures that are about four hours long followed by a required 7 hours of practice operating using a pig for practice. The first 2 procedures performed on a human patient must be done with a more experienced Da Vinci surgeon, but after that the doctor can go solo.

Most doctors are not going to just jump into using a expensive machine that they have never used before however hospital have been pushing for doctors to take on more procedures to make money. Rushing any surgery is never a good idea, especially if you are doing it with a 1.7 million dollar robot. It may be a case where, like the scalpel, the surgical robot is only as good as the surgeion who uses it. The past year had a increase in the number of lawsuits related to the robot. So far 10 lawsuits have been filed between 2011 and 2012.

UPDATE: The funding to keep the clinical trials blog was running out until a orlando car accident lawyer swooped in and replenished funding. Our thanks go out to them! If you are interested in using their legal services they have a short Youtube video you can watch to learn more.

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Manufactured Stem Cells Establish A Blood Circulation Intended For Bioengineered Internal Organs

Regenerating our bodies through developing completely new body parts or even fixing up impaired ones with only a few cells scraped from your flesh is really a exciting region of scientific research known as bioengineering. Each and every surviving cell in a organ is normally maintained through the bloodstream, which gives food and oxygen as well as passes through our circulatory system. Effective body organ bioengineering depends on creating this type of approach to blood circulation effective at attaining and aiding the vitality needs of each surviving cell.

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Blood vessels are located everywhere inside us and the walls of them are usually multiple cell layers in size. These walls are made up of endothelials, smooth muscles and a few other cell types that form the needed balance. It’s not exactly easy manufacturing a naturally complex process like this. When humans are tiny embryos, we have a natural pre written program that is responsible for creating multiple kinds of gene specific cells; all from a lone stem cell know as the pluripotent cell. Each pluripotent cell contains a large number of instructions responsible for telling the other cells what to do, where to go, and how to grow. Being able to use the ability of pluripotnet stem cells to help bioengineer organs always tends to bring up certain ethical problems because for years, the only way to obtain these cells was to get them from a human embryo. Our bodies naturally have a stem cell source commonly referred to as adult stem cells. These cells go into action when our body needs to repair itself. The only issue with utilizing adult stem cells for bioengineering is they are already specialized for a particular organ. On top of that it is virtually impossible to obtain a decent size to be able to even use. There are ways around this… One common method is to increase the number of cells by growing them. The issue with this is it is a slow and expensive process that is susceptible to failure. Not to mention messing with cells like this will alter what they are normally suppose to do. So even if you do manage to get them to grow there is a chance they will just keep going and never stop.

Our biggest issue is not getting enough new, pliable stem cells to efficiently get a blood supply to a manufactured organ. One solution is to use a full grown adult cell that is able to grow very well outside of the body, and turn it back into a pluripotent cell. A research team in the United Kingdom and in China have already been developing on this very idea. It’s called a “partially induced pluripotent stem cell,” and can be used as the building block for various different kinds of cells. The best part about it is it does not have the potential of turning into a cancer. The growth is completely controlled.

The Science behind it:

It begins with a kind of cell called a fibroblast. These are cells that give structural support to every organ in the body. The researchers were able to create four parts of specific DNA instructions that bring the cells back to a younger state. When this happened the instructed cells enter a genetically liquid state where the cell could turn into anything. For example it could form fat, nerves, bone, or even blood vessels. These reset cells were monitored with how they grew and survived. None of them displayed any types of growing out of control. Eventually some of the reset cells started to form endothelial cell like structures by becoming hollow. These are the cells that make up the vessels in your blood.

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Is there a possibility that these reset cells could be told to naturally develop into other things? In order to find out, the team administered a molecular liquid to the cells that was created to help them turn into a fully functional endothelial cell. Amazingly these cells formed into hearty blood vessel structures that could take on standard tasks like taking in lipoproteins. The team then slowly added these cells to a manufactured bioengineering set up, they linked up to create natural vessels that were made up of various cells types that were vascular. When the team injected these cells into the injured leg of a mouse, the reset cells attached and integrated with the muscle to improve the flow of blood and recreate the needed circulatory system to restore a O2 supply to the muscle that was damaged.

It is only a matter of time before these cells are approved to human clinical trials. We could use these cells to help keep donated organs alive while they are waiting to be transported.

Baby Born With HIV Cured By US Doctors

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For the first time in medical history, United States doctors have managed to cure a child born with HIV. Doctors working for the Univeristy of Mississippi Medical Center held a press release reporting that the child does not need medication for HIV, will have a normal life expectancy, and will not be infectious to other people.
The Mississippi born two and a half year old infant has tested negative for the virus for over a year without taking any medication. The case was brought to light on March 3rd at the Conference on Retroviruses and Opportunistic Infections in Atlanta, Georgia.
The invention of better drugs and public awareness has cause the number of babies born with HIV to drop significantly. Generally pregnant women who carry HIV are administered anti-retroviral drugs in order to minimize the number of viruses in their blood. After the child is born, it also goes on a course of similar drugs. It is reported that this prevents 98% of the virus transmission from the mom to the newborn.
According to Dr. Hannah Gay, the child’s care giver at the University of Mississippi Medical Center, this case is the first functional cure of a child infected with HIV. Although there is a chance that a small amount of the virus remains, a patient is considered functionally cured when standard testing results are negative for the HIV virus. Not even the most sensitive test are able to detect any traces of the virus one year after medication has been stopped.
Treatment began approximately 30 hours after the baby was born. Generally, HIV positive children are placed on a 3 anti-retroviral drugs that are administered via syringe. The doctor decided to perform a more aggressive treatment due to the mother not receiving any antiretroviral drugs during pregnacny. The mother had not discovered she was HIV positive until she was too close to delivery.
Blood taken from the baby showed it was infected with the virus, most likely before birth. In a positive turn of events a month after starting therapy, the HIV levels had in the blood had dropped low enough that the routine testing was not able to detect it.
Treatment was continued routinely for a year until the month started missing appointments. Eventually they stopped coming and did not show up again for six months. Doctors were expecting the virus levels to be extremely high however, they were shocked to see all of the results coming back as negative.
After examining the findings, Dr. Gay corresponded with Katherine Luzuriga, an exceptional immunologist at Massachusetts Medical School. The child’s blood was sent to the John Hopkins Children’s center where it was retested with more accuratcy. They found slight traces of HIV but no virus capable of reproducing.
Scientist are still unsure of exactly why the treatment was so effective. They suspect the treatment was so effective because of it’s potency and administered quickly after birth. The success has given hope that the doctors may eventually be able to completely remove the virus from all infected newborns.
About 1,200 kids in the United Kingdom and Ireland live with HIV they contracted from the womb, breast milk, or during childbirth. The issue is far more severe in third world countries, over 2.3 million children are infected in Africa.
THE QUICK SCIENCE BEHIND IT:
The drug blocks the HIV virus from replicated in short-living active immune cells. It also blocks the infection from longer living white blood cells (CD4) which the virus can lay dormant in for years. Treatment only works with newborns because the virus has already infected the CD4 cells in adults. Basically it is stopping the virus before it gets a total grip on the immune system.
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