GENERAL TERMS
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.
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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.
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-Sspecific 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.
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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 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.
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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
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
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 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—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.
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