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DILJEET K. SINGH, M.D.: I think one of the great things about the robotics compared to regular laparoscopy is if you watch, you can almost envision sort of hands making the movements that we're used to. That's one of the things that sort of allows us to do things more quickly, to do things I think more safely, in a way that we can't with regular laparoscopy. 00:03:08 TODD D. TILLMANNS, M.D.: Yeah, that last picture demonstrated very nicely the way that Dr. Lowe manipulates his instruments and as you said Dr. Singh, the devices allow us to have essentially seven degrees of freedom while we're operating, meaning that it's almost as if you're using your own wrists, which is a very nice attribute of this process. You can see the robot arms moving right there as Dr. Lowe controls them with the hand pieces. Essentially what happens is he fits his thumb and his forefinger into these ring-like devices and by opening them he can open the laparoscopic instruments and by closing his fingers he can do that as well. You can see him manipulating right now by just subtle movements of his arms and his hands. Those are transmitted to the robot to control the device. So he is controlling the robot at all times. Now he's opening up some spaces right there which we call the retroperitoneal space. You can see the blood vessel, which is the external iliac, pulsating right there alongside. 00:04:13 DILJEET K. SINGH, M.D.: Don't forget, please feel free to email us if you have any questions while you're watching Dr. Lowe operate, or if we bring up issues that you'd like to have us discuss further. 00:04:22 TODD D. TILLMANNS, M.D.: That last instrument that he was just using are what are called the “hot shears”. That device allows Dr. Lowe to coagulate blood vessels while he's dissecting the tissue. Right now it looks as if he's starting to move the intestines away just a little bit there and we're going to take a look at the ureter, which brings urine from the kidney down into the bladder. That's it right there. 00:04:53 DILJEET K. SINGH, M.D.: I think the thing that sometimes people think of as almost space age about this is having the surgeon not actually be at the patient. But as you guys can see, you're in the same room and there's doctors who are literally operating at the level of the patient. It's just that the surgeon has the capability to have improved visualization, and unfortunately I don't think we can our webcast get the actual view that the surgeon has through the console. You know all the technical description. You've got to tell us that stuff. 00:05:26 TODD D. TILLMANNS, M.D.: Exactly. I think what Dr. Lowe is seeing is essentially in three dimensions and it's in high definition as well. It's very difficult to explain to people. What Dr. Lowe is seeing is different than what all the viewers are seeing right now. As we see things in two dimensions, he actually can see depth to everything he sees. Although the technology does not have the ability at this point for haptic sensation, meaning that you have feedback to your hands, you actually after about 30 or 40 cases develop a sense that you're actually touching the tissue even though you can't feel it. It's very unusual and it's difficult to explain, but that's the best way I think I can explain it. 00:06:05 DILJEET K. SINGH, M.D.: Yeah, for the other surgeons on our webcast today, I do think that that's the most difficult thing, kind of learning to operate without the tactile sensation. But it really is true, the visualization is so excellent, you ability to see small vessels and eventually that sort of

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