A New Robotic Surgical Device

A New Robotic surgical device which may change the nature of surgery was developed over four years in Silicon Valley, USA and trialled in a world-first operation at Tauranga Hospital this week.
The connection between the two organisations is the head of the Bay of Plenty District Health Board Clinical School Associate Professor, Peter Gilling, who has an international reputation for the surgical treatment of benign prostatic hyperplasia (BPH) and works out of Tauranga.

BPH is an enlargement of the prostate gland and Dr Gilling said as many as a quarter of men older than 60 years have this condition.
Working alongside his California-based colleagues Dr Gilling, performed the world-first surgery in Tauranga Hospital this week on two men. The first to be treated was an 84 year old Mount Maunganui man. Dr Gilling said both men were aware that they were making medical history and were excited to be part of the trial,
“They both stayed in hospital overnight and were discharged within 48 hours of admission,” he said.
“The Urology Research Team have undertaken this study in conjunction with the Clinical Trials Unit as part of the Bay of Plenty District Health Board Clinical School,” he said. “BPH is a huge problem, and it is the first disease that this new technology will be attacking.”

Dr Gilling said the technology has been developed as a solution for BPH a condition that increases the size of the prostate, and can cause partial or sometimes virtually complete obstruction of the urethra. This leads to many urinary complications and discomfort. It does not lead to cancer or increase the risk of cancer, and can be controlled with medication. However, when the symptoms become intolerable it needs to be removed via surgery.

Most recently this procedure has been performed using thermal energy involving high powered lasers through the urethra. However PROCEPT BioRobotics, the creators of this new technology, are hoping to change the nature of surgery by using water instead.

Dr Gilling explained that this new technique cuts and cauterises using a waterjet as thin as a strand of hair, and a very low powered blue light laser. This surgical robotic device removes tissue using high pressure water with a precise and consistent fluid velocity rate.
PROCEPT BioRobotics flew their equipment over from America to undertake the operations.
“We have been working on this project for four years,” said Dr Nikolai Aljuri, Founder and CEO. “This live trial is the most important day in the history of our company.”
“The use of water has many benefits,” said Dr Aljuri. “There will be no secondary damage from heat, as there is with laser surgery, so there will be reduced complications and faster recovery time. It will also be very cost effective compared to laser surgery, as laser uses hundreds of watts, whilst waterjet guided laser only uses a few watts.”
“Water has beautiful characteristics and is tissue selective,” said Dr Aljuri, Founder and CEO. “This new technology called Aquablation is a very accurate and effective way of removing tissue, which will not only be better for patients, but for urologists.”

Professor Rodney Perkins of Stanford University, the Chairman and Co-Founder of PROCEPT BioRobotics was very pleased with how the first trial went, “We are pleased to be working with Peter Gilling, who is an outstanding contributor worldwide to urology and a world-class urologist. We appreciate the cooperation we’ve had in New Zealand and appreciate their contribution towards developing new innovations in urology so that they can be brought to the public more rapidly.”

After performing the world-first trial this week, PROCEPT BioRobotics will now do a pilot study on ten additional patients. If this is successful they will then do a larger study, before making the product commercially available.

How it works:
• The doctor takes measurements to determine how much tissue to remove and inputs it in a handheld computer.
• A robotic arm connected to a telescope is inserted into the patient.
• Jets of water carry out the rest of the operation automatically.
• A very low powered laser can be used to stop any bleeding if necessary.

How it works:• The doctor takes measurements to determine how much tissue to remove and inputs it in a handheld computer.
• A robotic arm connected to a telescope is inserted into the patient.
• Jets of water carry out the rest of the operation automatically.
• A very low powered laser can be used to stop any bleeding if necessary.

Harvard University in United States

Harvard is the oldest institution of higher education in the United States, established in 1636 by vote of the Great and General Court of the Massachusetts Bay Colony. It was named after the College’s first benefactor, the young minister John Harvard of Charlestown, who upon his death in 1638 left his library and half his estate to the institution. A statue of John Harvard stands today in front of University Hall in Harvard Yard, and is perhaps the University’s best known landmark.

Harvard University has 12 degree-granting Schools in addition to the Radcliffe Institute for Advanced Study. The University has grown from nine students with a single master to an enrollment of more than 20,000 degree candidates including undergraduate, graduate, and professional students. There are more than
 360,000 living alumni in the U.S. and over 190 other countries.

Harvard is known for global leadership in education, and the Harvard faculty is composed of men and women who are world-class scholars. Faculty members are passionate and curious individuals who continue their own research while teaching at Harvard. They come from across the country and all over the world, bringing with them a diverse wealth of knowledge.

Almost all Harvard College courses are designed, taught and overseen by Harvard faculty, and virtually all FAS faculty are required to teach as part of their duties.  The faculty is highly accessible, and Harvard College class sizes are on average below 40, with over half the courses being offered each semester enrolling 10 or fewer students. This allows for a closer student-professor relationship and contributes to the sense of community on campus. Professors also make themselves available to students outside of the classroom, even beyond office hours, such as meeting in the dining hall or before or after class. The faculty at Harvard make a point of connecting with their students to create a fulfilling academic experience.

Faculties, Schools, and an Institute

Harvard University is made up of 11 principal academic units – ten faculties and the Radcliffe Institute for Advanced Study. The ten faculties oversee schools and divisions that offer courses and award academic degrees.

UNDERGRADUATE COST AND FINANCIAL AID

Families with students on scholarship pay an average of $11,500 annually toward the cost of a Harvard education. More than 60 percent of Harvard College students receive scholarship aid, and the average grant this year is $40,000.  

Since 2007, Harvard’s investment in financial aid has climbed by more than 70 percent, from $96.6 million to $166 million per year.

 During the 2012-2013 academic year, students from families with incomes below $65,000, and with assets typical for that income level, will generally pay nothing toward the cost of attending Harvard College.  Families with incomes between $65,000 and $150,000 will contribute from 0 to 10 percent of income, depending on individual circumstances. Significant financial aid also is available for families above those income ranges.